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P500 Assessing physical activity, fatigue and quality of life in an outpatient cohort of IBD patients

Janssen , L.M.(1,2);Hendrix, E.M.B.(1,2);Spooren , C.E.G.M.(1,2);Stassen , L.P.S.(2,3);Pierik , M.J.(1,2);Jonkers , D.M.A.E.(1,2);

(1)Department of Internal Medicine Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, The Netherlands;(2)School for Nutrition and Translational Research in Metabolism NUTRIM, Maastricht University, Maastricht, The Netherlands;(3)Department of Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands

Background

Inflammatory bowel disease (IBD) has a substantial impact on quality of life (QoL). This can further be affected by modifiable psychosocial and lifestyle factors, like physical activity (PA). In the current study, we aimed to determine whether PA activity levels were associated with patient and disease characteristics, fatigue and QoL in IBD patients.

Methods

In this cross-sectional study, consecutive adult IBD outpatients were included. PA was assessed by the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH). Patients were considered to have adequate PA levels when exercising with moderate intensity during minimal 30 minutes for at least five days per week according to the Dutch Standards for Healthy Physical Activity. Body composition was assessed by body mass index (BMI) and fat-free mass using BodPod. Fatigue was measured with the Shortened Fatigue Questionnaire (SFQ) and QoL was determined using the SF-36. Patient and disease characteristics, fatigue, and QoL between patients with and without adequate PA levels were analyzed by a student’s t-test or X2-test when appropriate.

Results

Of the 200 patients (139 Crohn’s disease (CD), 61 ulcerative colitis (UC)), 53.3% were female, and 21.5% were active smoker. Mean disease duration was 11.4 [SD 9.9] years, and 28.6% had an exacerbation at inclusion. The Dutch Standards for Healthy Physical Activity were not met by 41.7%. CD patients (53.2%) were less likely to have adequate PA levels compared to UC (70.0%) patients (p=0.028). There were no other significant differences in patient and disease characteristics stratified by adequate PA level (i.e. sex, active smoking, age at inclusion, disease duration, Montreal classification, previous bowel resection, and disease activity). BMI and fat-free mass index were not associated with PA levels. However, patients not meeting PA standards were significantly more tired compared to patients meeting the standards (mean 17.4 [SD 7.0] vs. 13.5 [SD 7.2], p=0.015), and had lower physical and mental component scores (PCS: mean 43.5 [SD 9.7] vs. 46.0 [SD 8.5]; MCS: mean 46.2 [SD 11.3] vs. 52.3 [SD 9.5]) for QoL, reaching significance for SF-36 MCS (p=0.012).

Conclusion

IBD outpatients with low physical activity levels showed significantly higher fatigue and lower quality of life scores, regardless of disease characteristics. More research is necessary to identify contributing factors to further improve patients’ well-being by holistic management.

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