Clinical Scenario: Inflammatory Bowel Disease (IBD) can present several challenges to athletic participation due to unpredictable disease activity and uncontrollable systemic symptoms that severely impact daily activities, and limit exercise/sports participation. Limited studies and a lack of standardized guidelines for physical activity (PA) and exercise are additional barriers for patients. Limited sources have determined that exercise interventions of low-to-moderate intensity are safe and feasible for IBD patients. In theory, such interventions could promote improvements in exercise capacity and overall well-being. Focused Clinical Question: Is there evidence to suggest that established safe exercise-intensities promote improvements in exercise capacity in collegiate athletes (18-24 years of age) with IBD? Clinical Bottom Line: Aerobic exercise, resistance training, and combined exercise promotes improvements in cardiorespiratory fitness, muscle function, and body composition changes in the general IBD patient population. For patients with mild disease activity, low-impact aerobic exercises at 60-80% maximum HR and resistance exercises with no added resistance or resistance bands appear to be more suitable.38-39,43-45 For patients with inactive disease, aerobic exercises at 5-7/10 RPE or 65-80% maximum HR that involve activities with slightly more impact and resistance exercises with weight machines at up to ≥70% 1RM may be utilized.40-41,46 The exercise interventions reflect lower intensities than what collegiate athletes would be accustomed to, limiting the applicability of these findings specifically for collegiate athletes with IBD. However, there may be underlying practical implications for athletic trainers to use these exercise thresholds for gradually returning athletes to sport specific activities following resolution of disease activity. Strength of Recommendation: According to the Oxford Centre of Evidence-Based Medicine, there is variable evidence (ranging from level 4 to level 2 evidence) that suggests low-to-moderate aerobic and resistance exercise to be feasible and effective in promoting improvements in exercise capacity in IBD patients.
Appendix A Revisions
CAT JSMAHS Format Revisions with Changes in Red.docx (56 kB)
CAT Revisions with Visible Changes in Red
Roberts, Emily C.; Toonstra, Jenny; and Cripps, Andrea
"Establishing Safe Thresholds to Improve Exercise Capacity in Collegiate Athletes with Inflammatory Bowel Disease (IBD): A Critically Appraised Topic,"
Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association: Vol. 8:
3, Article 1.
Available at: https://scholarworks.bgsu.edu/jsmahs/vol8/iss3/1