| ObjectivesThe present study aimed at designing a home-based exercise training program which suits patients with inflammatory bowel disease(IBD)to exercise at home,and,through the applicaton,to explore its effects on fatigue,lower limb muscle strength,anxiety,depression and quality of life.With this study,we wish to provide scientific evidence for a safe and feasible training program in patients with IBD.MethodsThis study was divided into two parts.Part Ⅰ:Forty patients with IBD and 24 healthy adults who met the inclusion criteria were selected to record general demographic data and disease-related data.Meanwhile,Patients’ physical fitness level,including muscle strength and exercise endurance,was evaluated and the main parameters included handgrip strength,the lower extremity muscle strength and six-minute walking test(6MWT)results.The results of these paitents were compared with the ones in healthy adults.Designing a home-based training program based on literature review,expert consultation and trials.Part Ⅱ:Forty-six patients with IBD who met the inclusion criteria were selected by convenient sampling and randomly divided into intervention group(n=25)and control group(n=21).The experimental group received home-based exercise training for 12 weeks with 3 sessions/week,while the control group maintained the usual life style.After intervention ended,the control group was provided exercise training manual and professional training guidance.A total of 21 cases of intervention group and 13 cases of control group completed the intervention study.The two groups were compared with the results of fatigue,lower extremity muscle strength,6MWT distance,anxiety,depression and quality of life before(Pre)and after(Post)intervention.Results1 Physical fitness status of patients with inflammatory bowel disease and its relationship with disease activity,quality of life and physical activity level1.1 Base level of physical fitness in patients with IBDThe peak torque,total work(60/°s)and average power(60/°s and 180/°s)of lower limb flexors and extensors in IBD patients were lower than those in the control group(all P<0.05),especially in the extensors,there was a significant difference(P<0.001),and the muscle strength of CD group decreased more significantly.There was significant difference in grip strength between control group and UC group(P<0.05),but there was no significant difference between CD group and UC group(P>0.05).The 6-minute walking distance of IBD patients was significantly lower than that of healthy adults(P<0.001).Fatigue,disease activity,quality of life and leisure-related physical activities above moderate intensity were all related to flexor-extensor muscle strength(all P<0.05),but not to grip strength and 6-minute walking distance(all P<0.05).1.2 Formation of Home Sports Training Program for patients with inflammatory bowel diseaseOn the basis of literature review and the relationship between physical fitness level and disease activity,quality of life and physical activity level in patients with inflammatory bowel disease,a preliminary home-based exercise(raining program for IBD patients was formed,which was modified by expert opinions and preliminary experiments.Finally,a home-based exercise training program for IBD patients was formed,and a guide manual for exercise training for IBD patients.2 Effects of home-based exercise training in patients with IBD2.1 Effects on fatigueBefore and after the intervention,the scores of fatigue in the intervention group and general fatigue,mental fatigue and decreased motivation decreased(P<0.05),while the scores of general fatigue,mental fatigue and decreased motivation in the control group did not change significantly(P>0.05).After the intervention,there was no significant difference in scores between the two groups in each dimension(P>0.05).2.2 Effects on lower-limb muscle strengthAfter the intervention,the muscle strength of the two groups was compared with the baseline at 60 degrees/s and 180 degrees/s.The results showed that the peak moment and relative peak moment of the intervention group at 60 degrees/s were higher than those before the intervention(P<0.05),and at 180 degrees/s.The peak moment and relative peak moment of lower flexor muscle were higher than those before intervention(P>0.05).In the control group,the peak moment and relative peak moment of lower right flexor muscle were only higher than those before intervention(P>0.05).There was no significant difference between different groups(P>0.05).2.3 Effects on exercise enduranceAfter the intervention,the walking distance of 6 minutes in the intervention group was larger than that in the control group(P=0.033),and there was no significant difference between the intervention group and the control group before and after the intervention.2.4 Effects on anxiety and depressionThere was no significant difference in anxiety and depression scores between the two groups before and after intervention(P>0.05),and no significant difference was found between the two groups(P>0.05).2.5 Effects on quality of lifeThe total scores of quality of Iife,intestinal symptoms and social function dimension in intervention group were higher than those before intervention(P<0.05).After intervention,the total scores of quality of life,intestinal symptoms and social function dimension in intervention group were higher than those in control group(P<0.05).ConclusionsIn our study,we found that the physical fitness level,including muscle strength and exercise endurance,is significantly lower in patients with IBD compared with the healthy adults and isokinetic muscle strength of lower limbs is related to fatigue,disease activity,quality of life and leisure-related physical activities above moderate intensity.A 12-week of intervention in IBD patients through a home-based exercise training program can significantly increase their fatigue.Meanwhile,physical fitness level and quality of life are improved.Therefore,the home-based exercise training program we designed is worth to be applied in the patients with IBD at community and home. |
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