Physical Activity and Sedentary Behaviour in Patients With Inflammatory Bowel Disease - Epidemiology and Interventions

Brief Summary

Detailed Description

Although existing literature indicates potential health benefits of physical activity and exercise in patients with IBD, there is little consistency in the proposed interventions for promoting physical activity, and large variations in the applied physical activity intensities and types in the existing physical activity intervention studies. Patients with IBD experience barriers to engaging in physical activity that are related to both stigmatization and disease symptoms. These are barriers that might be overcome if the physical intervention is focusing on variation in physical activity intensity and is tailored to the individual patient. The investigators' hypothesis is that an individually tailored, behavioural intervention focusing on physical activity in a 24-hour perspective, including sedentary behaviour and physical activity from light to vigorous intensity, is feasible and effective in patients with IBD. The present feasibility study aims to test the behavioural intervention for feasibility and acceptability in a small sample (N=30) of patients with IBD from the gastroenterology outpatient clinic at Bispebjerg Hospital, Copenhagen, Denmark. By conducting a feasibility study with a small sample size, the investigators want to follow the course and applicability of an intervention that has been developed as an individual offer with possibilities and solutions for the individual patient, but still operated within a controlled and standardized research frame. Assessment of feasibility will include identification of barriers for recruitment, acceptance of group/randomization status, delivery methods, retention, outcome assessments and logistics. Outcome measures that will be tested for feasibility include objectively measured physical activity levels (over a 7-day period), health-related quality of life, fatigue, pain, mental health and cardio-metabolic biomarkers. The intervention will address the individual patient's knowledge, motivation, resources and opportunities for reducing sedentary behaviour and increasing daily physical activity and exercise in the individual's everyday life. The 20-week intervention will consist of a basic part for all participants, which will include 1. A group session with education about IBD in general and about physical activity and exercise in relation to IBD (definitions, evidence and recommendations). Following this session, the participants will also be offered access to a video with general information about IBD, physical activity and exercise 2. Four individual motivational counselling sessions (two physical and two telephone sessions) with a project nurse. The counselling sessions will involve identifying the individual's motivation and opportunities for increasing physical activity, behavioral goal setting and action planning. An optional intervention part will then follow, where the individual participant will have the possibility of choosing between (or all of) 1. A one-hour individual session with a physiotherapist from Bispebjerg/Frederiksberg Hospitals, which will involve guidance in physical activity and exercise tailored to the individual participant. This could be the case if a participant experiences specific symptoms or limitations when engaging in physical activity and/or exercise and needs individual guidance related to this. 2. Being teamed up with 1-2 'exercise buddies' (other participants from the overall intervention group). 3. Access to 4 short 2-3 minutes videos/'reels' of a physiotherapist explaining and demonstrating beneficial physical exercises. The videos aim to provide participants with new inspiration and practical suggestions to increase their physical activity and exercise. The main setting of the intervention will be the participants' everyday lives (family, work/school, leisure-time activities). However, the Gastroenterology Department, Bispebjerg Hospital, and potentially, local municipal health centres and sports clubs will be the actual physical places for the specific intervention elements (e.g. education, counselling sessions, physiotherapist-led sessions, exercising in small communities ('exercise buddies'). Participants randomized to the control group will be encouraged to maintain their usual lifestyle and activities. They will be expected to undergo the same baseline - and outcome assessment as the participants in the intervention group. Results from the present feasibility study will determine if and how to proceed with a large-scale randomized controlled trial evaluating the efficacy of the intervention.

Primary Outcomes

Secondary Outcomes

• Exercise self-efficacy measured by the Exercise Self-Efficacy Scale(Assessed at baseline and at 5 months (20 weeks))
• Fatigue measured by The Multi-dimensional Fatigue Inventory (MFI-20)(Assessed at baseline and at 5 months (20 weeks))
• Disease activity measured by a C-Reactive Protein (CRP) test(Assessed at baseline and at 5 months (20 weeks))
• Waist-hip-ratio(Assessed at baseline and at 5 months (20 weeks))
• Self-reported physical activity and sitting time measured by the Physical Activity Scale (PAS)(Assessed at baseline and at 5 months (20 weeks))
• Fatigue measured by the visual analogue scale for fatigue (VAS-Fatigue)(Assessed at baseline and at 5 months (20 weeks))
• Waist circumference measured in centimeters(Assessed at baseline and at 5 months (20 weeks))
• Mental health measured by The Hospital Anxiety and Depression Scale (HADS) questionnaire(Assessed at baseline and at 5 months (20 weeks))
• Body weight in kilograms(Assessed at baseline and at 5 months (20 weeks))
• Hip circumference measured in centimeters(Assessed at baseline and at 5 months (20 weeks))
• Objectively measured physical activity measured by SENS monitor(Assessed at baseline and at 5 months (20 weeks))
• IBD-related disease activity measured by fecal calprotectin(Assessed at baseline and at 5 months (20 weeks))
• Glycosylated hemoglobin (HbA1c) measured by blood sample(Assessed at baseline and at 5 months (20 weeks))
• Health-related quality of life measured by the Inflammatory Bowel Disease Questionnaire (IBDQ)(Assessed at baseline and at 5 months (20 weeks))
• Pain intensity measured by the visual analogue scale for pain (VAS-Pain)(Assessed at baseline and at 5 months (20 weeks))
• Serum lipids measured by blood sample(Assessed at baseline and at 5 months (20 weeks))
• Blood pressure measurements(Assessed at baseline and at 5 months (20 weeks))
• Body mass Index (BMI)(Assessed at baseline and at 5 months (20 weeks))