A COMPARISON OF EXERCISE MEASURES AMONG ADULTS WITH INFLAMMATORY BOWEL DISEASE

Abstract Background Individuals with IBD, comprised of Crohn’s disease (CD) and Ulcerative Colitis (UC), often have ongoing gastrointestinal symptoms that limit their ability to exercise. Importantly, exercise can help to maintain remission in individuals with IBD. Other positive health outcomes of exercise include improvement in quality of life, social and psychological well-being, weight maintenance, bone health, fatigue management and maintaining muscle mass and function. Unfortunately, many of the tools used to measure exercise are burdensome for clinical utility or are not applicable to the IBD population. The purpose of this secondary analysis was to determine if one question related to physical activity would capture exercise in adults with either UC or CD and those with active or inactive disease. Methods This study is a cross-sectional study using the data obtained from IBD Partners, an internet-based longitudinal cohort of adults ≥ 18 year of age living with IBD. This secondary analysis includes only those participants without a current ostomy or pouch, who completed demographic information, disease activity and exercise characteristics. Disease activity was measured via the simple clinical colitis activity index (SCCAI) for UC and the short Crohn’s disease activity index (sCDAI) for CD. Exercise was measured via the Godin Leisure -Time Activity Index (GLTA) questionnaire that assessed type of exercise and intensity for the past seven days. A separate measurement of physical activity included a single question: “How often did you participate in 1 or more physical activities of 20–30 minutes’ duration per session during your leisure time within the past 6 months?” measured via a 6-point ordered category item. Results A total of 8327 patients with IBD were included. Most (63%) of the participants had CD, and 54% were in remission. Majority of the participants were physically active based on GLTA scores (49.7%), and one question physical activity scores (62%; combined scores of 5 & 6). Polychoric correlation coefficient was computed, with a strong correlation between GLTA and the one question (r = 0.74, p < 0.001). Ordinal regression analysis between the one physical activity question and IBD type (UC vs CD) yielded higher odds of physical activity with UC (Odds ratio (OR)=1.2, 95% CI [1.11 -1.31], p < 0.0001). Similar results were noted with ordinal regression analysis between GLTA scores and UC;(OR=1.2, 95% CI [1.09 -1.3], p < 0.0001). Conclusions Both GLTA and the single question of physical activity were highly correlated. The ordinal regression results were comparable for both measures. Adoption of the single physical activity question may adequately reflect exercise status in IBD patients and reduce burden for clinical use. Further longitudinal studies are need to support the use of one question in measuring exercise in those with IBD.