Background
Inflammatory bowel disease (IBD) has a substantial impact on quality of life (QoL). This can further be affected by modifiable psychosocial and lifestyle factors, like physical activity (PA). We aimed to determine whether PA levels were associated with patient and disease characteristics, fatigue and QoL in IBD outpatients.

Methods
PA was assessed by the Short QUestionnaire to ASsess Health-enhancing physical activity. Exercising with moderate intensity during minimal 30 minutes for at least five days per week was considered an adequate PA level according to the Dutch Standards for Healthy Physical Activity. Fatigue was measured with SFQ and QoL was determined by the SF-36. Data were analyzed by student’s t-test or X²-test.

Results
Of the 200 patients (139 CD, 61 UC), 53.3% were female, and 21.5% were active smoker. Mean disease duration was 11.4 [SD 9.9] years, and 28.6% had an exacerbation at inclusion. The Dutch Standards for Healthy Physical Activity were not met by 41.7%. CD patients (53.2%) were less likely to have adequate PA levels compared to UC (70.0%) (p=0.028). There were no other significant differences in patient and disease characteristics stratified by adequate PA level (i.e. sex, active smoking, age at inclusion, BMI, fat-free mass index, disease duration, Montreal classification, previous bowel resection, and disease activity). However, patients not meeting PA standards were significantly more tired compared to patients meeting the standards (mean 17.4 [SD 7.0] vs. 13.5 [SD 7.2], p=0.015), and had lower physical and mental component scores (PCS: mean 43.5 [SD 9.7] vs. 46.0 [SD 8.5]; MCS: mean 46.2 [SD 11.3] vs. 52.3 [SD 9.5]) for QoL, reaching significance for SF-36 MCS (p=0.012).

Conclusion
IBD outpatients with low PA levels showed significantly higher fatigue and lower QoL scores. More research is necessary to identify contributing factors to further improve patients’ well-being by holistic management.