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N007. Patient empowerment through increased physical fitness. The Belgian IBD patient support group Mt Ventoux cycling and hiking event

E. Weyts1, P. Geens2, F. Van Dijk3, D. Staes4, F. Wieme4, K. Van Eyken4, J. Van Campfort4, D. De Bast5, Y. Van Craenenbroeck6, H. Peeters7, S. Vermeire1, G. Van Assche1, 1University Hospitals Leuven, Gastroenterology, Belgium, 2Imelda Hospital, Bonheiden, Belgium, 3University Hospital Antwerp, Gastroenterology, Antwerp, Belgium, 4CCV-VZW, Belgium, 5Association Crohn-RCUH asbl, Belgium, 6Fitclass, Belgium, 7University Hospital Gent, Gastroenterology, Gent, Belgium

Background

Physical training programs and improvement of general fitness have become standard components of modern care in several chronic disorders but data in IBD are limited.

We aimed to test the ability of patients with IBD to improve their physical performance and to work towards an athletic challenge in a pilot project managed by a national patient association with expert nursing and medical support.

Methods

A monitored training program with repeated testing was offered to patients with IBD to prepare them for an ascent of Mt Ventoux, 1912 m. Patients and support team members were recruited through the Belgian IBD support groups network. Progress of performance over a period of 10 months was monitored by repeated heart rate based endurance tests. Questionnaires were collected from all participants to assess disease characteristics and to minimize medical risks. Baseline blood results (Hb, Hct, CRP), were recorded when available. One month after completing the project patients were polled with a Likert scale questionnaire about the impact of the challenge on living with their disease. Two Olympic athletes publicly supported the program.

Results

A total of 23 patients (median age 46 (25–74), 16 M/7F) with a diagnosis of CD (14) or UC (9) participated in the project. Baseline fitness levels were highly variable. After the training program, the median change in peak performance expressed as IAND Watts was 15% (−16% to 57%) and 77% increased their performance level. The body weight did not change. In the actual one day challenge in Sep 2012 22 patients attempted to reach the summit. All but one cyclist and 100% of the hikers succeeded and all achieved their personal predefined goal. Symptoms interfering with the ascent included abdominal cramping, urgency and pelvic floor discomfort. In 3 cases these led to intervention by nursing staff or termination of the attempt. Eighty-seven, 75, 63 and 75% of patients felt that the project had positively influenced their performance, self-esteem, quality of life and coping strategies respectively, but only 38% felt a positive impact on fatigue. Worsening of symptoms during the challenge was recorded by 6%.

Conclusion

This pilot project shows that patient empowerment through a monitored training program and an athletic challenge is feasible in IBD and has a positive influence on disease perception and quality of life, but not on fatigue. Long term programs are needed to study the influence of physical training on disease outcomes.