P867 Abdominally targeted yoga-based physical exercises as a therapeutic intervention for Inflammatory Bowel Diseases

Abstract

Abstract Background Physical activity (PA) has positive effects on general well-being and stress. The effect of abdominally targeted PA on IBD disease measures and patient’s quality of life (QoL) is currently unknown. We aimed to examine the effect of routine, abdominally targeted, physical exercise sets, designed exclusively for IBD patients, on patients’ QoL and clinical response. Methods This randomized (1:1), controlled, double-blinded study assessed the effect of a set of 10-minute videos of specific abdominally targeted physical exercises inspired by Yoga, postulated to increase blood flow to the abdomen, on patients' disease activity and QoL, compared to a control general exercise videos. All patients signed an informed consent form. Patients performed either abdominally targeted (intervention) or control exercises, sequenced and performed by a trained and experienced yoga instructor, through an online application, at least 5 times/week. Disease activity (HBI/ SCCAI), inflammatory indices (CRP, fecal calprotectin), and QoL measures (PROMIS questionnaire), were compared before and after 30-days of the intervention. For collective analysis of patients, a combined clinical score scale was used (Table 1). Change in calprotectin was calculated as the initial minus the end value. Results Twenty-six mild-moderate patients with IBD (age 39.3±10 years) were randomized to perform either intervention (8 CD, 7 UC), or control (7 CD, 4 UC) sets of exercise. Upon completion, most IBD patients training with either the interventional or control videos, exhibited significant improvements in their clinical scores. Among the patients in the interventional arm, the clinical score decreased from 1.1±0.4 to 0.4±0.6 (p<0.001), and in the control group from 1.4±0.5 to 0.9±0.7 (p<0.01). Interestingly, calprotectin significantly decreased only in the interventional group, in comparison to the control (Delta calprotectin: 40.8±122 vs. -431±652μg/g, respectively, p≤0.01). No improvements were observed in CRP. QoL measures improved in the intervention group in pain (13.6±14%, p<0.005), anxiety (14.3±24%, p<0.05), fatigue (18.8±19%, p<0.05) and in social activities (7.1±9%, p<0.05). In contrast, in the controls, only anxiety score improved (8.3±9%, p<0.05). No differences were observed in scores of sleep disturbances, depression, and physical function in either group. Conclusion Routine PA can significantly improve IBD clinical scores and symptoms. Abdominally targeted exercises are associated with an additional improvement in clinical scores, fecal calprotectin and in self-perceived level of interference in pain and routine daily functions. These results suggest a positive effect of physical exercise in IBD and prompt further study.