Intest Res.  2022 Jan;20(1):43-52. 10.5217/ir.2020.00049.

An integrative review of physical activity in adults with inflammatory bowel disease

Affiliations
  • 1School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
  • 2School of Nursing, University of North Carolina at Charlotte, Charlotte, NC, USA
  • 3Department of Nursing Science, College of Nursing, East Carolina University, NC, USA
  • 4University of Virginia School of Nursing, Charlottesville, VA, USA

Abstract

Adults with inflammatory bowel disease (IBD) search for self-management strategies to manage their symptoms and improve their quality of life (QOL). Physical activity (PA) is one of the self-management strategies widely adopted by adults with IBD. This integrative review aimed to synthesize the evidence on health outcomes of PA in adults with IBD as well as to identify the barriers to engaging in PA. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), published literature was searched to identify the articles that addressed PA in adults with IBD. Twenty-eight articles met the inclusion criteria. Many of the reviewed studies used the terms of PA and exercise interchangeably. Walking was the most common PA reported in the studies. The findings from the majority of the reviewed studies supported the benefits of moderate-intensity exercise/PA among adults with IBD. The reviewed studies noted the following positive health outcomes of PA: improvement in QOL, mental health, sleep quality, gastrointestinal symptoms, fatigue and cardiorespiratory fitness. More importantly, participation in PA reduced the risk for development of IBD and the risk for future active disease. The findings from the reviewed studies highlighted the following barriers to engage in PA: fatigue, joint pain, abdominal pain, bowel urgency, active disease and depression.

Keyword

Inflammatory bowel disease; Integrative review; Exercise; Health outcomes; Barriers

Figure

  • Fig. 1. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram.


Reference

1. Bamias G, Pizarro TT, Cominelli F. Pathway-based approaches to the treatment of inflammatory bowel disease. Transl Res. 2016; 167:104–115.
Article
2. Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2018; 390:2769–2778.
Article
3. Stein DJ, Shaker R. Inflammatory bowel disease: a point of care clinical guide. London: Springer International;2015.
4. Kappelman MD, Long MD, Martin C, et al. Evaluation of the patient-reported outcomes measurement information system in a large cohort of patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2014; 12:1315–1323.
Article
5. Knowles SR, Graff LA, Wilding H, Hewitt C, Keefer L, Mikocka-Walus A. Quality of life in inflammatory bowel disease: a systematic review and meta-analyses. Part I. Inflamm Bowel Dis. 2018; 24:742–751.
Article
6. Tabibian A, Tabibian JH, Beckman LJ, Raffals LL, Papadakis KA, Kane SV. Predictors of health-related quality of life and adherence in Crohn’s disease and ulcerative colitis: implications for clinical management. Dig Dis Sci. 2015; 60:1366–1374.
Article
7. Eckert KG, Abbasi-Neureither I, Köppel M, Huber G. Structured physical activity interventions as a complementary therapy for patients with inflammatory bowel disease: a scoping review and practical implications. BMC Gastroenterol. 2019; 19:115.
8. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985; 100:126–131.
9. Saxena A, Fletcher E, Larsen B, Baliga MS, Durstine JL, Fayad R. Effect of exercise on chemically-induced colitis in adiponectin deficient mice. J Inflamm (Lond). 2012; 9:30.
Article
10. Bilski J, Mazur-Bialy AI, Brzozowski B, et al. Moderate exercise training attenuates the severity of experimental rodent colitis: the importance of crosstalk between adipose tissue and skeletal muscles. Mediators Inflamm. 2015; 2015:605071.
Article
11. Engels M, Cross RK, Long MD. Exercise in patients with inflammatory bowel diseases: current perspectives. Clin Exp Gastroenterol. 2017; 11:1–11.
Article
12. Pedersen BK, Saltin B. Exercise as medicine: evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports. 2015; 25 Suppl 3:1–72.
13. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6:e1000097.
Article
14. Artom M, Czuber-Dochan W, Sturt J, Murrells T, Norton C. The contribution of clinical and psychosocial factors to fatigue in 182 patients with inflammatory bowel disease: a cross-sectional study. Aliment Pharmacol Ther. 2017; 45:403–416.
Article
15. Aluzaite K, Al-Mandhari R, Osborne H, et al. Detailed multi-dimensional assessment of fatigue in inflammatory bowel disease. Inflamm Intest Dis. 2019; 3:192–201.
Article
16. Chae J, Yang HI, Kim B, Park SJ, Jeon JY. Inflammatory bowel disease patients’ participation, attitude and preferences toward exercise. Int J Sports Med. 2016; 37:665–670.
Article
17. Chan D, Robbins H, Rogers S, Clark S, Poullis A. Inflammatory bowel disease and exercise: results of a Crohn’s and Colitis UK survey. Frontline Gastroenterol. 2014; 5:44–48.
Article
18. DeFilippis EM, Tabani S, Warren RU, Christos PJ, Bosworth BP, Scherl EJ. Exercise and self-reported limitations in patients with inflammatory bowel disease. Dig Dis Sci. 2016; 61:215–220.
Article
19. Gatt K, Schembri J, Katsanos KH, et al. Inflammatory bowel disease [IBD] and physical activity: a study on the impact of diagnosis on the level of exercise amongst patients with IBD. J Crohns Colitis. 2019; 13:686–692.
Article
20. Hlavaty T, Toth J, Koller T, et al. Smoking, breastfeeding, physical inactivity, contact with animals, and size of the family influence the risk of inflammatory bowel disease: a Slovak case-control study. United European Gastroenterol J. 2013; 1:109–119.
Article
21. Holik D, Včev A, Milostić-Srb A, et al. The effect of daily physical activity on the activity of inflammatory bowel diseases in therapy-free patients. Acta Clin Croat. 2019; 58:202–212.
Article
22. Jones PD, Kappelman MD, Martin CF, Chen W, Sandler RS, Long MD. Exercise decreases risk of future active disease in patients with inflammatory bowel disease in remission. Inflamm Bowel Dis. 2015; 21:1063–1071.
Article
23. Khalili H, Ananthakrishnan AN, Konijeti GG, et al. Physical activity and risk of inflammatory bowel disease: prospective study from the Nurses’ Health Study cohorts. BMJ. 2013; 347–f6633.
Article
24. Mack DE, Wilson PM, Gilmore JC, Gunnell KE. Leisure-time physical activity in Canadians living with Crohn disease and ulcerative colitis: population-based estimates. Gastroenterol Nurs. 2011; 34:288–294.
Article
25. Ng SC, Tang W, Leong RW, et al. Environmental risk factors in inflammatory bowel disease: a population-based case-control study in Asia-Pacific. Gut. 2015; 64:1063–1071.
Article
26. de Souza Tajiri GJ, de Castro CL, Zaltman C. Progressive resistance training improves muscle strength in women with inflammatory bowel disease and quadriceps weakness. J Crohns Colitis. 2014; 8:1749–1750.
Article
27. Taylor K, Scruggs PW, Balemba OB, Wiest MM, Vella CA. Associations between physical activity, resilience, and quality of life in people with inflammatory bowel disease. Eur J Appl Physiol. 2018; 118:829–836.
Article
28. Tew GA, Jones K, Mikocka-Walus A. Physical activity habits, limitations, and predictors in people with inflammatory bowel disease: a large cross-sectional online survey. Inflamm Bowel Dis. 2016; 22:2933–2942.
Article
29. Nathan I, Norton C, Czuber-Dochan W, Forbes A. Exercise in individuals with inflammatory bowel disease. Gastroenterol Nurs. 2013; 36:437–442.
Article
30. Crumbock SC, Loeb SJ, Fick DM. Physical activity, stress, disease activity, and quality of life in adults with Crohn disease. Gastroenterol Nurs. 2009; 32:188–195.
Article
31. Ng V, Millard W, Lebrun C, Howard J. Low-intensity exercise improves quality of life in patients with Crohn’s disease. Clin J Sport Med. 2007; 17:384–388.
Article
32. Cronin O, Barton W, Moran C, et al. Moderate-intensity aerobic and resistance exercise is safe and favorably influences body composition in patients with quiescent Inflammatory Bowel Disease: a randomized controlled cross-over trial. BMC Gastroenterol. 2019; 19:29.
Article
33. Klare P, Nigg J, Nold J, et al. The impact of a ten-week physical exercise program on health-related quality of life in patients with inflammatory bowel disease: a prospective randomized controlled trial. Digestion. 2015; 91:239–247.
Article
34. Lykouras D, Karkoulias K, Triantos C. Physical exercise in patients with inflammatory bowel disease. J Crohns Colitis. 2017; 11:1024.
Article
35. Zaltman C, Braulio VB, Outeiral R, Nunes T, de Castro CL. Lower extremity mobility limitation and impaired muscle function in women with ulcerative colitis. J Crohns Colitis. 2014; 8:529–535.
Article
36. Tew GA, Leighton D, Carpenter R, et al. High-intensity interval training and moderate-intensity continuous training in adults with Crohn’s disease: a pilot randomised controlled trial. BMC Gastroenterol. 2019; 19:19.
Article
37. Cabalzar AL, Azevedo FM, Lucca FA, Reboredo MM, Malaguti C, Chebli JMF. Physical activity in daily life, exercise capacity and quality of life in patients with Crohn’s disease on infliximab-induced remission: a preliminary study. Arq Gastroenterol. 2019; 56:351–356.
Article
38. van Langenberg DR, Papandony MC, Gibson PR. Sleep and physical activity measured by accelerometry in Crohn’s disease. Aliment Pharmacol Ther. 2015; 41:991–1004.
Article
39. Wiestler M, Kockelmann F, Kück M, et al. Quality of life is associated with wearable-based physical activity in patients with inflammatory bowel disease: a prospective, observational study. Clin Transl Gastroenterol. 2019; 10:e00094.
Article
40. McNelly AS, Nathan I, Monti M, et al. The effect of increasing physical activity and/or omega-3 supplementation on fatigue in inflammatory bowel. Gastroenterol Nurs. 2016; 14:39–50.
Article
41. van Langenberg DR, Gibson PR. Factors associated with physical and cognitive fatigue in patients with Crohn’s disease: a cross-sectional and longitudinal study. Inflamm Bowel Dis. 2014; 20:115–125.
Article
42. Reboredo MM, Pinheiro BV, Chebli JMF. Physical exercise programmes in patients with inflammatory bowel disease. J Crohns Colitis. 2017; 11:1286.
Article
43. Shephard RJ. The case for increased physical activity in chronic inflammatory bowel disease: a brief review. Int J Sports Med. 2016; 37:505–515.
Article
44. Otto JM, O’Doherty AF, Hennis PJ, et al. Preoperative exercise capacity in adult inflammatory bowel disease sufferers, determined by cardiopulmonary exercise testing. Int J Colorectal Dis. 2012; 27:1485–1491.
Article
45. Johannesson E, Simrén M, Strid H, Bajor A, Sadik R. Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol. 2011; 106:915–922.
Article
46. Stollman N, Smalley W, Hirano I; AGA Institute Clinical Guidelines Committee. American Gastroenterological Association Institute Guideline on the management of acute diverticulitis. Gastroenterology. 2015; 149:1944–1949.
Article
47. Williams PT. Incident diverticular disease is inversely related to vigorous physical activity. Med Sci Sports Exerc. 2009; 41:1042–1047.
Article
48. Iovino P, Chiarioni G, Bilancio G, et al. New onset of constipation during long-term physical inactivity: a proof-of-concept study on the immobility-induced bowel changes. PLoS One. 2013; 8:e72608.
Article
49. Sellar CM, Courneya KS. Physical activity and gastrointestinal cancer survivorship. Recent Results Cancer Res. 2011; 186:237–253.
Article
50. Cook MD, Martin SA, Williams C, et al. Forced treadmill exercise training exacerbates inflammation and causes mortality while voluntary wheel training is protective in a mouse model of colitis. Brain Behav Immun. 2013; 33:46–56.
Article
51. Beck A, Bager P, Jensen PE, Dahlerup JF. How fatigue is experienced and handled by female outpatients with inflammatory bowel disease. Gastroenterol Res Pract. 2013; 2013:153818.
Article
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