Skip to main content

Advertisement

SpringerLink
Log in

Lifestyle im Management chronisch-entzündlicher Darmerkrankungen – Teil 2: Sport

Lifestyle in the management of inflammatory bowel disease—part 2: physical activity

  • Schwerpunkt
  • Published:
Die Gastroenterologie Aims and scope

Zusammenfassung

Hintergrund

Einen wichtigen Einflussfaktor für die weltweit zunehmende Prävalenz von chronisch-entzündlichen Darmerkrankungen (CED) stellt neben ernährungsrelevanten Faktoren auch die verminderte körperliche Aktivität dar, die zu einem Rückgang der Muskelmasse, zu einer Zunahme der Fettmasse und Verschlechterung des Herz-Kreislauf-Systems führen kann. Dies kann das Risiko für eine CED erhöhen und/oder sich ungünstig auf den Krankheitsverlauf auswirken.

Ziel der Arbeit/Fragestellung

Ziel dieses Beitrags ist es, die Vorgehensweise und die Aspekte zu erläutern, die beim Einsatz von Sport- und Bewegungstherapie zur Behandlung von Patienten mit CED zu berücksichtigen sind.

Material und Methoden

Neben der Erfassung der intestinalen und extraintestinalen Manifestationen, der entzündlichen Aktivität und der Ernährungssituation ist die körperliche Konstitution der Patient*innen mit CED für die Sport- und Bewegungstherapie von großer Bedeutung. Obwohl der positive Einfluss von Sport und Bewegung festgestellt wurde, gibt es keine spezifischen Leitlinien für die Dosierung und die Vorgehensweise. Daher werden im Folgenden Empfehlungen auf der Grundlage von Studienergebnissen als Leitfaden für Bewegungsinterventionen bei Patienten mit CED gegeben.

Ergebnisse und Diskussion

Eine an den Erkrankungszustand angepasste Sport- und Bewegungstherapie kann die Lebensqualität des Patienten verbessern und den Krankheitsverlauf positiv beeinflussen. Durch die Kombination aus Ausdauer- und Krafttraining kann es zur Verbesserung der Körperzusammensetzung und der körperlichen Leistungsfähigkeit kommen. Angesichts der Heterogenität der Patient*innen sind die sport- und bewegungstherapeutischen Interventionen individuell anzupassen.

Abstract

Background

The prevalence of inflammatory bowel disease (IBD) is increasing worldwide. Besides nutritional factors, reduced physical activity is also recognized as a significant influencing factor, leading to a reduction in muscle mass and an increase in fat reserves and a deterioration of the cardiovascular system. These factors can increase the risk of developing IBD and/or have an adverse impact on disease progression.

Aim

The goal of this paper is to explain the approach and aspects to be considered when using exercise and physical activity in the treatment of IBD.

Materials and methods

In addition to the intestinal and extraintestinal findings and the inflammatory activity, the physical constitution of patients with IBD is of tremendous importance for treatment that includes exercise and physical activity. Although the positive influence of exercise and physical activity on patients with IBD is a proven fact, there are no specific guidelines regarding the extent and type exercise and physical activity. Therefore, recommendations based on study results are given as guidelines for exercise interventions in patients with IBD.

Results and conclusion

Exercise and physical activity adapted to the disease state can positively influence the patient’s quality of life and the course of the disease. The combination of endurance and strength training can improve body composition and physical performance. In view of the heterogeneity of patients, however, physical exercise interventions must also be individualized.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Adriani A, Ribaldone DG, Astegiano M et al (2018) Irritable bowel syndrome: the clinical approach. Panminerva Med 60:213–222

    Article  PubMed  Google Scholar 

  2. Anonymous DGSP • Deutsche Gesellschaft für Sportmedizin und Prävention e. V. – Trainingsempfehlungen mit dem Rezept für Bewegung. https://www.dgsp.de/seite/389565/efsma-trainingsempfehlungen.html

  3. WHO (2020) WHO guidelines approved by the guidelines review committee. In: WHO guidelines on physical activity and sedentary behaviour. World Health Organization, Geneva

    Google Scholar 

  4. Bhagavathula AS, Clark CCT, Rahmani J et al (2021) Impact of body mass index on the development of inflammatory bowel disease: a systematic review and dose-response analysis of 15.6 million participants. Healthcare 9. https://doi.org/10.3390/healthcare9010035

  5. Bischoff SC, Bager P, Escher J et al (2023) ESPEN guideline on Clinical Nutrition in inflammatory bowel disease. Clin Nutr 42:352–379

    Article  PubMed  Google Scholar 

  6. Bryant RV, Trott MJ, Bartholomeusz FD et al (2013) Systematic review: body composition in adults with inflammatory bowel disease. Aliment Pharmacol Ther 38:213–225

    Article  CAS  PubMed  Google Scholar 

  7. Clarke SF, Murphy EF, O’sullivan O et al (2014) Exercise and associated dietary extremes impact on gut microbial diversity. Gut 63:1913–1920

    Article  CAS  PubMed  Google Scholar 

  8. Conraads VM, Pattyn N, De Maeyer C et al (2015) Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: The SAINTEX-CAD study. Int J Cardiol 179:203–210

    Article  PubMed  Google Scholar 

  9. Costa RJS, Snipe RMJ, Kitic CM et al (2017) Systematic review: exercise-induced gastrointestinal syndrome-implications for health and intestinal disease. Aliment Pharmacol Ther 46:246–265

    Article  CAS  PubMed  Google Scholar 

  10. Cronin O, Barton W, Moran C et al (2019) Moderate-intensity aerobic and resistance exercise is safe and favorably influences body composition in patients with quiescent Inflammatory Bowel Disease: a randomized controlled cross-over trial. BMC Gastroenterol 19. https://doi.org/10.1186/s12876-019-0952-x

  11. Das DK, Graham ZA, Cardozo CP (2020) Myokines in skeletal muscle physiology and metabolism: recent advances and future perspectives. Acta Physiol 228:e13367–e13367

    Article  CAS  Google Scholar 

  12. De Oliveira EP, Burini RC, Jeukendrup A (2014) Gastrointestinal complaints during exercise: prevalence, etiology, and nutritional recommendations. Sports Med 44(Suppl 1). https://doi.org/10.1007/S40279-014-0153-2

  13. De Souza Tajiri GJ, De Castro CLN, Zaltman C (2014) Progressive resistance training improves muscle strength in women with inflammatory bowel disease and quadriceps weakness. J Crohns Colitis 8:1749–1750

    Article  PubMed  Google Scholar 

  14. Deutsche Morbus Crohn/Colitis ulcerosa Vereinigung. https://www.dccv.de/betroffene-angehoerige/leben-mit-einer-ced/sport/sportuebungen-fuer-anfaenger. Zugegriffen: 05.06.2023

  15. Dewi RC, Rimawati N, Purbodjati P (2021) Body mass index, physical activity, and physical fitness of adolescence. J Public Health Res 10:2230–2230

    Article  PubMed  PubMed Central  Google Scholar 

  16. Eckert KG, Abbasi-Neureither I, Köppel M et al (2019) Structured physical activity interventions as a complementary therapy for patients with inflammatory bowel disease—a scoping review and practical implications. BMC Gastroenterol 19. https://doi.org/10.1186/S12876-019-1034-9

  17. Jones PD, Kappelman MD, Martin CF et al (2015) Exercise decreases risk of future active disease in inflammatory bowel disease patients in remission. Inflamm Bowel Dis 21:1063–1063

    Article  PubMed  Google Scholar 

  18. Kaur S, D’silva A, Rajagopalan V et al (2022) Evaluation of an integrated yoga program in patients with inflammatory bowel disease: a pilot study. Explore 18:335–341

    Article  PubMed  Google Scholar 

  19. Klare P, Nigg J, Nold J et al (2015) The impact of a ten-week physical exercise program on health-related quality of life in patients with inflammatory bowel disease: a prospective randomized controlled trial. Digestion 91:239–247

    Article  CAS  PubMed  Google Scholar 

  20. Liu S, Ding X, Maggiore G et al (2022) Sarcopenia is associated with poor clinical outcomes in patients with inflammatory bowel disease: a prospective cohort study. Ann Transl Med 10:367

    Article  PubMed  PubMed Central  Google Scholar 

  21. Monda V, Villano I, Messina A et al (2017) Exercise modifies the gut microbiota with positive health effects. Oxid Med Cell Longev. https://doi.org/10.1155/2017/3831972

  22. Ng V, Millard W, Lebrun C et al (2007) Low-intensity exercise improves quality of life in patients with Crohn’s disease. Clin J Sport Med 17:384–388

    Article  PubMed  Google Scholar 

  23. Nguyen NH, Ohno-Machado L, Sandborn WJ et al (2019) Obesity is independently associated with higher annual burden and costs of hospitalization in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol 17:709–718.e7

    Article  PubMed  Google Scholar 

  24. Pedersen BK, Febbraio MA (2008) Muscle as an endocrine organ: focus on muscle-derived interleukin‑6. Physiol Rev 88:1379–1406

    Article  CAS  PubMed  Google Scholar 

  25. Pérez CA (2009) Prescription of physical exercise in Crohn’s disease. J Crohns Colitis 3:225–231

    Article  PubMed  Google Scholar 

  26. Physical Activity Guidelines Advisory C (2018) 2018 physical activity guidelines advisory committee scientific report

    Google Scholar 

  27. Ploeger H, Obeid J, Nguyen T et al (2012) Exercise and inflammation in pediatric Crohn’s disease. Int J Sports Med 33:671–679

    Article  CAS  PubMed  Google Scholar 

  28. Robinson RJ, Krzywicki T, Almond L et al (1998) Effect of a low-impact exercise program on bone mineral density in Crohn’s disease: a randomized controlled trial. Gastroenterology 115:36–41

    Article  CAS  PubMed  Google Scholar 

  29. Rozich JJ, Holmer A, Singh S (2020) Effect of lifestyle factors on outcomes in patients with inflammatory bowel diseases. Am J Gastroenterol 115:832–840

    Article  PubMed  PubMed Central  Google Scholar 

  30. Sadeghian M, Sadeghi O, Keshteli AH et al (2018) Physical activity in relation to irritable bowel syndrome among Iranian adults. PLoS ONE 13:e205806–e205806

    Article  PubMed  PubMed Central  Google Scholar 

  31. Sainsbury A, Heatley RV (2005) Review article: psychosocial factors in the quality of life of patients with inflammatory bowel disease. Aliment Pharmacol Ther 21:499–508

    Article  CAS  PubMed  Google Scholar 

  32. Sakamoto A, Sinclair PJ, Moritani T (2012) Muscle activations under varying lifting speeds and intensities during bench press. Eur J Appl Physiol 112:1015–1025

    Article  PubMed  Google Scholar 

  33. Seeger WA, Thieringer J, Esters P et al (2020) Moderate endurance and muscle training is beneficial and safe in patients with quiescent or mildly active Crohn’s disease. United Eur Gastroenterol J 8:804–804

    Article  Google Scholar 

  34. Sharif K, Watad A, Bragazzi NL et al (2018) Physical activity and autoimmune diseases: get moving and manage the disease. Autoimmun Rev 17:53–72

    Article  CAS  PubMed  Google Scholar 

  35. Shephard RJ (2016) The case for increased physical activity in chronic inflammatory bowel disease: a brief review. Int J Sports Med 37:505–515

    Article  CAS  PubMed  Google Scholar 

  36. Sigurdsson GV, Schmidt S, Mellström D et al (2021) Physical exercise is associated with beneficial bone mineral density and body composition in young adults with childhood-onset inflammatory bowel disease. Scand J Gastroenterol 56:699–707

    Article  CAS  PubMed  Google Scholar 

  37. Such U (2010) Die maximale Herzfrequenz. Dtsch Z Sportmed 61(12)

  38. Tew GA, Leighton D, Carpenter R et al (2019) High-intensity interval training and moderate-intensity continuous training in adults with Crohn’s disease: a pilot randomised controlled trial. BMC Gastroenterol 19. https://doi.org/10.1186/s12876-019-0936-x

  39. Ticinesi A, Lauretani F, Milani C et al (2017) Aging gut microbiota at the cross-road between nutrition, physical frailty, and Sarcopenia: is there a gut–muscle axis? Nutrients 9. https://doi.org/10.3390/nu9121303

  40. Van Erp LW, Roosenboom B, Komdeur P et al (2021) Improvement of fatigue and quality of life in patients with quiescent inflammatory bowel disease following a personalized exercise program. Dig Dis Sci 66:597–604

    Article  PubMed  Google Scholar 

  41. Zhang T, Ding C, Xie T et al (2017) Skeletal muscle depletion correlates with disease activity in ulcerative colitis and is reversed after colectomy. Clin Nutr 36:1586–1592

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hector-Center für Ernährung, Bewegung und Sport, Medizinische Klinik 1 – Gastroenterologie, Pneumologie und Endokrinologie, Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland

    Daniel Herz, Linda Weber, Joachim Hans Herrmann &  Yurdagül Zopf

Authors
  1. Daniel Herz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Linda Weber
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joachim Hans Herrmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yurdagül Zopf
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yurdagül Zopf.

Ethics declarations

Interessenkonflikt

D. Herz, L. Weber, J.H. Herrmann und Y. Zopf geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Redaktion

Jörg Bojunga, Frankfurt am Main

Mathias Plauth, Dessau-Roßlau

Christian Trautwein, Aachen

Hinweis

Den Beitrag Lifestyle im Management chronisch-entzündlicher Darmerkrankungen – Teil 1: Ernährung finden Sie in Ausgabe 4/2023 von Die Gastroenterologie oder online unter https://doi.org/10.1007/s11377-023-00704-4.

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Herz, D., Weber, L., Herrmann, J.H. et al. Lifestyle im Management chronisch-entzündlicher Darmerkrankungen – Teil 2: Sport. Gastroenterologie 18, 270–277 (2023). https://doi.org/10.1007/s11377-023-00705-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11377-023-00705-3

Schlüsselwörter

Keywords

Search

Navigation