Construction And Preliminary Application Of Exercise Regimen For Fatigued Patients With Inflammatory Bowel Disease Under The Concept Of "Body-medicine Integration"

Objective Under the guidance of the concept of "integration of body and medicine",this study used evidence-based methods to comprehensively search the relevant literature of exercise training in patients with inflammatory bowel disease fatigue,extract exerciserelated guidance content,form the best evidence of exercise training in patients with inflammatory bowel disease fatigue,and construct a complete,scientific and specific exercise training program for patients with inflammatory bowel disease fatigue according to the best evidence.The constructed exercise training program for patients with inflammatory bowel disease fatigue was applied to the clinic,and its feasibility and efficacy in improving fatigue in patients with inflammatory bowel disease were discussed.Methods1.Using the literature research method,searching,screening and evaluating guidelines,consensus,systematic reviews and various original literature at home and abroad with the theme of inflammatory bowel disease fatigue and exercise,extracting relevant evidence,using the GRADE evidence grading system to rate the evidence level and recommended strength of the included evidence,based on the included evidence and clinical actual formation of the first draft of the exercise plan for patients with inflammatory bowel disease fatigue.2.Using the expert meeting method,revise and improve the preliminary draft of the plan,finally determine the exercise training program for patients with inflammatory bowel disease fatigue,and use the quasi-experimental research method to verify the feasibility of the clinical practice of the previously constructed program and the effectiveness of the exercise training program.3.Using quasi-experimental research methods,patients with inflammatory bowel disease fatigue who met the criteria for discharge were included in the gastroenterology ward of a tertiary hospital in Shanghai,including 38 cases in the intervention group,38 cases in the control group,4 cases lost to the intervention group during the study(2cases lost due to the epidemic and 2 cases were transferred to hospital),and 3 cases were lost to the control group(1 case was not retested,1 case was relocated,and 1 case withdrew without reason).The feasibility and effectiveness of the pre-construction scheme were verified by evaluating the adverse events,exercise endurance,fatigue,exercise self-efficacy and quality of life of patients before discharge,1 month after discharge and 3 months after discharge.Results1.Through search and screening,21 articles were finally included,including 6guidelines,3 expert consensus,9 systematic reviews,and3 RCT,which summarized 11 aspects of implementation team and method,fatigue screening and assessment,intervention and exercise object,exercise evaluation,exercise prescription,exercise venue selection,exercise monitoring and safety,exercise cycle,exercise precautions,exercise risk control and health guidance,and formed 20 review indicators.After clinical baseline review and expert meeting,the exercise training regimen and intervention mode map of patients with inflammatory bowel disease fatigue were formed.2.The implementation of the exercise training program for patients with inflammatory bowel disease fatigue reduced the fatigue score from(114.36±2.07)before intervention to(91.15±1.81)(P<0.001),exercise endurance increased from(304.67±5.54)before intervention to(350.76±7.27)(P<0.001),and exercise self-efficacy increased from(39.39±3.40)before intervention to(74.36± 2.07)(P<0.05),and the quality of life increased from(192.60±3.75)before intervention to(207.89±3.51)(P<0.001).Conclusion1.This study based on the best evidence to summarize the exercise training program for patients with inflammatory bowel disease fatigue,and the multidisciplinary team implementation plan can provide some guidance for the clinical nursing practice of inflammatory bowel disease in gastroenterology.2.The exercise training program designed in this study has a clear process,and the exercise prescription follows the principles of exercise frequency,exercise intensity,exercise time and exercise type(FIIT),which has good safety and feasibility.3.The exercise training program of inflammatory bowel disease is scientific,feasible and simple to operate,which can help patients with inflammatory bowel disease enhance their exercise tolerance,improve exercise efficiency,improve the degree of fatigue of patients,and then improve the quality of life of patients.