Systematic Reviews
Copyright ©The Author(s) 2023.
World J Gastroenterol. Oct 14, 2023; 29(38): 5406-5427
Published online Oct 14, 2023. doi: 10.3748/wjg.v29.i38.5406
Table 1 Overview of methods used to assess health-related physical fitness components in patients with inflammatory bowel disease
Health-related physical fitness component
Gold standard or practical field test
Assessment method
Outcome
Number of studies
Cardiorespiratory fitnessGold standard testCPET on a cycle ergometerVO2max/VO2peak7[28,43-45,57,59,61]
WRpeak1[71]
Practical field testIncremental cycle ergometer testSubmaximal heart rate2[42,72]
WRpeak1[73]
6-min walk testDistance2[28,53]
Speed1[74]
Incremental shuttle walk testDistance2[75,76]
CAFT step testEstimated VO2max1[60]
Bruce treadmill stress testDuration of exercise and heart rate recovery index1[77]
Rockport 1-mile walk testEstimated VO2max1[56]
Duke activity status indexPoints1[78]
Muscular strengthGold standard testIsometric dynamometryPeak torque7[30,42,46-49,72]
Isokinetic dynamometryPeak torque5[28,50-52,79]
Practical field testHandgrip strengthPeak torque31[42,49,51,55,58,72,74-76,80-101]
Jumping mechanographyPmax, Fmax, jump height4[99,102-104]
Finger pinching strengthPeak torque2[42,72]
Isometric leg-press strengthPeak torque1[98]
Isometric HHDPeak torque1[58]
Respiratory muscle strengthMIP, MEP1[76]
Peak expiratory flow1[93]
Muscular enduranceGold standard testIsometric dynamometrySlope of median muscle activation frequency1[48]
Decrement in peak torque1[30]
Practical field testHandgrip enduranceDecrement in peak torque2[86,87]
Mean peak torque1[98]
Chair-stand test/sit-to-stand testRepetitions1[51]
Time4[49,51,55,74,98]
3-meter walk testSpeed1[55]
Leg-press enduranceMean force1[98]
Arm-curl testRepetitions1[51]
Sit-upsRepetitions1[54]
Back extensionsRepetitions1[54]
Push-upsRepetitions1[54]
SquatsRepetitions1[54]
Plank positionTime1[54]
FlexibilityN/AN/A0
CAFT: Canadian aerobic fitness test; CPET: Cardiopulmonary exercise testing; Fmax: Maximum force; HHD: Hand-held dynamometry; MEP: Maximal expiratory pressure; MIP: Maximal inspiratory pressure; N/A: Not available; Pmax: Maximum power; VO2max: Maximal oxygen uptake; VO2peak: Oxygen uptake at peak exercise; WRpeak: Work rate at peak exercise.
Table 2 Description and main findings of studies examining cardiorespiratory fitness by objective maximal oxygen uptake or oxygen uptake at peak exercise assessment in patients with inflammatory bowel disease
Ref.
Study design, country
Sample size (n)
Sample features
CD, UC, IBD-U (n)
Female sex, (%)
Age in yr, mean (SD)
Disease activity
Control group
Test protocol
Main findings, mean (SD), or median (IQR)
Ploeger et al[43], 2011Cross-sectional study, Canada29N/A19, 10, 041%13.7 (2.3)Remission (n = N/A) or mildly active disease (n = N/A)Healthy age-matched and sex-matched youthIncremental ramp cycle ergometer test: Height-based increase of work rate every 2 min until exhaustion (pedaling frequency < 50 rpm)VO2peak: CD, 34.9 (6.5) mL/kg/min; UC, 37.8 (7.7) mL/kg/min; Total, 36.0 (7.0) mL/kg/min; VO2peak CD, UC, total < VO2peak ref (P < 0.05, P < 0.001)
Nguyen et al[44], 2013Cross-sectional study, Canada7N/A7, 0, 0N/A15.2 (2.3) Remission (n = 7)Healthy age-matched and sex-matched CG (n = 7)Incremental ramp cycle ergometer test: Height-based increase of work rate every 2 min until exhaustion (pedaling frequency < 50 rpm)VO2peak: CD, 43.1 (6.5) mL/kg/min; CG, 53.5 (4.6) mL/kg/min; VO2peak CD < VO2peak CG (P < 0.01)
Otto et al[45], 2012Retrospective study, United Kingdom100Patients awaiting colorectal surgery54, 46, 0N/A41.1 (14.9)Active disease requiring surgery (n = 100)Reference values[105]Incremental ramp cycle ergometer test (8-12 min): Work rate increments based on prediction quotation and PA until exhaustion (pedaling frequency < 40 rpm)VO2peak: CD, 20.0 (7.9) mL/kg/min;UC, 21.9 (7.1) mL/kg/min; Total, 20.9 (7.6) mL/kg/min; VO2peak total; VO2peak ref (P < 0.0001)
Vogelaar et al[28], 2015Cross-sectional study, The Netherlands20With fatigue (n = 10), without fatigue (n = 10)15, 5, 050%37.3 (11.4)Remission (n = 20)Reference values[106]Incremental ramp cycle ergometer test (8-12 min): Work rate starting at 20 W, which increased by 15-20 W/min until exhaustion (pedaling frequency < 60 rpm)VO2peak: IBD with fatigue, 1.99 (0.44) L/min; IBD without fatigue, 2.43 (0.75) L/min; VO2peak IBD < VO2peak ref (P = N/A)
Tew et al[59], 2019Pilot RCT, United Kingdom36N/A36, 0, 053%36.9 (11.2)Remission (n = 32) or mildly active disease (n = 4)N/AIncremental ramp cycle ergometer test: Work rate starting at 0 W, which increased by 15-20 W/min until exhaustion (pedaling frequency < 60 rpm)[107]VO2peak1: CD, 28.2 (8.6) mL/kg/min
Bottoms et al[61], 2019Secondary analysis of Tew et al[59], United Kingdom25HIIT group (n = 12), MICT group (n = 13)25, 0, 060%N/A for total sampleRemission (n = 32) or mildly active disease (n = 4)N/AIncremental ramp cycle ergometer test: Work rate starting at 0 W, which increased by 15-20 W/min until exhaustion (pedaling frequency < 60 rpm)[107]VO2peak1: N/A for total sample; CD HIIT group, 27.3 (7.7) mL/kg/min; CD MICT group, 28.7 (8.6) mL/kg/min
van Erp et al[57], 2021Pilot study, The Netherlands25With severe fatigue21, 3, 140%45 (2.6)Remission (n = 25)N/AIncremental ramp cycle ergometer test: Protocol N/AVO2max1: IBD, 28 (25-31) mL/kg/min
1Baseline values are shown.
CD: Crohn’s disease; CG: Control group; HIIT: High-intensity interval training; IBD: Inflammatory bowel disease; IBD-U: Inflammatory bowel disease unclassified; IQR: Interquartile range; MICT: Moderate-intensity continuous training; N/A: Not available; PA: Physical activity; RCT: Randomized controlled trial; ref: Reference; SD: Standard deviation; UC: Ulcerative colitis; VO2max: Maximal oxygen uptake; VO2peak: Oxygen uptake at peak exercise.
Table 3 Description and main findings of studies examining muscular strength and muscular endurance by isokinetic or isometric strength or endurance assessment on a dynamometer in patients with inflammatory bowel disease
Ref.
Study design, country
Sample size (n)
Sample features
CD, UC (n)
Female sex, (%)
Age in yr, mean (SD), mean (95%CI), or median (IQR)
Disease activity
Control group
Test protocol
Main findings, mean (SD), mean (95%CI), or median (IQR)
Lee et al[47], 2015Cross-sectional study, United States64Recently diagnosed64, 041%12.8 (2.7)Remission to mild active disease (n = 26), moderate-to-severe active disease (n = 38)Healthy subjects (n = 264)Isometric muscular strength dynamometry (Biodex): AD peak torque (20° plantar flexion)AD peak torque: CD, 14.7 (10.1-18.8) ft/lbs; CG, 17.9 (11.2-24.8) ft/lbs; AD peak torque CD (remission-mild activity) = AD peak torque CG (P = 0.72); AD peak torque CD (moderate-to-severe activity) < AD peak torque CG (P = 0.05)
Lee et al[46], 2018Prospective study, United States138With low bone density138, 052%14.2 (2.8)Remission (n = 85), or mild (n = 46), or moderate-to-severe (n = 7) active diseaseHealthy subjects (n = 264)Isometric muscular strength dynamometry (Biodex): AD peak torque (20° plantar flexion)AD peak torque Z-score1 (relative to age, sex, race, adjusted for tibia length): CD, -0.43 (0.90); AD peak torque CD < AD peak torque ref (P < 0.0001)
Geerling et al[50], 1998Cross-sectional study, The Netherlands32With longstanding disease32, 0 56%40.0 (34.3-54.0)Remission (n = 17) or active disease (n = 15)Healthy age-matched and sex-matched CG (n = 32)Isokinetic muscular strength dynamometry (Cybex II): KE and KF peak torque (60°/s, 180°/s)KE peak torque: CD 60°/s, 123.1 (27.4) Nm; CD 180°/s, 81.5 (18.5) Nm; CG 60°/s, 136.5 (53.8) Nm; CG 180°/s, 88.7 (39.7) Nm; KE peak torque CD = KE peak torque CG (P = N/A); KF peak torque: CD 60°/s, 71.6 (22.3) Nm; CD 180°/s, 45.6 (15.2) Nm; CG 60°/s, 87.6 (33.4) Nm; CG 180°/s, 59.3 (31.9) Nm; KF peak torque CD (60°, 180°/s) < KF peak torque CG (P < 0.02, P < 0.05)
Geerling et al[52], 2000Cross-sectional study, The Netherlands69Recently diagnosed23, 4652%35.4 (13.6)Remission (n = 61) or active disease (n = 8)Healthy age-matched and sex- matched CG (n = 69)Isokinetic muscular strength dynamometry (Cybex II): KE and KF peak torque (60°/s, 180°/s)KE peak torque: N/A for total sample; CD 60°/s, 127.5 (33.4) Nm; CD 180°/s, 81.5 (25.7) Nm; CG for CD 60°/s, 142.4 (33.2) Nm; CG for CD 180°/s, 93.2 (37.2) Nm; UC 60°/s, 148.8 (44.6) Nm; UC 180°/s, 96.1 (30.7) Nm; CG for UC 60°/s, 155.7 (50.0) Nm; CG for UC 180°/s, 100.5 (38.4) Nm; KE peak torque CD and UC = KE peak torque CG (P = N/A); KF peak torque: N/A for total sample; CD 60°/s, 74.9 (23.5) Nm; CD 180°/s, 46.8 (25.3) Nm; CG for CD 60°/s, 86.8 (19.8) Nm; CG for CD 180°/s, 57.8 (22.0) Nm; UC 60°/s, 89.7 (31.9) Nm; UC 180°/s, 58.6 (21.3) Nm; CG for UC 60°/s, 98.5 (37.3) Nm; CG for UC 180°/s, 64.8 (30.4) Nm; KF peak torque CD and UC = KF peak torque CG (P = N/A)
Jensen et al[72], 2002Follow-up study of Kissmeyer-Nielsen et al[42], Denmark20Patients who accepted follow-up 4-6 yr after J-pouch surgery0, 2060%38 (9)N/AN/AIsometric muscular strength dynamometry (Metitur): KE peak torque (60° knee flexion), AF peak torque (90° elbow flexion)KE peak torque: UC preoperative, 475 (187) N; UC 4-6 yr postoperative, 532 (179) N (P = 0.080); AF peak torque: UC preoperative, 258 (93) N; UC 4-6 yr postoperative, 275 (83) N (P = 0.017)
Salacinski et al[48], 2013Cross-sectional study, United States19≥ 1 small bowel resection and idiopathic musculoskeletal pain or weakness19, 053%44.2 (10.3)Remission (n = 19)Healthy age-matched and sex- matched CG (n = 19)Isometric muscular strength dynamometry (customized): KE and KF peak torque (45° knee flexion) KE peak torque/KE peak torque normalized to BW: CD, 75.2 (45.4) Nm/0.06 (0.03) Nm/kg; CG, 105.6 (40.7) Nm/0.07 (0.03) Nm/kg; KE peak torque CD < KE peak torque CG (P = 0.013, normalized to BW P = 0.039); KF peak torque/KF peak torque normalized to BW: CD, 27.2 (10.7) Nm/0.02 (0.01) Nm/kg, CG, 53.7 (27.3) Nm/0.09 (0.02) Nm/kg; KF peak torque CD < KF peak torque CG (P = 0.001, normalized to BW P = 0.022)
Isometric muscular endurance dynamometry (customized): Slope of median VL and RF muscle activation frequency measured with EMG during 60-s submaximal (60% of maximum) contraction (45° knee flexion)RF fatigue rate: CD, -0.069 (0.06) Hz/s; CG, -0.142 (0.09) Hz/s; RF fatigue rate CD < FR fatigue rate CG (P = 0.015); VL fatigue rate: CD, -0.028 (0.042) Hz/s; CG, -0.027 (0.085) Hz/s; VL fatigue rate CD = VL fatigue rate CG (P = 0.969)
van Langenberg et al[30], 2014Cross-sectional study, Australia27N/A27, 056%43 (38, 48) Remission (n = 19) or active disease (n = 8)Healthy age-matched and sex-matched CG (n = 22)Isometric muscular strength dynamometry (Biodex): KE peak torque (60° knee flexion)KE peak torque: CD 60°, 148.8 (130, 168) Nm; CG 60°, 133.6 (111, 156) Nm; KE peak torque CD = KE peak torque CG (P = 0.29)
Isometric muscular endurance dynamometry (Biodex): Fatigue rate as decrement of KE peak torque from maximal peak torque (repetition 2 or 3) to peak torque at the end of 30 maximal contractions (at 60° knee flexion)KE fatigue rate: CD, -5.2 (-8.2, -2.2) Nm/min; CG, -1.3 (-3.9, 1.4) Nm/min; KE fatigue rate CD > KE fatigue rate CG (P = 0.047)
Zaltman et al[49], 2014Case-control study, Brazil23Sedentary0, 23100%43.9 (10.0)Remission (n = 8), mild (n = 9), or moderate (n = 5), or severe (n = 1) active diseaseHealthy age-matched, sex-matched, and BMI-matched CG (n = 23)Isometric muscular strength dynamometry (IsoTeste): KE peak torque (angle N/A)KE peak torque: UC, 38.6 (4.4) Kgf; CG, 41.0 (1.1) Kgf; KE peak torque UC < KE peak torque CG (P = 0.012)
Subramaniam et al[79], 2015Prospective study, Australia19Starting with IFX19, 042%33.2 (10.7)Active disease (n = 19)N/AIsokinetic muscular strength dynamometry (Cybex/HUMAC Norm): KE peak torque (30°/s, 60°/s, 90°/s)KE peak torque1: CD 30°/s left leg, 166.5 (93.4) Nm, right leg 184.8 (96.6) Nm; CD 60°/s left leg, 172.8 (103.5) Nm, right leg 183.5 (116.4) Nm; CD 90°/s left leg, 128.5 (55.9) Nm, right leg 139.4 (54.4) Nm
Vogelaar et al[28], 2015Cross-sectional study, The Netherlands20With fatigue (n = 10), without fatigue (n = 10)15, 550%37.3 (11.4)RemissionReference valuesIsokinetic muscular strength dynamometry (Biodex): KE and KF peak torque (60°/s, 180°/s)KE peak torque: N/A for total sample; IBD with fatigue 60°/s, 107.1 (25.4) Nm; IBD with fatigue 180°/s, 60.7 (12.3) Nm; IBD without fatigue 60°/s, 123.7 (38.0) Nm; IBD without fatigue 180°/s, 73.5 (21.4) Nm; KE peak torque IBD with and without fatigue < KE peak torque ref (P = N/A); KF peak torque: N/A for total sample; IBD with fatigue 60°/s, 51.7 (14.3) Nm; IBD with fatigue 180°/s, 31.1 (8.0) Nm; IBD without fatigue 60°/s, 63.0 (20.1) Nm; IBD without fatigue 180°/s, 38.9 (14.2) Nm; KF peak torque IBD with and without fatigue < KF peak torque ref (P = N/A)
Jones et al[51], 2020RCT, United Kingdom47N/A47, 068%49.3 (13.0)Remission (n = 31) or mild active disease (n = 16)Healthy age-matched, sex-matched, PA-matched, BMI-matched, and ethnicity-matched CG (n = 33)Isokinetic muscular strength dynamometry (Biodex): KE peak torque (60°/s, 180°/s), EF peak torque (60°/s, 120°/s)KE peak torque1: CD 60°/s, 72.6 (33.3) Nm; CD 180°/s, 46.2 (23.0) Nm; CG 60°/s, 94.6 (46.6) Nm; CG 180°/s, 60.1 (34.9) Nm; KE peak torque CD < KE peak torque CG (P = 0.001, P = 0.011); EF peak torque1: CD 60°/s, 25.4 (11.2) Nm; CD 120°/s, 22.3 (9.1) Nm; CG 60°/s, 26.0 (12.4) Nm; CG 120°/s, 22.2 (11.2) Nm; EF peak torque CD = EF peak torque CG (P = 0.664, P = 0.747)
1Baseline values are shown.
95%CI: 95% confidence interval; AD: Ankle dorsiflexor; AF: Arm flexor; BMI: Body mass index; BW: Body weight; CD: Crohn’s disease; CG: Control group; EF: Elbow flexor; EMG: Electromyography; IBD: Inflammatory bowel disease; IFX: Infliximab; IQR: Interquartile range; KE: Knee extensor; KF: Knee flexor; N/A: Not available; PA: Physical activity; RCT: Randomized controlled trial; RF: Rectus femoris; ref: Reference; SD: Standard deviation; UC: Ulcerative colitis; VL: Vastus lateralis.
Table 4 Description and main findings of studies examining the effect of physical activity and physical exercise training interventions on health-related physical fitness components in patients with inflammatory bowel disease
Ref.Study design, countrySample size, nSample featuresCD, UC, IBD-U (n)Female sex, (%)Age in yr, mean (SD)Disease activityHealthy control groupIntervention, IGComparator, CGHRPF components assessedEffect on HRPF components
Mählmann et al[53], 2017Pilot study, Switzerland21Pediatric patients12, 7, 348%13.88Remission (n = 14) or active disease (n = 7)Age-matched and sex-matched HC (n = 23)Moderate-intensity aerobic exercise training with active video gameplay (n = 21), 5 sessions/wk (30 min) for 8 wkN/ACardiorespiratory fitness with 6-min walk test (practical field test) at wk 8Distance reached in 6 min increased in patients with active disease from 655 (95%CI: 542-769) m to 758 (95%CI: 610-906) m, and in patients in remission from 655 (95%CI: 542-769) m to 758 (95%CI: 610-906) m, and in CG from 678 (95%CI: 640-715) m to 727 (95%CI: 74-93) m, without between-group differences (P = N/A)
Trivić et al[54], 2022Intervention study, Croatia42Pediatric patients22, 18, 240%N/A for total sampleRemission (n = 42)N/APersonalized home-based structured resistance training (n = 42), 3 sessions/wk for 6 moN/ABody composition (LBM) with DEXA; muscular endurance 30 s sit-ups, push-ups, back extensions, squats, and holding a plank position for as long as possible (practical field tests), all at 6 moImprovement in LBM from 37.12 (SD: 1.43) kg to 38.75 (SD: 1.61) kg, (P = 0.012) but not in LBM z-score. Improvement in muscular endurance tasks: Number of sit-up repetitions from 19.32 (SD: 5.82) to 21.00 (SD: 6.53) (P = 0.024), back extension repetitions from 27.39 (SD: 12.09) to 38.27 (SD: 16.10) (P < 0.001), push-up repetitions from 17.37 (SD: 6.67) to 24.59 (SD: 7.58) (P < 0.001), squat repetitions from 22.10 (SD: 4.87) to 24.88 (SD: 6.23) (P < 0.001), and time holding the plank position from 81.0 (SD: 46.26) s to 114.34 (SD: 74.06) s (P < 0.001)
Loudon et al[60], 1999Pilot study, Canada16Sedentary adult patients16, 0, 083%38.3 (7.5)Remission or mild active disease (n = N/A)N/ASupervised indoor (group) walking program, 3 sessions/wk (of 20-35 min) for 12 wkN/ACardiorespiratory fitness with CAFT step test (practical field test) at wk 12Improvement in estimated VO2max from 30.6 (SD: 4.7) mL/kg/min to 32.4 (SD: 4.8) mL/kg/min (P = 0.0013)
Bottoms et al[61], 2019Secondary analysis of Tew et al[59], United Kingdom25Adult patients25, 0, 060%N/A for total sampleRemission or mild active disease (n = N/A)N/AHIIT (n = 13) or MICT (n = 12), 3 sessions/wk for 3 moN/ACardiorespiratory fitness with CPET (gold standard test) at week 4, 8, and 12Increase in WRpeak after HIIT from baseline to week 4 with mean difference of 20.5 (SD: 10.8) W (P = 0.03), and from week 4 to week 12 with 12.30 (SD: 6.32) W, (P = 0.02); No change in WRpeak after MICT
Cronin et al[56], 2019Cross-over RCT, Ireland17Physically inactive adult patients N/A for total sampleN/A for total sample25 (6.5)Remission (n = 17)N/ACombined aerobic and resistance exercise program (n = 13, of which 7 crossed-over), 3 sessions/wk (of 60 min) for 8 wkUsual care (n = 7)Body composition (body fat and lean tissue mass) with DEXA, cardiorespiratory fitness with Rockport 1-mile walk test (practical field test), all at week 8Total body fat decreased in the IG with 2.1% (IQR: -2.15 to -0.45) but increased in the CG with 0.1% (IQR: -0.4-1), (P = 0.022); total lean tissue mass increased in the IG with 1.59 (IQR: 0.68-2.69) kg but decreased in the CG with 1.38 (IQR: -2.45-0.26) kg, (P = 0.003); improvement of estimated VO2max in the IG from 43.41 mL/kg/min to 46.01 mL/kg/min, (P = 0.03)
Tew et al[59], 2019Pilot RCT, United Kingdom36Adult patients36, 0, 053%36.9 (11.2)Remission (n = 32) or mildly active disease (n = 4)N/AHIIT (n = 13) or MICT (n = 12), 3 sessions/wk for 3 moUsual care (n = 11)Cardiorespiratory fitness with CPET (gold standard test) at 3 moChange in VO2peak from 27.3 (SD: 7.7) mL/kg/min to 29.7 (SD: 8.2) mL/kg/min after HIIT. Change in VO2peak from 28.7 (SD: 8.6) mL/kg/min to 29.3 (SD: 6.6) mL/kg/min after MICT. Change in VO2peak from 28.6 (SD: 10.0) mL/kg/min to 28.5 (SD: 9.2) mL/kg/min after usual care. Mean change in VO2peak from baseline to 3 mo relative to the usual care was greater following HIIT than MICT (+2.4 vs +0.7 mL/kg/min) (P = N/A)
Jones et al[51], 2020RCT, United Kingdom47Adult patients47, 0, 068%49.3 (13.0)Remission (n = 31) or mild active disease (n = 16)Age-matched, sex-matched, PA-matched, BMI-matched, and ethnicity-matched HC (n = 33)Combined impact and resistance exercise training (n = 23), 3 sessions/wk (of 60 min) for 6 moUsual care (n = 24)Muscular strength and endurance with isokinetic dynamometry (gold standard test) as well as with HGS, chair-stand test, and arm-curl test (practical field tests), all at 6 moImprovement of all muscular strength and endurance tests in the IG compared to the CG: mean difference KE peak torque 60°/s, 22.4 (95%CI: 12.1-32.8) Nm; KE peak torque 180°/s, 16.8 (95%CI: 9.0-24.5) Nm; EF peak torque 60°/s, 6.8 (95%CI: 3.9-9.6) Nm; EF peak torque 180°/s, 6.3 (95%CI: 3.3-9.3) Nm; HGS, 8.3 (95%CI: 6.2-10.5) kg; Chair-stand test, 4 (95%CI: 3-6) repetitions; arm-curl test, 7 (95%CI: 5-8) repetitions; All P < 0.001
Seeger et al[58], 2020Pilot RCT, Germany45Adult patients45, 0, 063%N/A for total sampleRemission or mild active disease (n = N/A)N/AModerate endurance training (n = 17, only n = 9 were analyzed), or moderate muscle training (n = 15, only n = 13 analyzed), 3 sessions/wk (of 30-40 min) for 12 wkUsual care (n = 13)Muscular strength with HGS and isometric HHD (practical field tests) at week 12Improvement of HGS and QS in both endurance training IG (P = 0.01, P = 0.035) and muscle training IG (P = 0.01, P = 0.002), while HGS decreased and QS did not change in CG (P = 0.01, P = 0.23)
Van Erp et al[57], 2021Pilot study, The Netherlands25Adult patients with severe fatigue21, 3, 140%45 (2.6)Remission (n = 25)N/AAerobic and progressive resistance training, 3 sessions/wk (of 60 min) for 12 wkN/ACardiorespiratory fitness with a CPET (gold standard test) at week 12No significant change in VO2max. A significant change in WRpeak from 2.4 (SD: 0.5) W/kg to 2.7 (SD: 0.5) W/kg (P = 0.002)
Zhao et al[55], 2022RCT, China28Adult patients with low nutritional risk state [RT + WP intervention (n = 15), RT + placebo intervention (n = 13)]N/A31%44.1Remission (n = 3), or mild (n = 12), moderate (n = 9), or severe (n = 4) active diseaseN/AUnsupervised resistance training (n = 28), 3 sessions/wk for 8 wkMuscular strength with HGS and muscular endurance with 3-m walk speed and 5-time chair-stand-test (all practical field tests), all at week 8HGS changed from 36.7 (SD: 10.8) kg to 42.6 (SD: 8.4) kg in the RT + WP group and from 31.7 (SD: 12.6) kg to 32.9 (SD: 12.5) kg in the RT + placebo group. 3-m walk speed changed from 1.0 (SD: 0.3) m/s to 0.9 (SD: 0.1) m/s in the RT + WP group and from 1.1 (SD: 0.2) m/s to 1.0 (SD: 0.2) m/s in the RT + placebo group. Time to perform the 5-time chair-stand test changed from 7.0 (SD: 1.5) s to 6.2 (SD: 1.4) s in the RT + WP group and from 6.6 (SD: 1.6) s to 6.2 (SD: 1.3) s in the RT + placebo group. All are not statistically significant (P = N/A)
95%CI: 95% confidence interval; BMI: Body mass index; CAFT: Canadian aerobic fitness test; CD: Crohn’s disease; CG: Control group; CPET: Cardiopulmonary exercise test; DEXA: Dual-energy X-ray absorptiometry; EF: Elbow flexor; HC: Healthy controls; HGS: Handgrip strength; HHD: Hand-held dynamometry; HIIT: High-intensity interval training, HRPF: Health-related physical fitness; IBD-U: Inflammatory bowel disease unclassified; IG: Intervention group; IQR: Interquartile range; KE: Knee extensor; LBM: Lean body mass; MICT: Moderate-intensity continuous training; N/A: Not available; PA: Physical activity; QS: Quadriceps strength; RCT: Randomized controlled trial; RT: Resistance training; SD: Standard deviation; UC: Ulcerative colitis; VO2max: Maximal oxygen uptake; VO2peak: Oxygen uptake at peak exercise; WP: Whey protein; WRpeak: Work rate at peak exercise.