Improving Exercise Compliance in Patients with Inflammatory Bowel Disease

Abstract

Background: Regular physical activity offers numerous health benefits to an individual. Worryingly the level of physical activity participation worldwide is at an all-time low and patients with Inflammatory Bowel Disease (IBD) are participating in even less physical activity than the general population. Objectives: The objectives of this study are to investigate what the current levels of physical activity, preferences around exercise, and barriers to physical activity patients with IBD face in Dunedin, New Zealand, if a multidimensional approach to a personalised exercise programme will result in high compliance to physical activity, and finally, what changes to the well-being will occur following a personalised exercise programme. Methods: Potential participants for the study were identified using the Episoft® database of patients with IBD in Dunedin and surrounding areas. Each participant received a personalised exercise programme for the four-month intervention and was offered the choice of joining one of two groups during the study: either exercising unsupervised for four months (independent group) or with an initial month of optional supervised sessions then three further months unsupervised (support group). Participants were asked to complete a number of questionnaires at baseline and at the conclusion of the exercise programme including exercise preferences & attitudes, International Physical Activity Questionnaire, Hospital Anxiety & Depression Scale, Multidimensional Fatigue Inventory, Inflammatory Bowel Disease Fatigue Scale, the Inflammatory Bowel Disease Quality of life Questionnaire, and Disease activity indices (Harvey Bradshaw Index or Simple Clinical Colitis Activity Index). Results: Eighty-two patients consented to participate in the study with seventeen choosing the support group and sixty-five choosing the independent group. Eleven participants withdrew and a further thirteen were lost to follow up during the study. Overall compliance to the study was 55.8% using intention-to-treat analysis and 83.3% when using perprotocol analysis. Physical activity increased significantly following the intervention, p<0.05. Fatigue, disease activity, depression, and anxiety levels decreased significantly and quality of life increased significantly following the exercise programme, p<0.05. There was no significant difference between the two groups in terms of improvement in well-being or physical activity following the exercise intervention. Conclusion: Increasing physical activity offers a clear benefit to the well-being of patients with IBD, and the pragmatic multidimensional approach offered in this study resulted in high compliance levels to the exercise programme.