Journal Article

O16 Combined impact and resistance training in adults with stable Crohn’s Disease: PROTECT randomised controlled trial

Thompson, Nick P, Baker, Katherine, Jones, Katherine, Speight, Richard A, Tew, Garry

2021

Overview

IntroductionReduced bone mineral density (BMD) and muscle dysfunction are complications of Crohn’s Disease (CD). This study evaluates the effect of exercise on BMD and muscular function in adults with CD.MethodsThis was a randomised, parallel-group and assessor-blind trial (Trial registration: ISRCTRN11470370). Adults (>16 years) in clinical remission or with a mildly active CD (Crohn’s Disease Activity Index <220; Faecal Calprotectin <250 mcg/g) were recruited from The Newcastle Upon Tyne Hospitals NHS Foundation Trust, UK. Eligible patients were randomly allocated (1:1) to receive either a 60-minute, thrice-weekly, 6-month progressive impact and resistance training programme with usual care or usual care only, stratified by gender and disease activity using a computer based programme . Primary outcomes were BMD, (lumbar spine (L2-L4), femoral neck, greater trochanter) and muscle function parameters at 6 months in the intention-to-treat population, with analyses adjusted for baseline values, gender and disease status.ResultsBetween February 2018 and March 2019, 76 patients were assessed for eligibility, of whom 47 patients were recruited and randomised (68% female; mean age 49.3 [SD 13.0] years) to the exercise intervention (n= 23) or control (n=24). 6-month follow up data were recorded for 43 (91%) of 47 participants. At 6 months, BMD values were superior in the exercise group at the lumbar spine (adjusted mean difference 0.036 g/cm2, 95% CI 0.024 to 0.048; p<0.001) and femoral neck (0.018 g/cm2, 0.001 to 0.035; p=0.039), but not at the greater trochanter (0.013 g/cm2, -0.019 to 0.045; p=0.415). Muscular function parameters were also superior in the exercise group: grip strength (8.3 kg, 6.2 to 10.5; p <0.001), 30-seconds bicep curl test (7 reps, 5 to 8; p<0.001), 30-seconds chair stand test (4 reps, 3 to 6; p<0.001), isokinetic knee extension strength at angular velocities of 60°/s and 180°/s and isokinetic elbow flexion strength at angular velocities of 60°/s and 120°/s (all p<0.001). Three exercise-related adverse events were recorded: light-headedness (n=2) and nausea (n=1).ConclusionsProgressive impact and resistance training is a safe and effective method to enhance BMD and muscular function in adults with CD and should be considered as a therapeutic option for the preservation of bone and muscle parameters. Due to the small sample size, further larger-scale studies are warranted.

• Publisher: BMJ Publishing Group LTD
• Subject: Adverse events / Bone mineral density / Crohn's disease / Elbow / Femur / Gender / Nausea / Patients / Physical training / Remission / Spine (lumbar) / Strength training / Trochanter