P363 Moderate endurance and muscle training are safe to perform for patients with quiescent or mild active Crohn’s disease and increases their strength

W.A. Seeger1,2, J. Thieringer1, P. Esters1, B. Allmendinger1, H. Schulze1, A. Dignass1

1Department of Medicine I, Agaplesion Markus Hospital, Goethe-University, Frankfurt, Germany, 2Department of Gastroenterology, Infectious Diseases, Rheumatology, Charité -Universitätsmedizin, Berlin, Germany

Background

The aim of this study was to examine the practicability and potential influence of moderate endurance and muscle training in patients with quiescent or mildly active Crohn’s disease (CD).

Methods

In this randomised controlled pilot trial 45 CD Patients with a CDAI below 220 were randomised to a control, an endurance or a muscle training group. Participants had to exercise individually for 3 months three times per week. Outcome parameters included disease activity (CDAI), inflammatory parameters and calprotectin, anthropometric data, general well-being (sIBDQ), physical activity (IPAQ), cardiorespiratory fitness as well as strength in the upper and lower extremities.

Results

Forty-five patients were randomised into an endurance (17), muscle (15) and control (13) group, respectively. In the endurance group, the dropout rate was 47% (8) vs. 13% (2) in the muscle group and 0 in the control group. Only one patient discontinued the study due to CD specific symptoms. One patient had to stop the study due to another concomitant disease. One patient in each intervention group was lost to follow-up. The most frequent reason for termination was lack of time and motivation: 37.5% (3) in the endurance group vs. 50% (1) in the muscle group. In both groups, the maximal and average force in the upper and lower extremity increased significantly (all p < 0.04). A statistically significant improvement of the quality of life could only be seen in the endurance group in the subclass ‘mood’ of the sIBDQ (p = 0.03). CDAI decreased in the muscle group in contrast to both other groups, statistical significance, however, was not reached.

Conclusion

This study shows that both endurance and muscle training can be safely performed in patients with mild-to-moderate CD. Muscle training seems to be more feasible for this patient group. Both forms of exercise have beneficial effects on strength and presumably on comorbidities, e.g. bone mineral density and thromboembolic complications. Further research in a larger population and also patients with higher disease activity is needed to examine the effects of moderate exercise on disease activity and immunological changes in CD patients.