炎症性肠病患者运动管理的最佳证据总结

Summary of the best evidence for exercise management in patients with inflammatory bowel disease

目的系统检索、遴选、综合炎症性肠病(inflammatory bowel disease,IBD)患者运动管理的相关证据。方法系统检索国内外数据库、指南网和相关专业学会网站中关于IBD患者运动管理的所有证据,文献类型包括专题证据汇总、临床指南、证据总结、系统评价及专家共识。检索时限为建库至2023年3月21日。由4名经过循证培训的研究者完成文献质量评价,2名研究者根据主题、运动处方原则提取证据,康复医学运动处方师核查相关证据,并通过2轮专家论证会进行证据整合。结果最终纳入文献15篇,包括专题证据汇总1篇,指南2篇、系统评价8篇及专家共识4篇。汇总了涵盖多学科管理、运动前评估、知情同意、运动原则、运动处方、运动指导和支持、运动监督等7个维度25条证据。结论本研究综合了IBD患者运动管理的最佳证据,旨在辅助临床决策。医疗机构应组建多学科IBD团队,以患者为中心,基于证据权衡不同类型运动训练收益与风险,制定最适宜IBD患者的运动方案,并采取多元促进策略提高患者运动依从性,以改善患者预后。

Objective To systematically search,select,and synthesize relevant evidence on exercise management in patients with inflammatory bowel disease(IBD).Methods All the evidence on exercise management in IBD patients were systematically searched in the domestic and foreign databases,guideline websites,and websites of relevant professional societies,including thematic evidence collection,clinical guidelines,evidence summary,systematic evaluation,and expert consensus.The search period was from inception of the database to 21 March 2023.The literature quality evaluation was completed by 4 researchers with evidence-based training,and the evidence was extracted by 2 researchers according to the theme and exercise prescription principles,and the relevant evidence was examined by the rehabilitation medicine exercise prescriber,and the evidence was integrated through 2 rounds of expert argumentation.Results A total of 15 articles were included,including 1 thematic evidence summary,2 guidelines,8 systematic reviews,and 4 expert consensuses.A total of 25 pieces of evidence were collected from 7 dimensions,including multidisciplinary management,pre-exercise assessment,informed consent,exercise principles,exercise prescription,exercise guidance and support,and exercise supervision.Conclusion The best evidence on exercise management in IBD patients is synthesized in this study so as to aid clinical decision-making.Medical institutions should set up a multidisciplinary IBD team,patient-centered,weigh the benefits and risks of different types of exercise training based on evidence,formulate the most suitable exercise plan for IBD patients,and adopt multiple promotion strategies to improve patients'exercise compliance to improve patient prognosis.