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 program 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, Ph.D. 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 &rRsistance 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 program. 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 program 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.
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