Non-pharmacological therapies for inflammatory bowel disease: Recommendations for self-care and physician guidance

Table 2 Summary of best available evidence for physical activity and exercise in inflammatory bowel disease

Type	Recommendation	Ref.
Physical activity	Lower levels of physical activity are associated with fatigue[60,61], systemic inflammation[60], and reduced cardiovascular fitness[61], whereas higher levels of physical activity may improve quality of life[67] and decrease risk of active disease[62]. Unstructured “lifestyle” and work-related physical activity may be preferential over exercise[58,60,67], although both are encouraged	van Langenberg et al[60], 2015 Vogelaar et al[61], 2015 Jones et al[62], 2015 Crumbock et al[67], 2009 Mack et al[58], 2011
Exercise	Structured exercise may improve overall fatigue[70], general well-being[68], and disease activity[70]. Thus, exercise, including cardiovascular and resistance training, should supplement “lifestyle” physical activity	Van Langenberg et al[70], 2014 Chan et al[68], 2013
Cardiovascular training	Low-moderate intensity cardiovascular training may improve cardiovascular fitness[64], disease activity[65], perceived stress[64,65], and quality of life[64,65], including social and general well-being[63,64]. Cardiovascular training should be incorporated into exercise regimen a minimum of 30 mins, 3 d per week	Klare et al[63], 2015 Loudon et al[64], 1999 Ng et al[65], 2007
Resistance training	Low-moderate intensity progressive resistance training may improve bone health[66], strength[73], and quality of life[73]. More evidence is needed for a specific prescription	Robinson et al[66], 1998 de Souza et al[73], 2014