P0833Effects of a 16-Week Integrated Exercise Program on Gut Microbiota, Inflammatory Markers, and Multi-Systemic Functions in Patients with Quiescent Inflammatory Bowel Disease: A Randomized Controlled Trial

Background In patients with inflammatory bowel disease (IBD) in remission, persistent subclinical inflammation, gut dysbiosis and compromised physical and psychological health are associated. Current management often lacks integrated approaches that simultaneously address these multifaceted issues. The efficacy of structured exercise programs, particularly integrating Chinese approaches, remains underexplored in this population. Methods This RCT recruited 72 adults in remission from IBD. Participants were allocated to one of two groups: an intervention group (IG, n = 35) who received a 16-week moderate-intensity integrated exercise programme (including aerobic exercise and resistance training based on the traditional Chinese Ba Duan Jin exercises) alongside biologic therapy; or a control group (CG, n = 37) who continued with biologic therapy alone. IG was monitored via wearable devices and routine follow-up. Outcomes included disease activity (SES-CDAI/modified Mayo), gut microbiota (alpha diversity, beta diversity, specific microbial groups), inflammatory and metabolic indicators (CRP, IL-6, TNF-α, Irisin, Adiponectin), patient-reported outcomes (FACIT-F, GAD-7, PHQ-9, IBDQ), body composition (BMI, BFP, ASM and liver CAP), patient-reported outcomes (FACIT-F, GAD-7, PHQ-9, IBDQ), physical fitness (strength, cardiorespiratory endurance, balance), and adherence. Results Compared to the CG, the IG demonstrated significant improvements: reduced disease activity scores (CD: p = 0.015; UC: p = 0.038), gut microbial α diversity showed a significant increase (p<0.05), with a more pronounced effect observed in CD patients (p<0.05). Regarding β diversity, the microbial community structure evolved significantly over time, accompanied by the enrichment of numerous beneficial bacterial communities. Favorable shifts in inflammatory markers (e.g., decreased IL-6, TNF-α; p < 0.01) and adipokines (e.g., increased irisin, adiponectin; p < 0.05), increased ASM (e.g., left upper limb: p = 0.004), decreased BFP (p<0.001) and liver CAP (p<0.001), and reduced fatigue (FACIT-F; p<0.01), anxiety (GAD-7; p<0.001), and depression (PHQ-9; p<0.001). IBDQ total and subscale scores significantly improved (p<0.001). Physical fitness measures (grip strength, knee strength, Y-Balance, ST index) also increased significantly (p<0.01). Compliance was fully maintained (attendance rate: 97.3%; target heart rate achievement rate: 95.0%). Conclusion A 16-week, moderate-intensity, integrated exercise programme significantly improves gut microbiota, clinical inflammation and physical and mental health outcomes in IBD patients in remission. Excellent adherence is facilitated by wearable monitoring and patient education. This approach is a valuable addition to comprehensive IBD management. Conflict of interest: Prof. An, Ping: No conflict of interest Wang, Lvming: No conflict of interest Li, Zuying: No conflict of interest Tang, Zhishun: No conflict of interest