P0977 Health-Related Physical Fitness and Its Association with Disease- and Treatment-related Characteristics in Patients with Inflammatory Bowel Disease Versus Healthy Controls
Authors: Demers K , van den Bergh N , Bongers B C , van Kuijk S M J , Mujagic Z , Jonkers D M A E , Pierik M J , Stassen L P S 
Published: January 2025

Abstract

Background
Inflammatory Bowel Disease (IBD) may negatively impact health-related physical fitness components (body composition, cardiorespiratory fitness, muscular strength, muscular endurance, and flexibility) due to sedentary behavior and disease-specific effects. Limited data on health-related physical fitness in IBD hinders the development of targeted physical exercise training interventions to improve disease outcomes and well-being. This study aimed to compare health-related physical fitness between IBD patients and age- and sex-matched healthy controls and to assess associations with disease- and treatment-related characteristics in IBD.

Methods
This cross-sectional study included 105 IBD patients (in remission or mild-to-moderate clinical disease activity) and 102 age- and sex-matched healthy controls (Table 1). Participants performed validated tests for health-related physical fitness, including four-site skinfold thickness for body fat percentage, the steep ramp test for cardiorespiratory fitness and muscular strength, the 60-second sit-to-stand test and hand-held dynamometry for muscular strength, isokinetic dynamometry for muscular endurance, and the sit-and-reach test for flexibility.1 Fatigue (Checklist Individual Strength) and self-reported physical activity (International Physical Activity Questionnaire Short Form) were also assessed. Clinical data were collected, including body mass index, comorbidities, disease duration, disease activity, extra-intestinal manifestations, medication use, and prior intestinal resections.

Results
Patients with IBD had a higher body fat percentage (29.5% vs. 26.9%, p=0.012), lower steep ramp test performance (WRpeak 4.2 W/kg vs. 4.8 W/kg, p&lt;0.001), fewer sit-to-stand repetitions (42 vs. 47, p=0.002), and reduced hand-held dynamometry hamstring strength (3.0 N/kg vs. 3.2 N/kg, p=0.011), as compared to healthy controls (Figure 1). Differences persisted after adjusting for age, sex, Charlson comorbidity index, smoking, and educational level. Multivariable linear regression analyses showed associations for increased body fat and reduced cardiorespiratory fitness and muscular strength with older age, female sex, higher body mass index (BMI), fatigue, arthritis, and a higher number of biologicals. No differences were found in muscular endurance or flexibility.

Conclusion
Patients with IBD have elevated levels of body fat and reduced cardiorespiratory fitness and muscular strength compared to healthy controls, with no observed differences in muscular endurance or flexibility. Targeted exercise interventions, especially for those with higher BMI, fatigue, arthritis, or multiple biologic treatments, may improve deficits in health-related physical fitness and potentially enhance disease outcomes.

References
1.Demers K, Bongers BC, van Kuijk SMJ, Plasqui G, Jonkers DMAE, Pierik MJ, Stassen LPS. Criterion Validity of Screening Tools and Field-Based Tests for Health-Related Physical Fitness in Inflammatory Bowel Disease. Dig Dis Sci. 2024 Oct 19. doi: 10.1007/s10620-024-08682-5. Epub ahead of print. PMID: 39425857.