Physical Activity and Education in the Care of IBD: The Role of the Physiotherapist-A Narrative Review.

Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are chronic, immune-mediated conditions that significantly affect quality of life (QoL). The disease can cause extraintestinal manifestations, the most common of which is musculoskeletal involvement, which can lead to reduced physical activity (PA) and further impair QoL. In this narrative review, the literature was studied regarding the effects of PA types and patient education in IBD. There is growing evidence that regular PA and an active lifestyle have a positive impact on patients' QoL, reduce symptoms, and contribute to maintaining remission. Aerobic and resistance training programs, when properly dosed, have been shown to be safe, improve physical condition, and have an impact on psychological well-being, while not increasing disease activity. On the other hand, there is no consensus on the safety of high-intensity training, so individualized, gradual training programs are recommended. The lack of PA and low levels of PA among IBD patients are partly due to fatigue, fear of symptoms, and joint pain, which may be caused by a lack of adequate education. A multidisciplinary approach and the involvement of physiotherapists are often lacking. Available data show that structured, patient-centered education programs and personalized exercise therapies can help increase PA and improve QoL. Overall, regular PA should be an important therapeutic adjunct to IBD treatment, but further research is needed to investigate training programs of appropriate intensity and frequency that can be used safely, and we also recommend assessing the need for patient education.