Gravina AG, Pellegrino R, Durante T, Palladino G, D’Onofrio R, Mammone S, Arboretto G, Auletta S, Imperio G, Ventura A, Romeo M, Federico A. Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity: The “BE-FIT-IBD” study. World J Gastroenterol 2023; 29(41): 5668-5682 [PMID: 38077160 DOI: 10.3748/wjg.v29.i41.5668]
Corresponding Author of This Article
Raffaele Pellegrino, MD, Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania Luigi Vanvitelli, Via L. de Crecchio, Naples 80138, Italy. raffaele.pellegrino@unicampania.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Nov 7, 2023; 29(41): 5668-5682 Published online Nov 7, 2023. doi: 10.3748/wjg.v29.i41.5668
Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity: The “BE-FIT-IBD” study
Antonietta Gerarda Gravina, Raffaele Pellegrino, Tommaso Durante, Giovanna Palladino, Rossella D’Onofrio, Simone Mammone, Giusi Arboretto, Salvatore Auletta, Giuseppe Imperio, Andrea Ventura, Mario Romeo, Alessandro Federico
Antonietta Gerarda Gravina, Raffaele Pellegrino, Giovanna Palladino, Rossella D’Onofrio, Simone Mammone, Giusi Arboretto, Salvatore Auletta, Giuseppe Imperio, Andrea Ventura, Mario Romeo, Alessandro Federico, Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania Luigi Vanvitelli, Naples 80138, Italy
Tommaso Durante, Mental Health Department, S. Pio Hospital, Benevento 82100, Italy
Author contributions: Gravina AG, Pellegrino R, and Federico A designed the study; all authors participated in the acquisition and interpretation of the data and drafted the initial manuscript; Pellegrino R performed the analysis; all the authors revised the article critically for important intellectual content.
Institutional review board statement: The study was conducted in compliance with the Declaration of Helsinki and received approval from the Ethics Committee of the University of Campania Luigi Vanvitelli (protocol number 7892, 15 March 2023).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raffaele Pellegrino, MD, Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania Luigi Vanvitelli, Via L. de Crecchio, Naples 80138, Italy. raffaele.pellegrino@unicampania.it
Received: August 16, 2023 Peer-review started: August 16, 2023 First decision: October 8, 2023 Revised: October 9, 2023 Accepted: October 23, 2023 Article in press: October 23, 2023 Published online: November 7, 2023
ARTICLE HIGHLIGHTS
Research background
Patients with inflammatory bowel diseases (IBD) often experience reduced quality of life (QoL) and disability. Regular physical activity (PA) determines QoL. Initial studies have shown that mild PA seems safe in IBD and is not associated with an increased risk of flare-ups.
Research motivation
There are no precise guidelines on what type of PA and the intensity to recommend for patients with IBD. Epidemiological levels of PA in the IBD population are not yet fully known, nor are the barriers that block patients from practising regular PA.
Research objectives
This study aimed to weigh PA levels with standardised instruments in an Italian IBD population to examine PA's relationship with IBD disease activity and identify barriers to PA.
Research methods
This cross-sectional study employed the standardised International Physical Activity Questionnaire (IPAQ) to weigh PA and the patient-reported outcome 2 (PRO-2) to assess IBD disease activity. PA was expressed as multiples of resting metabolic rate (Met) in Met min/wk. This study included only patients with confirmed, excluding patients with severe or hospitalised activity.
Research results
Two hundred nineteen patients were included. Fifty-three per cent were found to be sufficiently active, 42.9% as inactive, and only 4.1% as health-enhancing PA active. Median overall PA levels were 834.5 Met min/wk, just above the threshold for inactivity (i.e., 700 Met min/wk). Ulcerative colitis PRO-2 showed a negative correlation with intense PA activities. Several barriers to PA were identified (e.g., fear of IBD flare-up, fears initiated as early as IBD diagnosis).
Research conclusions
Patients with IBD were found in this setting to be burdened by a significant rate of physical inactivity. Barriers persist on which to act to regain adherence to regular PA. As measured by the PRO-2, disease activity did not drastically affect PA. The IPAQ questionnaire showed excellent feasibility and ease of completion and interpretation.
Research perspectives
Regular PA has multiple benefits (from cardiovascular health to psychological health), and it is necessary to make sure that patients with IBD practice it so that these benefits are not lost. It is appropriate for gastroenterologists to pay more attention to this aspect during medical visits. IPAQ can be a potential tool for recognising and monitoring physically inactive patients.
