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P166. The physical fitness of IBD patients is impaired

L. Vogelaar1, E. Kuipers2, R. van den Berg-Emons3, H. Bussmann3, C.J. van der Woude1

1Erasmus Medical Center, Department of Gastroenterology & Hepatology, Rotterdam, Netherlands; 2Erasmus Medical Center, Rotterdam, Netherlands; 3Erasmus Medical Center, Department of Rehabilitation, Rotterdam, Netherlands

Background: Inflammatory bowel disease (IBD) impacts the overall quality of life negatively in a large subset of patients. Subsequently IBD patients suffer from disabling fatigue. The first aim of this pilot study was to investigate the physical fitness and physical activity in IBD patients. Secondly we investigated whether physical fitness and physical activity were related to fatigue.

Methods: In this pilot study, after informed consent, 10 fatigued (F) and 10 non-fatigued (NF) IBD patients with quiescent disease were included. Fatigued and NF patients were matched for age and sex. Fatigue was measured by the Checklist Individual Strength. Demographics and disease characteristics were assessed. To determine physical fitness, peak oxycon uptake during cycle ergometry (aerobic capacity; VO2peak (L/min‑1)), 6‑minute walk distance (in meters), isokinetic muscle strength of the leg flexors and leg extensors (in Newton meter (Nm)). Level of daily physical activity was measured with an accelerometry-based Activity Monitor.

Results: Mean age was 37 yrs (SD 11), males 50%. There were no significant differences in demographics and disease characteristics, smoking, BMI and fat free mass between the groups. Overall, aerobic capacity of the pts was significantly lower in the total group compared to normative values of healthy controls (median VO2peak: 1.9 L/min vs 2.2 L/min, respectively; p = 0.04). Other significant differences of IBD pts compared to the healthy population included: the isokinetic muscle strength (median: 53 Nm flexors/113 Nm extensors vs median: 78 Nm flexors/158 Nm extensors, respectively; p < 0.05) and 6‑minute walk distance (568 meter versus 690 meter, respectively; p = 0.001). Physical activity was similar.

Fatigue pts showed an aerobic capacity of 85% of the normative values compared to 107% in NF pts (p = 0.05). In the F pts strength of the flexors was 67% of the normative values compared to 89% in NF pts (p = 0.027). Strength of the extensors was 64% of the norm in F pts compared to 81% in NF pts (p = 0.018). In F pts the 6‑minute walk distance was 78% of the normative values compared to 85% in NF pts (p = 0.049). No differences were found in daily physical activity between F pts and NF pts.

Conclusions: Physical fitness in IBD patients is impaired compared to healthy controls and particularly in fatigued patients whereas their activity level is normal. This suggests that fatigued patients might benefit from individualized fitness programs in order to lower the fatigue burden.