Physical fitness in children and adolescents with inflammatory bowel disease: protocol for a case-control study

Jérémy Vanhelst, Laurent Beghin, Stéphanie Coopman, Julien Labreuche, Djamal Djeddi, Frédéric Gottrand, Dominique Turck, Delphine Ley, Jérémy Vanhelst, Laurent Beghin, Stéphanie Coopman, Julien Labreuche, Djamal Djeddi, Frédéric Gottrand, Dominique Turck, Delphine Ley

Abstract

Introduction: Inflammatory bowel disease (IBD) is a chronic disorder of the gastrointestinal tract, associated with adverse health consequences that may adversely influence physical activity and body composition in youth. These effects may lead to changes in physical fitness, which is positively associated with health-related outcomes. The aim is to assess health-related physical fitness levels in paediatric patients with IBD and to compare these levels with those in healthy matched controls.

Methods and analysis: This trial is a bicentric case-control study. Fifty paediatric patients with IBD and 50 matched healthy controls will be recruited (1:1), and physical fitness levels (cardiorespiratory fitness, muscular strength, speed/agility and flexibility) will be assessed. The primary outcome is cardiorespiratory fitness, which will be compared between children and adolescents with IBD and healthy controls matched for age, sex and body mass index class. We will assess whether the two groups differ with respect to other physical fitness components and cardiovascular risk in adulthood according to sex-specific cut-offs for a healthy cardiorespiratory fitness level in adolescents. We will identify relationships between physical fitness and characteristics of IBD, quality of life and daily physical activity.

Ethics and dissemination: This study was approved by the Research Ethics Committee (Comité de Protection des Personnes, Centre-Ouest I, Tours, France; No 2019-A02651-56) and was declared to the Commission Nationale de l'Informatique et des Libertés. All procedures will be performed according to the ethical standards of the 1975 Declaration of Helsinki, as revised in 2008, and the European Union's Guidelines for Good Clinical Practice. Written informed consent will be obtained from the youths and their parents. Research findings will be disseminated in peer-reviewed journals and scientific meetings, as well as in social media and IBD family support groups.

Trial registration number: NCT04647578.

Keywords: Inflammatory bowel disease; Paediatric gastroenterology; SPORTS MEDICINE.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

References

    1. Loddo I, Romano C. Inflammatory bowel disease: genetics, epigenetics, and pathogenesis. Front Immunol 2015;6:551. 10.3389/fimmu.2015.00551
    1. SC N, Shi HY, Hamidi N. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet 2018;390:2769–78.
    1. Ghione S, Sarter H, Fumery M, et al. . Dramatic Increase in Incidence of Ulcerative Colitis and Crohn’s Disease (1988–2011): A Population-Based Study of French Adolescents. Am J Gastroenterol 2018;113:265–72. 10.1038/ajg.2017.228
    1. Conrad MA, Rosh JR. Pediatric inflammatory bowel disease. Pediatr Clin North Am 2017;64:577–91. 10.1016/j.pcl.2017.01.005
    1. Balestrieri P, Ribolsi M, Guarino MPL, et al. . Nutritional aspects in inflammatory bowel diseases. Nutrients 2020;12:372. 10.3390/nu12020372
    1. Schüle S, Rossel Jean‐Benoît, Frey D, et al. . Prediction of low bone mineral density in patients with inflammatory bowel diseases. United European Gastroenterol. j. 2016;4:669–76. 10.1177/2050640616658224
    1. Pirinen T, Kolho K-L, Simola P, et al. . Parent and self-report of sleep-problems and daytime tiredness among adolescents with inflammatory bowel disease and their population-based controls. Sleep 2010;33:1487–93. 10.1093/sleep/33.11.1487
    1. Sawczenko A, Sandhu BK. Presenting features of inflammatory bowel disease in Great britain and ireland. Arch Dis Child 2003;88:995–1000. 10.1136/adc.88.11.995
    1. Narula N, Fedorak RN. Exercise and inflammatory bowel disease. Can J Gastroenterol 2008;22:497–504. 10.1155/2008/785953
    1. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985;100:126–31.
    1. Ortega FB, Ruiz JR, Castillo MJ, et al. . Physical fitness in childhood and adolescence: a powerful marker of health. Int J Obes 2008;32:1–11. 10.1038/sj.ijo.0803774
    1. Carnethon MR, et al. . Cardiorespiratory fitness in young adulthood and the development of cardiovascular disease risk factors. JAMA 2003;290:3092–100. 10.1001/jama.290.23.3092
    1. Gulati M, Pandey DK, Arnsdorf MF. Exercise capacity and the risk of death in women: the ST James women take heart project. Circulation 2003;108:1554–9.
    1. Kurl S, Laukkanen JA, Rauramaa R, et al. . Cardiorespiratory fitness and the risk for stroke in men. Arch Intern Med 2003;163:1682–8. 10.1001/archinte.163.14.1682
    1. Metter EJ, Talbot LA, Schrager M, et al. . Skeletal muscle strength as a predictor of all-cause mortality in healthy men. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2002;57:B359–65. 10.1093/gerona/57.10.B359
    1. Myers J, Prakash M, Froelicher V, et al. . Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 2002;346:793–801. 10.1056/NEJMoa011858
    1. García-Hermoso A, Ramírez-Campillo R, Izquierdo M. Is muscular fitness associated with future health benefits in children and adolescents? A systematic review and meta-analysis of longitudinal studies. Sports Med 2019;49:1079–94. 10.1007/s40279-019-01098-6
    1. Smith JJ, Eather N, Morgan PJ, et al. . The health benefits of muscular fitness for children and adolescents: a systematic review and meta-analysis. Sports Med 2014;44:1209–23. 10.1007/s40279-014-0196-4
    1. Högström G, Nordström A, Nordström P. Aerobic fitness in late adolescence and the risk of early death: a prospective cohort study of 1.3 million Swedish men. Int J Epidemiol 2016;45:1159–68. 10.1093/ije/dyv321
    1. Ortega FB, Silventoinen K, Tynelius P, et al. . Muscular strength in male adolescents and premature death: cohort study of one million participants. BMJ 2012;345:e7279. 10.1136/bmj.e7279
    1. Melinder C, Hiyoshi A, Hussein O, et al. . Physical fitness in adolescence and subsequent inflammatory bowel disease risk. Clin Transl Gastroenterol 2015;6:e121. 10.1038/ctg.2015.49
    1. Vogelaar L, van den Berg-Emons R, Bussmann H, et al. . Physical fitness and physical activity in fatigued and non-fatigued inflammatory bowel disease patients. Scand J Gastroenterol 2015;50:1357–67. 10.3109/00365521.2015.1046135
    1. Rendo-Urteaga T, de Moraes ACF, Collese TS, et al. . The combined effect of physical activity and sedentary behaviors on a clustered cardio-metabolic risk score: the Helena study. Int J Cardiol 2015;186:186–95. 10.1016/j.ijcard.2015.03.176
    1. Steele RM, Brage S, Corder K, et al. . Physical activity, cardiorespiratory fitness, and the metabolic syndrome in youth. J Appl Physiol 2008;105:342–51. 10.1152/japplphysiol.00072.2008
    1. Bourdier P, Saidi O, Rochette E, et al. . Physical activity and sedentary levels in children with juvenile idiopathic arthritis and inflammatory bowel disease. A systematic review and meta-analysis. Pediatr Res 2019;86:149–56. 10.1038/s41390-019-0409-5
    1. Turner D, Otley AR, Mack D, et al. . Development, validation, and evaluation of a pediatric ulcerative colitis activity index: a prospective multicenter study. Gastroenterology 2007;133:423–32. 10.1053/j.gastro.2007.05.029
    1. Hyams JS, Ferry GD, Mandel FS, et al. . Development and validation of a pediatric Crohnʼs disease activity index. J Pediatr Gastroenterol Nutr 1991;12:439–47. 10.1097/00005176-199105000-00005
    1. Ortega FB, Artero EG, Ruiz JR, et al. . Reliability of health-related physical fitness tests in European adolescents. The Helena study. Int J Obes 2008;32:S49–57. 10.1038/ijo.2008.183
    1. Léger LA, Mercier D, Gadoury C, et al. . The multistage 20 metre shuttle run test for aerobic fitness. J Sports Sci 1988;6:93–101. 10.1080/02640418808729800
    1. Ruiz JR, España-Romero V, Ortega FB, et al. . Hand span influences optimal grip span in male and female teenagers. J Hand Surg Am 2006;31:1367–72. 10.1016/j.jhsa.2006.06.014
    1. Vanhelst J, Vidal F, Drumez E, et al. . Comparison and validation of accelerometer wear time and non-wear time algorithms for assessing physical activity levels in children and adolescents. BMC Med Res Methodol 2019;19:72. 10.1186/s12874-019-0712-1
    1. Migueles JH, Cadenas-Sanchez C, Ekelund U, et al. . Accelerometer data collection and processing criteria to assess physical activity and other outcomes: a systematic review and practical considerations. Sports Med 2017;47:1821–45. 10.1007/s40279-017-0716-0
    1. Fairclough SJ, Noonan R, Rowlands AV, et al. . Wear compliance and activity in children wearing Wrist- and Hip-Mounted Accelerometers. Med Sci Sports Exerc 2016;48:245–53. 10.1249/MSS.0000000000000771
    1. van Hees VT, Gorzelniak L, Dean León EC, et al. . Separating movement and gravity components in an acceleration signal and implications for the assessment of human daily physical activity. PLoS One 2013;8:e61691. 10.1371/journal.pone.0061691
    1. Rich C, Geraci M, Griffiths L, et al. . Quality control methods in accelerometer data processing: defining minimum wear time. PLoS One 2013;8:e67206. 10.1371/journal.pone.0067206
    1. Chandler JL, Brazendale K, Beets MW, et al. . Classification of physical activity intensities using a wrist-worn accelerometer in 8-12-year-old children. Pediatr Obes 2016;11:120–7. 10.1111/ijpo.12033
    1. Cole TJ, Lobstein T. Extended International (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes 2012;7:284–94. 10.1111/j.2047-6310.2012.00064.x
    1. Slaughter MH, Lohman TG, Boileau RA. Skinfold equations for estimation of body fatness in children and youth. Hum Biol 1988;60:709–23.
    1. Lai J-S, Cella D, Kupst MJ, et al. . Measuring fatigue for children with cancer: development and validation of the pediatric functional assessment of chronic illness Therapy-Fatigue (pedsFACIT-F). J Pediatr Hematol Oncol 2007;29:471–9. 10.1097/MPH.0b013e318095057a
    1. Ruiz JR, Huybrechts I, Cuenca-García M, et al. . Cardiorespiratory fitness and ideal cardiovascular health in European adolescents. Heart 2015;101:766–73. 10.1136/heartjnl-2014-306750
    1. Vanhelst J, Béghin L, Salleron J, et al. . A favorable built environment is associated with better physical fitness in European adolescents. Prev Med 2013;57:844–9. 10.1016/j.ypmed.2013.09.015
    1. Welk GJ, Laurson KR, Eisenmann JC, et al. . Development of youth aerobic-capacity standards using receiver operating characteristic curves. Am J Prev Med 2011;41:S111–6. 10.1016/j.amepre.2011.07.007

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する