Inflammatory bowel diseases (IBD), which incorporate Crohn’s disease (CD), ulcerative colitis (UC), and inflammatory bowel disease-unclassified (IBD-U), are chronic, systemic, and undulating inflammatory conditions affecting primarily the gastrointestinal tract of patients. The global incidence of IBD has been rising steadily in recent years, and a study conducted in southern New Zealand by Coppell et al. showed a peak incidence of IBD of 29.8/100,000 people. While the exact mechanism and cause of IBD are unknown, it is thought to incorporate 4 key elements: genetic predisposition, environmental triggers, abnormal immune response, and gut microbiome changes.
Many patients with IBD suffer from significant fatigue, depression and anxiety, and a reduced health-related quality of life (HRQoL) because of the impact the symptoms of the disease can have on their life. The level of their psychological well-being does not always correlate with the severity of their disease. For example, Aluzaite et al. reported that while 83% of patients with active IBD experience fatigue, up to 44% of patients whose disease is in remission can also suffer from significant fatigue. It is clear that just treating IBD with current medical management is ineffective at improving patient’s psychological well-being, and this is directing researchers to investigate other options such as increasing physical activity.
Physical activity is defined as any bodily movement produced by skeletal muscles resulting in energy expenditure. Regular physical activity has been shown to significantly improve health in the general “healthy” population in numerous ways including decreasing blood pressure, body weight, and bone loss, as well as improving sleep quality and immune response. Exercise is well known to improve psychological well-being, including reducing depression and anxiety levels, fatigue, and stress. In patients with IBD, habitual exercise has been found to increase the time spent in remission, improve gastrointestinal permeability, and improve HRQoL.
While the numerous health benefits from regular exercise are well known, the level of physical activity engagement worldwide is poor, with only 50% of the general population meeting the current physical activity guideline of 150 MET-mins/week. The majority of studies worldwide report that patients with IBD are also not meeting the recommended physical activity levels, but the level of physical activity in patients with IBD in New Zealand is currently unknown.
Therefore, the primary objective of the study was to investigate current physical activity levels in a cohort of participants with IBD in Dunedin, New Zealand. Secondary objectives included assessing participants’ attitudes and preference towards exercise and investigating any relationship between physical activity levels and quality of life, depression, anxiety, fatigue, and disease activity.