抗阻训练对改善帕金森病患者下肢肌力及平衡功能的效果

目的研究抗阻训练对帕金森病(PD)患者下肢肌力及平衡功能的影响。方法将64例PD患者随机分为实验组和对照组各32例。两组患者均接受神经内科常规药物及健康指导,实验组在此基础上进行12 w的抗阻训练。采用下肢等速肌力测试系统、10次坐-立体位试验(STS10)、姿势稳定极限性测试(LOS)和Berg平衡量表(BBS)比较两组训练前后的效果。结果训练前两组患者双下肢髋关节伸肌群、膝关节伸肌群和小腿踝关节背屈肌群的肌力,STS10、LOS和BBS得分均差异无统计学意义(P>0. 05)。12 w抗阻训练后,实验组患者双下肢髋关节伸肌群、膝关节伸肌群和小腿踝关节背屈肌群的肌力,LOS及BBS得分与对照组相比,差异有统计学意义(P<0. 05);实验组训练前后差异有统计学意义(P<0. 05),对照组差异无统计学意义(P>0. 05)。训练后两组患者STS10测试时间比较差异无统计学意义(P>0. 05)。结论抗阻训练可以改善PD患者下肢肌力,对提高患者姿势稳定及平衡能力有积极的效果。     

电针穴位刺激对膝骨性关节炎患者的疗效观察

目的探讨电针穴位刺激对轻中度膝关节骨性关节炎的治疗效果,为今后膝关节骨性关节炎保守治疗提供一定的临床基础。方法选取2019年1月至2020年1月来自国家体育总局运动医学研究所体育医院运动创伤骨科和康复科的轻中度膝关节骨性关节炎患者,随机分为对照组(常规康复训练)和试验组(电针穴位刺激加常规康复训练),2个月后行Lequesne评分和等速肌力测试,比较两组治疗效果。结果治疗2个月后,两组Lequesne评分无统计学差异(P>0.05);等速肌力测试中,两组相对峰力矩(60°/s和240°/s)和耐力比较,电针穴位刺激加常规康复训练组均较单纯行康复治疗组效果好,治疗后60°/s的伸屈肌群PT/TW:试验组屈肌(1.33±0.21),伸肌(2.55±0.41);240°/s伸屈肌群PT/TW:试验组屈肌(0.96±0.11),伸肌(1.41±0.41);伸屈肌群耐力(ER):试验组屈肌(0.77±0.09),伸肌(0.82±0.11),与对照组相比存在统计学差异(P<0.01)。结论电针穴位刺激联合康复训练能够很好地恢复膝关节功能,并能恢复膝关节肌肉力量,是一种针对轻中度骨性关节炎有效的治疗方式。     

八段锦训练防治肌肉衰减征的临床研究

目的 观察八段锦防治肌肉衰减征的临床疗效.方法 募集社区无严重疾病及合并症的老年志愿者22例,女性19例,男性3例,对比观察八段锦训练前和训练1年后的握力、膝关节等速肌力、6 min步行以及下肢肌力和耐力的变化.结果 与训练前比八段锦训练1年后,握力无明显变化.CS-30测试“起-坐”动作频次增加[(23.86 ±4.62)次vs(19.95±4.28)次,P=0.001];左膝关节伸肌群峰力矩[(76.28±21.13)NM vs (48.09±15.79) NM,P＜0.001]、左膝关节屈肌群峰力矩[(37.30± 13.57) NM vs(22.86±11.99) NM,P＜0.001]、右膝关节伸肌群峰力矩[(78.10±21.73)NM vs(45.48±16.91) NM,P＜0.001]、右膝关节屈肌群峰力矩[(37.60±13.86)NM vs(23.29±11.57) NM,P＜0.001]均增强.观察过程中无不良事件发生.结论 八段锦训练能增强下肢肌力并延缓上肢肌力的衰退,可以用于国人肌肉衰减征的预防和治疗.     

城市中老年女性踝关节力量的年龄变化特征

目的 探讨城市中老年女性踝关节力量的衰退特征.方法 实验于2005年3～5月在上海体育学院体质测试中心完成测试.150名受试者按年龄分为3组:40～49岁组、50～59岁组、60～69岁组,每组50名.所有受试者在Contrex肌力测试系统上进行踝关节60°/s的等速肌力测试.观察运动女性踝关节肌力的衰退特征.结果 受试者的踝关节屈肌最大力矩/kg、屈肌最大功率/kg与年龄呈显著负相关(r=-0.449,-0.451,P=0.002);踝关节伸肌最大力矩/屈肌最大力矩与年龄呈正相关(r=0.516,P=0.00).结论 在50～59岁期间,踝关节屈肌力量随年龄增大而迅速衰退,在60～69岁期间衰退趋于平缓;在60～69岁期间,踝关节伸、屈肌衰退明显不平衡,屈肌快于伸肌.     

8w振动训练对老年女性下肢关节肌力和耐力的影响

目的探讨振动训练对老年女性下肢关节肌力和耐力的影响。方法采用美国Power-Plate振动仪对14例60~65岁老年女性,进行8 w,每周3次,20 min/次(频率35~40 Hz,振幅2 mm)的振动训练,并在振动干预前后使用德国Iso Med 2000仪器对受试者的膝、踝关节进行等速肌力测试。结果 1受试者膝和踝关节屈、伸峰力矩增幅分别为15.4%(P=0.040)、16.15%(P=0.030)和22.83%(P=0.002)、16.94%(P=0.042);2膝和踝关节屈、伸肌群肌肉耐力增幅分别为11.90%(P=0.265)、21.43%(P=0.006)和13.79%(P=0.045)、20.75%(P=0.030)。结论8 w的高频振动训练增强了老年女性膝、踝关节屈、伸肌群的力量和耐力,减小了跌倒的风险,说明振动训练对预防老年女性跌倒有积极的效果。     

老年人脑白质结构的扩散张量成像研究

目的应用扩散张量成像（diffusion tensor imaging，DTI）阐明老年人脑白质结构平均弥散系数（ADCavg）和部分各向异性（FA）的变化。方法老年组及非老年组各30例。所有受检者均进行神经科查体和简易智能精神状态量表（MMSE）测试，无影响神经系统的疾病。所有受检者均行DTI检查，选择额叶白质、顶叶白质、半卵圆中心、胼胝体膝部、胼胝体压部为兴趣区，定量测量ADCavg与FA值。结果ADCavg、FA值男、女性别差异无统计学意义（P〉0．05），左右半球无明显改变。随着年龄增长，ADCavg值与年龄呈正相关，FA值与年龄呈负相关。在额叶白质（ADCavg：r=0．449，P〈0．05；FA：r=0．350，P〈0．05）、半卵圆中心（ADCavg：r=0．347，P〈0．05；FA：r=0．409，P〈0．05）、胼胝体膝部（ADCavg：r=0．452，P〈0．01；FA：r=0．556，P〈0．01）、压部（ADCavg：r=0．296，P〉0．05；FA：r=0．289，P〉0．05）、顶叶白质（ADCavg：r=0．367，P〈0．05；FA：r=0．287，P〉0．05）。老年组额叶白质、胼胝体膝部、半卵圆中心的ADCavg、FA值与简易智能精神状态量表（MMSE）相关，尤其是额叶白质的FA值相关更显著（r=0．466，P〈0．01）。结论与年龄相关的定量DTI分析，可有助于评价与年龄相关的变化。并且可建立一个与神经变性疾病比较对照的标准。DTI功能与结构的结合，表明老年人认知功能的衰退与白质微结构密切相关。     

坐位低频全身振动训练对老年下肢残疾者肌肉力量及行走能力的影响

目的探讨坐位低频全身振动训练(WBVT)对老年下肢残疾者肌肉力量及行走能力的影响。方法募集上海市杨浦区殷行街道自愿报名的老年下肢残疾者20例(因外伤致残,残疾等级为42~44),其中男性9例,女性11例,年龄(66.6±4.8)岁,所有受试者接受每周3 d共计8周的WBVT,比较训练前后受试者膝关节屈、伸肌肌力、6分钟步行测试(6 MWT)、10米行走测试(10 MWT)和计时起立-行走(TUG)测试结果。应用SPSS 22.0统计软件对数据进行分析,训练前后比较采用配对t检验。结果所有受试者皆顺利完成振动训练及测量,无缺失及不适、不安全情况发生。受试者WBVT训练后相比训练前膝关节屈肌肌力[(39.36±16.09)vs(37.37±16.12)Nm]、伸肌肌力[(58.18±21.31)vs(56.49±21.69)Nm]增高,TUG[(7.73±2.17)vs(9.70±2.22)s]和10 MWT[(7.51±2.26)vs(7.86±2.30)s]水平降低,6 MWT[(438.74±125.10)vs(401.99±114.08)m]水平升高,差异具有统计学意义(P0.05)。结论 8周坐位低频WBVT可明显提高老年下肢残疾者膝关节屈、伸肌肌力,显著改善行走平衡能力和提高速度。     

脉压指数与原发性高血压左心室功能的相关性研究

目的探讨脉压指数（PPI）与原发性高血压患者左心室功能损害程度的关系。方法178例经外周肱动脉压力测定收缩压（sBP）、舒张压（DBP）,以PPI〉0．40、PPI≤0．40分组,两组进行分析。比较两组左心形态、左心室收缩功能和舒张功能情况。结果PPI〉0．40组左心房内径明显增大[PPI〉0．40、PPI≤0．40的LAD分别为（35．02±3．15）mm、（28．05±2．01）mm,P〈0．05];左心室内径无明显改变（P〉0．05）;室间隔、左心室后壁明显增厚,E／A值降低（P〈0．05）,而左心室射血分数差异无统计学意义（P〉0．05）。结论原发性高血压患者左心室舒张功能异常出现早于左心室收缩功能异常,PPI〉0．40提示高血压患者早期合并有舒张功能异常。     

乙型肝炎肝硬化腹水患者心脏血流动力学临床观察

目的研究乙型肝炎（乙肝）肝硬化腹水患者心脏血流动力学变化,探讨心脏血流动力学参数在肝硬化腹水中的临床意义。方法以27例乙肝肝硬化腹水患者为研究对象,将20例慢性乙肝患者设为对照组,采用无创血流动力检测仪测定心脏血流动力学参数。结果肝硬化腹水组的心率明显高于对照组（P〈0．05）;平均动脉压、每搏出量、每搏指数、全身血管阻力、全身血管阻力指数、左心作功和左心作功指数显著降低（P〈0．05）;心输出量和心脏指数较对照组无明显变化（P〉0．05）。结论心脏血流动力学参数可用于判断乙肝肝硬化腹水患者的心脏泵功能,为评价预后提供参考因素。     

早期康复治疗脑卒中后肌肉痉挛疗效观察

目的探讨早期康复治疗脑卒中后肌肉痉挛临床疗效。方法将脑卒中后128例患者分为康复组（66例）和对照组（62例）,对康复组、对照组治疗前和治疗3个月后的肌痉挛程度（Ashworth）和肢体运动功能（FMA）分别进行评价。结果康复组肌肉痉挛发生率为34．9％明显低于对照组（74．2％,P〈0．05）,两组肢体运动功能评分、肌肉痉挛程度评分治疗前无统计学意义（P〉0．05）,治疗后康复组优于对照组（P〈0．01）。结论早期康复治疗能明显降低肌肉痉挛的发生率,提高肢体的运动功能。     

Is hand-held dynamometry useful for the measurement of quadriceps strength in older people? A comparison with the gold standard Bodex dynamometry

BACKGROUND: The lower limb muscle strength is an important determinant of physical function in older people. However, measurement in clinical and epidemiological settings has been limited because of the requirement for large-scale equipment. A protocol using a novel, versatile hand-held dynamometer (HHD) has been developed to measure the quadriceps strength in a supine position. OBJECTIVE: The objective of this study was to assess the validity of this new methodology for measuring the lower limb muscle strength compared to the gold standard Biodex dynamometer. METHODS: The supine quadriceps strength was measured twice with each of the Biodex and the HHD in 20 men and women, aged 61-81 years, on their non-dominant leg. The agreement between the peak torques obtained by Biodex and HHD was analyzed. RESULTS: The mean peak Biodex and HHD results were 83.4 +/- (SD) 28.0 Nm and 68.9 +/- 19.6 Nm, respectively. The HHD undermeasured the quadriceps strength by an average of 14.5 Nm (95% CI 8.5, 20.6) compared to the Biodex, and this effect was most marked in the strongest participants. Nevertheless, there was a good correlation between the measures (r = 0.91, p < 0.0001). Classification of individuals into tertiles of muscle strength showed good agreement between the two methods (Kappa = 0.69, p < 0.0001). CONCLUSIONS: Our findings suggest that the HHD using a supine positioning offers a feasible, inexpensive, and portable test of quadriceps muscle strength for use in healthy older people. It underestimates the absolute quadriceps strength compared to the Biodex particularly in stronger people, but is a useful tool for ranking muscle strength of older people in epidemiological studies. It may also be of value for quick and objective assessment of physical function in the clinical setting.     

An investigation of the association between grip strength and hip and knee joint moments in older adults

Grip strength is a predictor of health outcomes but with differing rates of age-related decline in muscle strength, it is unclear whether handgrip is a reliable indicator of lower limb moments. This study investigated the relationship between grip strength and lower extremity moments in community-dwelling older adults. Eighty-two healthy volunteers aged 60-82 years (mean age 73.2 years) performed maximal voluntary contractions of knee and hip extensors and flexors at three positions and at neutral position for hip abductors and adductors using a custom-built dynamometer. Grip strength was measured using an electronic Jamar dynamometer. The relative reduction in muscle strength of 80s age category compared to 60-year-olds ranged from 14% for grip strength to 27% for hip abductors. Peak torque of flexors and extensors of the knee and hip joints were significantly correlated with grip strength and Pearson's correlation coefficients ranged from 0.56 to 0.78 with the highest correlations observed between knee moments and grip strength. "Good" correlation was found but only 31-60% of the variation in grip strength could be related to changes in joint torques. Hence the assumption that grip strength is an indicator of strength in the lower limb would seem unjustified in the healthy older adult.     

Reliability of a single-session isokinetic and isometric strength measurement protocol in older men

BACKGROUND: The purposes of the current study were (a) to determine the test-retest reliability of a single-session isokinetic and isometric strength testing protocol in older healthy men, and (b) to compare the outcomes of the reliability measures derived from averaged torque scores with those derived from a single peak torque score. METHODS: In 19 men (mean age, 72 +/- 5 years), both lower limbs were assessed independently on 2 separate test days using the Biodex System 3 dynamometer. After completing a 5-minute warm-up, each man performed three submaximal knee extensions followed by five maximal contractions at 90 degrees /s (CON), 0 degrees /s (ISO), and -90 degrees /s (ECC). Average (best 3 of 5) and peak CON, ISO, and ECC torque, and CON work and CON power were determined. Peak CON work and CON power were recorded from the highest peak torque concentric contraction (HPTCC). RESULTS: Intraclass correlation coefficients ranging from 0.84 to 0.94 were found to have good reliability. The typical error as a coefficient of variation ranged from 8% to 10% for averaged measures and from 8% to 17% for peak torque and HPTCC. The ratio limits of agreement for average and peak CON, ISO, and ECC torque ranged from 23% to 33% and from 40% to 54% for average CON and HPTCC work and power. CONCLUSIONS: The test-retest reliability of a single-session isokinetic and isometric strength testing protocol in this group of older healthy men displayed good relative reliability (intraclass correlation coefficient > 0.84); however, because the typical error as a coefficient of variation and ratio limits of agreement (absolute reliability) were large, single-session testing is not recommended.     

MUSCLE STRENGTH IN HEALTHY PEOPLE AND IN PATIENTS SUFFRING FROM RECENT-ONSET INFLAMMATORY ARTHRIRIS

Neuromuscular function was compared among 20 patients with relativelyrecent onset (symptomatic period 17 ± 24 months) rheumatoidarthritis (RA) (experimental group; EG), and 20 age- and sex-matchedhealthy people (control group; CG).The comparison was repeatedafter a period of 6 months, when 16 patients had carried outprogressive strength training. At baseline maximal grip strengthand maximal dynamic unilateral strength of the knee extensorsin the EG were significantly (P < 0.05) lower in comparisonto the CG. The groups did not differ from each other in maximalisometric strength of the trunk flexors and extensors or theknee extensors. The 6-month dynamic strength training in theEG resulted in significant increases in maximal dynamic strengthof the knee extensors (P < 0.001), in isometric grip strength(P < 0.001) and in isometric strength of the trunk flexors(P < 0.05) and extensors (P < 0.05) to the level of thehealthy controls. Only minor changes took place in explosivestrength and maximal isometric strength of the knee extensors.Erythrocyte sedimentation rate (P < 0.001), Ritchie's articularindex (P < 0.01) and modified health assessment questionnaire(P < 0.01) improved significantly during the training period.The results suggest that inflammatory arthritis decreases dynamicand/or isometric muscle strength in selected muscle groups ofthe body already in the early stages of disease. However, progressivedynamic strength training rapidly increases the neuromuscularperformance capacity of the patients even to the level of healthypeople without detrimental effects on disease activity. KEY WORDS: Recent-onset inflammatory arthritis, Muscle strength, Neuromuscular function, Strength training, Disease activity, Healthy people     

Skeletal muscle contractile characteristics and fatigue resistance in patients with chronic heart failure

Whole muscle contractile characteristics and fatigue resistancewere studied in male patients with chronic heart failure (n=6)and in healthy control subjects (n=6). Maximum voluntary isometricstrength in the major muscle groups of leg (plantar flexorsand knee extensors) and arm (elbow extensors and elbow flexors),was found to be similar for both groups of subjects. However,a faster isometric twitch time course was observed in the plantarflexor and knee extensor muscles of heart failure chronic patients.The poor resistance to fatigue in the knee extensors of chronicheart failure patients was confirmed in the present study, butusing twitch interpolation this was shown not to be due to pooractivation. The plantar flexors of chronic heart failure patientsalso showed a tendency to be less resistance to fatigue, evenwhen the muscle was activated by direst electrical stimulation. The present study shows that independent of muscle strength,patients with chronic heart failure may possess muscles thatare faster to contract and less resistant to fatigue. However,it seems this increased fatigability is not due to poor muscleactivation.     

The unreliability of clinical measures of muscle tone: implications for stroke therapy

BACKGROUND: the central tenet of the neurofacilitatory approach to stroke therapy is that muscle tone needs to be normal before normal movement can occur. A reliable clinical measure of the full spectrum of muscle tone is needed to test: (i) the purported relationship between muscle tone, other motor impairments and disability, and (ii) the effectiveness of stroke therapy to restore movement. AIM: the purpose of the study was to test the inter-rater reliability of clinical categorization of muscle tone (spastic/normal/flaccid) and also a visual analogue scale with anchor points of 'lowest tone possible' (score 0) and 'highest tone possible' (score 100). METHODS: four independent raters assessed tone of elbow flexors and knee extensors of 14 stroke rehabilitation inpatients using the categorical scale. Six independent raters assessed tone of elbow flexors and knee extensors of 25 chronic stroke patients and two healthy volunteers using the visual analogue scale. All assessment orders were randomized. RESULTS: both scales were unreliable, with K coefficients for the categorical scale ranging from -0.046 to 0.56 for the categorical scale, and intra-class correlation coefficients for the visual analogue scale of 0.595 for elbow flexors and 0.451 for knee extensors. Assessment order effects for the visual analogue scale were non-significant for elbow flexors (P= 0.545) and knee extensors (P= 0.911). CONCLUSIONS: these results, and those of earlier studies, suggest that clinical measures of muscle tone are consistently unreliable. Systematic investigation of the therapy rationale for planning and evaluating treatment is required before relevant clinical measures can be developed.     

The relationship between lower body strength and obstructed gait in community-dwelling older adults

OBJECTIVES: To determine the relationship between lower body strength of community-dwelling older adults and the time to negotiate obstructed gait tasks. DESIGN: A correlational study. SETTING: The Biomechanics Laboratory, Deakin University, Australia. PARTICIPANTS: Twenty-nine women and 16 men aged 62 to 88 were recruited using advertisements placed in local newspapers. The participants were independent community dwellers, healthy and functionally mobile. MEASUREMENTS: Maximal isometric strength of the knee extensors and dynamic strength of the hip extensors, hip flexors, hip adductors, hip abductors, knee extensors, knee flexors, and ankle plantar flexors were assessed. The times to negotiate four obstructed gait tasks at three progressively challenging levels on an obstacle course and to complete the course were recorded. The relationship between strength and the crossing times was explored using linear regression models. RESULTS: Significant associations between the seven strength measures and the times to negotiate each gait task and to walk the entire course at each level were obtained (r = -0.38 to -0.55; P < .05). In addition, the percentage of the variance explained by strength (R(2)), consistently increased as a function of the progressively challenging level. This increase was particularly marked for the stepping over task (R(2) = 19.3%, 25.0%, and 27.2%, for levels 1, 2, and 3, respectively) and the raised surface condition (R2 = 17.1%, 21.1%, and 30.8%, for levels 1, 2, and 3, respectively). CONCLUSION: The findings of the study showed that strength is a critical requirement for obstructed locomotion. That the magnitude of the association increased as a function of the challenging levels suggests that intervention programs aimed at improving strength would potentially be effective in helping community-dwelling older adults negotiate environmental gait challenges.     

Effects of long-term resistive training on mobility and strength in older adults with diabetes

BACKGROUND: Strength training has been shown to be beneficial in older adults. However, very little data exist on the effects of strength training in older diabetics. METHODS: 31 community-dwelling older adults with diabetes (mean age = 66.1 years) were randomly assigned to either an exercise (EX) or control (CO) group. The EX group trained the plantar flexors, knee extensors, knee flexors, hip extensors, and hip flexors muscle groups at 50%, 60%, and 70% of 1-repetition maximum, 2.6 days a week, for 24 months. Mobility tests included the timed up and go, 50-foot walk, and walking up and down 8 stairs. Strength and mobility for both groups were evaluated at 6-month intervals. RESULTS: There was a group and time effect as the EX group increased 31.4% (p <.001) in strength for all muscle groups after the first 6 months of training, and the strength gains were retained for the duration of the training intervention. There was also a group and time effect for mobility as performance increased 8.6% and 9.8% (p =.032 and p = 0.031) for the first 6 and 12 months, respectively, but decreased to 4.6% above baseline at the end of the intervention. There were essentially no changes from baseline strength or mobility values for the CO group. CONCLUSION: In conclusion, these data suggest that a moderate-intensity resistive-training program can improve mobility and strength for the duration of a 24-month intervention in older adults with diabetes, thus potentially reducing the rate of mobility loss during aging.     

臂踝脉搏波速度测量的重复性研究

目的评价臂踝脉搏波速度测量的可靠性。方法由两名测量者对23名心血管疾病高危患者和7名健康受试者进行臂踝脉搏波速度的测量。测量分为两阶段，中间间隔2周，每一阶段在同一天上午（8：30～11：00）和下午（13：30～16：00）分别进行测量。结果重复测量方差分析显示，测量者间和测量者内（不同时间）臂踝脉搏波速度无显著性差异。心血管疾病高危患者测量者间和测量者内臂踝脉搏波速度的Pearson相关系数为0．925～0．992（P〈0.01），组内相关系数为0．924-0．992（P〈0．01）；健康受试者测量者间和测量者内臂踝脉搏波速度的Pearson相关系数为0．674-0．974（P〈0．05），组内相关系数为0．672-0．973（P〈0．05）。Bland-Altman图显示，测量者间和测量者内臂踝脉搏波速度有较好的一致性。结论在规范的测量条件下，测量者间和测量者内的臂踝脉搏波速度的重复性好。     

Physical fitness and physical activity in fatigued and non-fatigued inflammatory bowel disease patients

Abstract

Objective. To assess physical fitness and physical activity in inflammatory bowel disease (IBD) patients and whether fatigue is associated with impaired physical fitness and impaired physical activity. Materials and methods. Ten patients with quiescent IBD and fatigue (fatigue group [FG]) based on the Checklist Individual Strength-Fatigue score of ≥35 were matched for age (±5 years) and sex with a non-fatigue group (NFG) with IBD. Physical fitness was measured with a cyclo-ergometric-based maximal exercise test, a submaximal 6-min walk test, and a dynamometer test to quantify the isokinetic muscle strength of the knee extensors and flexors. Level of physical activity was measured with an accelerometer-based activity monitor. Results. The patients in both groups did not differ in regard to medication use, clinical characteristics, and body composition. However, medium-to-large effect sizes for impaired physical fitness (both cardiorespiratory fitness and muscle strength) and physical activity were seen between the patients in the FG and the NFG. Especially, intensity of physical activity was significantly lower in the FG patients compared with the NFG patients (effect size: 1.02; p = 0.037). Similar results were seen when outcomes of the FG and NFG were compared with reference values of the normal population. Conclusion. Fatigued IBD patients show an impaired physical fitness and physical activity compared with non-fatigued IBD patients. This gives directions for a physical component in fatigue in IBD patients. Therefore, these new insights into fatigue indicate that these patients might benefit from an exercise program to improve physical fitness and physical activity.