Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity: The “BE-FIT-IBD” study

Abstract

BACKGROUND

The place regular physical activity (PA) should occupy in managing patients with inflammatory bowel diseases (IBD) is unclear.

AIM

To assess PA levels and barriers in a southern Italian IBD population.

METHODS

IBD patients with non-severe disease activity [assessed with partial Mayo score for ulcerative colitis (UC) and Harvey-Bradshaw index for Crohn’s disease] were approached to receive an anonymous online questionnaire to assess PA levels using the International Physical Activity Questionnaire (IPAQ) and to assess disease activity as patient-reported outcomes 2 (PRO-2) and finally to assess habits, beliefs and barriers in conducting regular PA. Clinical, anthropometric and demographic data of patients were also collected. PA was expressed as continuous units of resting metabolic rate (Met) in min/wk. Three PA groups were identified: Inactive (< 700 Met min/wk), sufficiently active (700-2500 Met min/wk) and health enhancing PA (HEPA) (i.e., HEPA active, > 2500 Met min/wk) patients.

RESULTS

Included patients (219) showed overall PA levels of 834.5 Met min/wk, with a large proportion (94, 42.9%) classified as inactive while only a minority (9, 4.1%) as health-enhancing PA. Patients without dyslipidaemia (P < 0.0001) or on biologics therapy (P = 0.022) showed better IPAQ scores in moderate activities. UC PRO-2 correlated negatively with IPAQ intense activities scores (τ = -0.156, P = 0.038). PRO-2 did not show notable sensitivity/specificity in predicting IPAQ inactivity (AUC < 0.6). IBD activity did not differ between active and inactive patients (P > 0.05). Active patients expressed the need to discuss PA with their gastroenterologist. Some barriers (e.g., diagnosis of IBD and fear of flare-ups after PA) are significantly more reported by inactive patients.

CONCLUSION

A significant rate of physical inactivity was recorded in this setting. IPAQ showed good feasibility. PA should be an element of discussion in IBD visits assessed quickly with non-invasive questionnaires.

Keywords: Crohn’s disease; Inflammatory bowel disease; International Physical Activity Questionnaire; Physical activity; Ulcerative colitis

Core Tip: The place regular physical activity (PA) should occupy in managing patients with inflammatory bowel diseases (IBD) is unclear. IBD patients were approached to receive an anonymous questionnaire to assess PA levels using the International Physical Activity Questionnaire (IPAQ), assess disease activity as patient-reported outcomes 2, and assess habits, beliefs and barriers in conducting regular PA. A large proportion of included IBD patients were classified as inactive. Patients on biologics therapy showed better IPAQ scores in moderate activities. Inactive patients report some barriers. PA should be an element of discussion in IBD gastroenterology visits.