Research from Northumbria University,
Newcastle, has shown the important role specific types of exercise can play in
the management of bone loss, fatigue and muscle dysfunction for those with
Crohn’s disease.
Crohn's
disease is a type of inflammatory bowel disease which is estimated to affect about one in every 650 people in the UK. It causes inflammation of parts of
the digestive system, which can lead to abdominal pain, severe diarrhoea,
fatigue, weight loss and malnutrition.
People
with Crohn’s are also more at risk of developing thinner and weaker bones –
osteoporosis – due to factors such as inflammation of the gut, low levels of
calcium and vitamin D, taking steroids or removal of parts of the small bowel. Reduced
muscle strength in comparison to the general population is also common.
Having
thinner or weaker bones can lead to them fracturing more easily. Likewise,
muscle dysfunction can cause physical disability and contributes to fatigue
which is a common symptom.
Until
now, scientific evidence of the effects of exercise on people with Crohn’s
disease has been sparse - studies have focused on modes of exercise which have proven
to be less effective in improving bone health, such as walking, cycling or
yoga.
In
this latest research, published in the medical journal Alimentary Pharmacology & Therapeutics online today, scientists investigated the effects of an impact and
resistance training programme on people with Crohn’s. They found that these
types of exercise led to meaningful improvements in participants’ bone and
muscle health, therefore decreasing their risk of sustaining a fracture.
Led by Dr
Garry Tew, Associate Professor of Exercise and Health Sciences and Katherine
Jones, PhD student from the Department of Sport, Exercise & Rehabilitation at Northumbria, the research is a collaboration with clinical colleagues from
Newcastle Hospitals NHS Foundation Trust.
Impact and resistance training on
trial
Previous
research in the general population has shown that exercise training comprising
a combination of impact activities, such as jumping, and high-intensity
resistance training can have beneficial effects on bone mass and strength. Meanwhile
resistance training has also been shown to improve muscle mass and function.
Working with
consultant gastroenterologists Dr Ally Speight and Dr Nick Thompson from the
Department of Gastroenterology at Newcastle Hospitals, the research team evaluated
whether this type of exercise training could reduce the future risk of
osteoporotic fractures and disability in adults with Crohn's disease.
In this novel
study, 47 patients with Crohn’s disease with an average age of 49 took part in
a six-month impact and resistance training programme. Participants were
encouraged to complete three, 60-minute exercise sessions on non-consecutive
days each week for 26 consecutive weeks.
Each session
involved a combination of impact exercises, such as rope skipping, broad jumps
and squat jumps, and high-effort resistance exercises including lunges,
press-ups and bicep curls using TheraBand® elastic bands.
After six
months, results demonstrated that the exercise programme had produced meaningful
improvements in a range of bone and muscle health outcomes. On average,
patients bone mineral density improved by 3.8% and 2.3% at the lumbar spine and
femoral neck, respectively.
Such
improvements are significant: recent research efforts indicated that a 2%
improvement in lumbar spine or femoral neck bone mineral density was associated
with a 28% reduction in vertebral fracture risk, and a 15-22% reduction in hip
fracture risk.
Dr Garry Tew
says: “Clinical guidelines on the management of inflammatory bowel disease
state that weight-bearing and resistive exercises should be promoted to help
prevent bone loss. However, specific exercise prescriptions are currently not
provided and the recommendation is based largely on research in the general
population.
“This study
provides novel and important data on the feasibility and efficacy of a specific
bone-loading and muscle-strengthening exercise programme in adults with Crohn's
disease. This may help guide clinical practice so that patients can be provided
with a specific exercise prescription that is supported by research evidence”
he added.
Dr Nick
Thompson said: “Muscle weakness and bone thinning are important consequences of
Crohn’s disease and can seriously impact on a patient’s quality of life through
fatigue and increased risk of a fracture. These exercise programmes look to empower patients to help improve muscle
and bone strength.”
