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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Scoping review on health-related physical fitness in patients with inflammatory bowel disease: Assessment, interventions, and future directions
Karlijn Demers, Michiel T J Bak, Bart C Bongers, Annemarie C de Vries, Daisy M A E Jonkers, Marieke J Pierik, Laurents P S Stassen
Karlijn Demers, Laurents P S Stassen, Department of Surgery, Maastricht University Medical Center+, Maastricht 6229 HX, Netherlands
Karlijn Demers, Marieke J Pierik, Department of Internal Medicine, Division of Gastroenterology-Hepatology, Maastricht University Medical Center+, Maastricht 6229 HX, Netherlands
Karlijn Demers, Daisy M A E Jonkers, Marieke J Pierik, Department of Internal Medicine, Division of Gastroenterology-Hepatology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht 6229 ER, Netherlands
Karlijn Demers, Bart C Bongers, Laurents P S Stassen, Department of Surgery, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht 6229 ER, Netherlands
Michiel T J Bak, Annemarie C de Vries, Department of Gastroenterology and Hepatology, Erasmus University Medical Center Rotterdam, Rotterdam 3015 GD, Netherlands
Bart C Bongers, Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht 6229 ER, Netherlands
Author contributions: Demers K, Bak MTJ, Bongers BC, Jonkers DMAE, de Vries AC, Pierik MJ, and Stassen LPS contributed to the conception and design of this review; Demers K performed the literature search; Demers K and Bak MTJ performed study selection and data acquisition; Demers K drafted the manuscript; Bak MTJ, Bongers BC, Jonkers DMAE, de Vries AC, Pierik MJ, and Stassen LPS critically revised the manuscript for important intellectual content; All authors revised the manuscript and approved the final version.
Conflict-of-interest statement: Karlijn Demers, Michiel TJ Bak, and Bart C Bongers declare no conflicts of interest. Daisy MAE Jonkers reports grant from the public-private partnership grants of Dutch Top Institute of Food and Nutrition (TIFN), Top Knowledge Institute (TKI) Agri&Food and Health Holland, by the Carbokinetics program as part of the NWO-CCC Partnership Program, by Organic A2BV/Mothersfinest BV and, EU/FP7 SysmedIBD/305564, BIOM/305479 and Character/305676, H2020 DISCOvERIE/848228, all outside the submitted work. Annemarie C de Vries has served on advisory boards for Takeda, Janssen, Bristol Myers Squibb, Abbvie, Pfizer, and Galapagos and has received unrestricted research grants from Takeda, Janssen, and Pfizer outside the submitted work. Marieke J Pierik reports grants and non-financial support from Falk Pharma, grants from European commission, grants from ZONMW (Dutch national research fund), grants and non-financial support from Takeda, grants and non-financial support from Johnson and Johnson, grants and non-financial support from Abbvie, non-financial support from Ferring, non-financial support from Immunodiagnostics, non-financial support from MSD, all outside the submitted work. Laurents PS Stassen has served as a speaker and received research support from Takeda, outside the submitted work.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Karlijn Demers, MD, MSc, Department of Surgery, Maastricht University Medical Center+, Maastricht 6229 HX, Netherlands.
k.demers@maastrichtuniversity.nl
Received: July 28, 2023
Peer-review started: July 28, 2023
First decision: August 25, 2023
Revised: September 6, 2023
Accepted: September 12, 2023
Article in press: September 12, 2023
Published online: October 14, 2023
Processing time: 75 Days and 22.1 Hours
ARTICLE HIGHLIGHTS
Research background
Reaching the Selecting Therapeutic Targets in Inflammatory Bowel Disease-II (STRIDE-II) therapeutic targets for inflammatory bowel disease (IBD) requires an interdisciplinary approach. Lifestyle interventions to enhance and maintain health-related physical fitness (HRPF) could potentially aid in improving subjective health, decreasing disability, or even controlling inflammation. However, ambiguity remains about the status and impact of HRPF (encompassing body composition, cardiorespiratory fitness, muscular strength, muscular endurance, and flexibility) in IBD patients, hindering the development of physical activity and physical exercise training guidelines.
Research motivation
Accurate evaluation of HRPF components is imperative for a deeper understanding of the state of HRPF in IBD patients as well as to clearly define endpoints in intervention studies to determine whether physical activity or physical exercise training can improve HRPF components in patients with IBD. Hence, accurate assessment of the HRPF concept is the initial step toward investigating and implementing targeted physical activity or physical exercise training interventions, aiming to improve clinical outcomes and patient-reported outcomes in IBD.
Research objectives
The primary objective of this scoping review was to provide an overview of studies on the assessment of HRPF components in patients with IBD. The second objective was to review the effects of physical activity and physical exercise training interventions on HRPF in patients with IBD.
Research methods
A systematic search was conducted in multiple databases for original studies that included patients with IBD, assessed one or more HRPF components, and/or evaluated physical activity or physical exercise training interventions.
Research results
Sixty-eight articles were included. No study examined the complete concept of HRPF, and considerable heterogeneity existed in assessment methods, with frequent use of non-validated tests. According to studies that used gold standard tests, cardiorespiratory fitness seemed to be reduced, but findings on muscular strength and endurance were inconsistent. A limited number of studies that evaluated physical activity or physical exercise training interventions reported effects on HRPF, overall showing a positive impact.
Research conclusions
The findings of this scoping review indicated a shortcoming in the present literature regarding the accurate assessment of the HRPF concept, as most studies considered only one or two HRPF components, and no single study assessed flexibility. Important methodological limitations of studies that evaluated physical activity or physical exercise training interventions were identified.
Research perspectives
More well-designed large-scale studies are warranted to assess the status of the various components of HRPF in patients with IBD using validated assessment methods and to subsequently investigate their association with patient-specific and disease-specific factors as well as clinical and patient-reported outcomes. Furthermore, more research on the effect of physical activity or physical exercise training interventions on disease outcomes is required to determine the optimal training paradigm before (inter)national guidelines regarding physical activity and physical exercise training can be integrated in the holistic therapeutic care for patients with IBD.
