EFFECTS OF MODERATE-INTENSITY WEIGHT TRAINING VS. HOME TRAINING ON QUALITY OF LIFE IN NON-ATHLETE MALE PATIENTS WITH IRRITABLE BOWEL SYNDROME

Abstract

Irritable bowel syndrome (IBS) is a common condition that affects many individuals worldwide and is diagnosed by various accompanying symptoms. Its treatment focuses on alleviating and reducing the severity of symptoms, with exercise being one of the suggested treatments. This study aims to determine the effect of moderate-intensity weight training (MIWT) and home training (HT) on quality of life in non-athletic males with IBS. The sample included 16 non-athletic Algerian males who were diagnosed with irritable bowel syndrome using the Rome Ш criteria. They were randomly divided into two groups: MIWT group (п = 8) and HT group (п = $). Each group practiced their training three times a week for 35-40 minutes per session over 8 weeks. The IBS Quality of Life Questionnaire (IBS-QOL) was used to collect data. Both t-test and two-way ANOVA were used for statistical analysis. Study results showed an improvement in quality of life in all domains of IBSQOL (total score; dysphoria; activity interference; body image; health anxiety; food avoidance; social reactivity; sexual; relationships) for both groups (p < .05). Only one interference with activity showed greater improvement in the MIWT group compared to the HT group (p<.05). Both MIWT and HT contribute to improved quality of life in non-athlete males with IBS, with a superiority of MIWT over HT in the variable interference with activity only. Therefore, researchers recommend using both methods to alleviate the symptoms of IBS.

Headnote

ABSTRACT

Irritable bowel syndrome (IBS) is a common condition that affects many individuals worldwide and is diagnosed by various accompanying symptoms. Its treatment focuses on alleviating and reducing the severity of symptoms, with exercise being one of the suggested treatments. This study aims to determine the effect of moderate-intensity weight training (MIWT) and home training (HT) on quality of life in non-athletic males with IBS.

The sample included 16 non-athletic Algerian males who were diagnosed with irritable bowel syndrome using the Rome Ш criteria. They were randomly divided into two groups: MIWT group (п = 8) and HT group (п = $). Each group practiced their training three times a week for 35-40 minutes per session over 8 weeks. The IBS Quality of Life Questionnaire (IBS-QOL) was used to collect data. Both t-test and two-way ANOVA were used for statistical analysis.

Study results showed an improvement in quality of life in all domains of IBSQOL (total score; dysphoria; activity interference; body image; health anxiety; food avoidance; social reactivity; sexual; relationships) for both groups (p < .05). Only one interference with activity showed greater improvement in the MIWT group compared to the HT group (p<.05).

Both MIWT and HT contribute to improved quality of life in non-athlete males with IBS, with a superiority of MIWT over HT in the variable interference with activity only. Therefore, researchers recommend using both methods to alleviate the symptoms of IBS.

Keywords: weight training, home training, irritable bowel syndrome, quality of life, individuals

INTRODUCTION

Physical activity and sports are important healthy behaviors for improving community public health, encompassing physical and psychological aspects (Dhuli et al., 2022). Many specialists and doctors today recommend turning exercise into a lifestyle. It is known that the lack of exercise and physical inactivity 1s one of the changes that have occurred in many societies today (PiSot, 2021). This includes an increase in office work at the expense of jobs that require physical effort on the one hand and an increase in modern means of transportation and their variety on the other hand. All these factors, among others, have contributed to the decrease in individuals" physical activity. This reduction in physical activity is accompanied by an irregular and hybrid diet, such as fast food and excessive consumption of soft drinks (Dhuli et al., 2022).

This decline in activity and poor diet have contributed, in one way or another, to the emergence of several diseases, such as excessive weight gain, diabetes, osteoporosis, premature aging, and diseases that affect the digestive system (Gonzalez et al., 2017). IBS is one of the most common digestive disorders today. It is a common chronic condition with unknown causes (El-Salhy, 2023). According to World Health Organization statistics, approximately 9% to 23% of the world's population suffers from some form of IBS symptoms (Arnaout et al., 2023).

The symptoms of IBS can be intermittent or continuous, including constipation, diarrhea, colon cramps, and spasms that cause emotional responses (Arnaout et al., 2023). Due to the lack of a clear cause, treatment often focuses on alleviating the individual's symptoms (Riezzo et al., 2023). IBS symptoms or Irritable Bowel Syndrome symptoms vary from person to person and may resemble other health conditions, making diagnosis difficult. Therefore, diagnosing IBS often involves excluding other conditions with similar symptoms. To assist in the diagnosis process, experts have developed two sets of criteria for diagnosing functional digestive disorders, such as the Rome criteria. This criterion is based on the symptoms experienced by the person after excluding the possibility of other conditions (Drossman, 2006).

Exercise is known to have a positive effect on health, as it affects the body in different ways (Dhuli et al., 2022). Physical activity often helps prevent different pathological disorders and conditions before they become severe, making them difficult to treat. Therefore, it can be said that physical exercise is beneficial in alleviating IBS symptoms. However, no specific data has been available linking physical exercise and IBS symptoms (Johannesson et al., 2011).

In recent years, Riezzo et al. (2023) have found an improvement in IBS symptoms following an aerobic exercise program, with bloating being the most common symptom, which decreased significantly. Psychological questionnaires and quality-of-life assessments indicated reduced levels of anxiety, depression, and stress. Ahmad and Thnaibat (2023), through their research on studies and databases (from 2018-2023), found that light and regularly practiced aerobic and anaerobic exercises play an effective role in alleviating IBS symptoms, improving bowel function, enhancing psychological well-being and quality of life.

Previous studies on IBS have shown that physical exercise, especially aerobic exercises, is an important means of alleviating symptoms and improving quality of life. However, researchers did not find studies comparing different types of exercises (MIWT and HT) on the quality of life of IBS patients. Therefore, this study aimed to determine the impact of weight and home training on the quality of life of non-athletic male IBS patients and identify Which method is better for this purpose.

METHODOLOGY

Participants

Sixteen non-athlete Algerian males who had been diagnosed with symptoms of irritable bowel syndrome by Rome III criteria voluntarily participated in this study. It was confirmed that all participants were free of other diseases. The participants' average age was 38.18 + 2.85, their weight was 79.93 + 3.74, their height was 177.37 = 1.92, and their BMI was 25.41 + 0.93. They were divided into two groups, represented by MIWT group (n=8) and HT group (n=8). Table 1 outlines the characteristics of each group. All participants were informed about the objectives of the study, its duration, and potential risks, and all gave written informed consent. This study followed the guidelines outlined in the Helsinki Declaration (World Medical Association, 2013).

Data collection

Data in this study were collected using various measurement tools. Anthropometric measurements were taken in a pharmacy, where weight, height, and BMI were measured using a Keito machine (Staal et al., 2004).

The Rome III criteria: This criterion was used to detect the patients of IBS in this study. It was introduced in 2006 and brought a significant change compared to Rome II by classifying IBS into subtypes based on stool consistency rather than frequency (Drossman, 2006). These subtypes include IBS-C (constipation), IBS-D (diarrhea), IBS-M (mixed), and IBS-U (unclassified). Bloating as a primary symptom was also removed from the definition, as it was considered too common to be a specific indicator of IBS (Lacy & Patel, 2017). Ford et al. (2013), involving IBS patients who underwent colonoscopy, reported a sensitivity of 68.8% and a specificity of 79.5% for the Rome III criteria.

The IBS-QOL questionnaire: It is a 34item questionnaire developed and validated by Patrick et al. (1998) to measure health-related quality of life in patients with non-subtyped IBS, meaning it is comprehensive and addresses the various ways in which IBS can affect individuals (Andrae et al., 2013). Masaeli et al. (2013) and Abedi et al. (2023) clarified that the IBS-QOL questionnaire is valid and reliable for assessing the quality of life in individuals with IBS. To analyze the results, the following indicators were taken: total score, dysphoria, interference with activity, body image, health worry, food avoidance, social reaction, and sexual relationships (Riezzo et al., 2023). The average score of each indicator (from 0 to 100) was also taken to analyze the results.

Design and procedures

This study employed a comparative intervention design to evaluate the effects of two different training methods on irritable bowel syndrome (IBS) symptoms in non-athlete males. The independent variable consisted of MIWT and HT methods, while the dependent variable was the quality of life of non-athlete males.

Initially, the Rome III criteria and the IBSQOL questionnaire were applied to a small pilot group of 5 individuals outside the main study sample. This preliminary step was taken to assess the tools" suitability and identify any potential obstacles to conducting the full study. By analyzing the pilot data, we were able to confirm the tools" reliability and validity for identifying individuals with IBS and assessing their baseline quality of life. After confirming their effectiveness, both the Rome III criteria and IBS-QOL questionnaire were administered to the actual study sample to identify individuals with IBS and assess their baseline quality of life.

The IBS-QOL questionnaire was completed for 8 weeks before the implementation of the training program specific to each group. After the necessary period had passed, the researchers redistributed the questionnaire to determine the effect of the two programs on alleviating IBS severity.

Training programs

The participants followed two different training programs (MIWT and HT), each performed three times a week for eight weeks. Both programs were designed to progressively increase strength over time, especially since studies have shown that these exercises at these intensities can induce muscle strength growth in non-athletic individuals (Ogawa et al., 2023; Behm et al., 2024).

MIWT Program: The MIWT program focuses on improving muscular strength through targeted exercises for specific muscle groups. Each training session lasted between 35 and 40 minutes and was divided into three different workout days: one day for chest and triceps exercises, another day for legs, shoulders, and abdominal exercises, and a third day for back and biceps exercises. For each muscle group, participants performed 3 exercises, resulting in 6 exercises per session. Each exercise was completed for 2 to 3 sets of 6 to 12 repetitions, with 3 minutes of rest between sets. The training intensity began at 20% of the participants' one-repetition maximum (1RM) (Nuzzo et al., 2024) and increased gradually every 15 days, reaching 40% of 1RM by the end of the program. All sessions took place in a gym setting, and the estimated rating of perceived exertion (RPE) ranged from 3 to 4 as participants adapted to the training loads; the RPE method takes into consideration both the intensity and the duration of a training session (Foster et al., 2001).

HT Program: The HT program was designed to improve strength and endurance using bodyweight exercises. Each session lasted between 35 and 40 minutes and included exercises such as push-ups, back exercises, squats, jumping and hopping drills, as well as abdominal and plank exercises. Participants performed 10 repetitions per exercise, with 30-second holds for plank exercises. The sessions consisted of 3 sets of 8 exercises, with 2 minutes of rest between each set. The intensity of the HT program ranged between 50% and 60% of the participants' maximum heart rate (MHR) (Strath et al., 2000). The training was designed to be completed at home. The estimated RPE for this program ranged from 2 to 3. The characteristics of each program are represented in Table 2.

Statistical analysis

The statistical analysis was conducted using SPSS V26 software outputs, calculating the mean and standard deviation (SD). Shapiro-Wilk test was used to assess the normal distribution of the data. Independent samples T-test was used to determine the difference in the pre-test between the two training groups. Paired samples T-test was used to compare the pre-test and post-test within each group. A two-way ANOVA was used to identify the difference between the groups in the post-test, considering the factors of time (pre and post) and group (MIWT and HT). Bonferroni post hoc tests were conducted following the two-way ANOVA were applied if a significant group x time interaction was observed. The significance level was set at p<.05.

RESULTS

The Shapiro-Wilk test showed no differences (p>.05), indicating a normal distribution of the data. Table 3 and Figure 1 showed no significant differences between the two groups in the pre-test for most variables (2>.05). However, body image demonstrated a significant difference between the two groups in the pre-test (p<.05).

The comparison between the pre-test and post-test within each group revealed significant differences in total score, dysphoria, interference with activity, body image, health worry, food avoidance, social reaction, and sexual and relationship domains (p<.05).

The main effects of time were significant across all variables (p<.05). However, the time x group interactions were not significant for most variables (p>.05), except for interference with activity, which showed greater improvement in the MIWT group compared to the HT group.

DISCUSSION

This study aimed to investigate the impact of MIWT and HT on the quality of life of non-athletic males with IBS. The main findings revealed a significant improvement in the quality of life for IBS patients following the exercise interventions, whether MIWT or HT, With a significant difference in interference with activity favoring the MIWT group.

Our findings align with the American College of Health and Prevention guidelines, which recommend moderate-intensity aerobic exercise for its positive effects on general health (Thompson et al., 2022). This supports our results, where moderate-intensity MIWT and HT significantly improved the quality of life and positively affected general health. Johannesson and Simrén (2011) emphasized that physical activity should be a primary treatment method for IBS, highlighting the role of exercise in alleviating IBS symptoms. The choice of suitable exercises depends on the patient's overall condition, health, and fitness level and can be tailored based on IBS symptoms. Examples of suitable exercises to alleviate IBS symptoms and improve quality of life include low and moderate-intensity workouts (Riezzo et al., 2023).

The results of our study also align with Mônnikes H. (2011), who suggested that regular exercise improves bowel function, reduces bloating, and lowers stress, all of which help alleviate symptoms of IBS (Russel & Pastoor, 1997). Additionally, several studies indicate a strong link between anxiety and increased IBS severity, which aligns with our study's findings that IBS patients experience mood disturbances, such as dysphoria (Alhazmi, 2024). Therefore, healthcare professionals should assess and treat accompanying psychological disorders in IBS patients to improve their overall health and quality of life. Previous studies have found that around 50-90% of IBS patients have comorbid psychological disorders, with anxiety and depression being the most common (Kawoos, 2017).

Another study on a random sample of yoga practitioners observed that yoga was effective, compared to medication, in reducing IBS symptoms and enhancing physical health (IBS symptom severity, gastric motility, autonomic and physical symptom scores, and physical performance), as well as improving mental health outcomes (depression, anxiety, gut-specific anxiety, and quality of life) (D'Silva, 2020). This supports our study's findings regarding improvements in quality of life, mood disorders, physical symptoms, and physical health.

The beneficial effects of regular physical activity on health are undeniable in modern medicine. Exercise is often the first step in lifestyle modification to prevent and manage chronic diseases. According to a report by the U.S. Department of Health and Human Services, regular exercise significantly reduces mortality rates by up to 30% in both men and women (Us DHHS, 2002). This finding supports our study's conclusion on the beneficial effects of exercise in improving the quality of life for IBS patients.

Moreover, exercise has been proven to treat or prevent anxiety and depression in numerous studies (Stróhle, 2009), widely accepted as an affordable, non-invasive, and accessible intervention for individuals under psychological stress. Recent studies indicated that due to the COVID-19 pandemic, individuals with anxiety and stress could not access exercise facilities, making home workouts crucial in reducing stress and anxiety and improving quality of life. A study proposed a 16-week home training program that effectively improved health-related quality of life, functional capacity, and persistent symptoms in COVID-19 survivors (Longobardi et al., 2023).

IBS symptoms contribute to changing individuals' eating behaviors, leading to irregular eating patterns and inability to eat when desired, thus exacerbating suffering and impacting quality of life. Interestingly, many researchers have reported a correlation between diet, lifestyle habits, and IBS (Simrén, 2001). There is also a relationship between physical inactivity and irregular eating (Guo et al, 2015). Exercise helps regulate metabolism, stimulates appetite, and reduces accumulated fats.

Exercise enhances social integration, reduces isolation, and helps build strong friendships and social connections, whether in gyms or competitions. It also promotes discipline, group integration, and a sense of social belonging (Penna et al., 2023), reducing life stress and pressures and eliminating feelings of laziness, lethargy, and continuous isolation (Anderson & Shivakumar, 2013). This aligns with our study's findings on improved social relationships for IBS patients due to exercise, with significant improvements in their relationships within their communities (Johannesson et al., 2015).

Physical activities and sports can also enhance body image and fitness through appropriate and regulated physical activities (Seguin et al., 2013), increasing muscle strength and endurance. Exercise helps prevent excessive weight gain or maintain ideal weight, boosting self-confidence and body satisfaction, thereby improving quality of life by distracting individuals from focusing on body appearance. A particular lifestyle, including regular moderate-intensity exercise, can control IBS symptoms by reducing stress, improving bowel movements, and reducing bloating (Daley & Grimmett, 2008). Regular exercise also improves energy levels and erection quality in males, particularly those with erectile dysfunction tion (Niu & Santtila, 2023), thus potentially enhancing sexual desire and

relationships. Regarding the interference with variable, both MIWT and HT improved interference with activity, but MIWT proved to be more effective. This can be attributed to the type of exercises included in the MIWT program, which helps enhance muscle strength and endurance (Wang et al., 2023). Additionally, these exercises offer a mental benefit, as their performance requires focus and motivation, further aiding in the completion of daily tasks with efficiency while avoiding fatigue (Cheng et al., 2022).

This study has some limitations, including a small sample of male participants from the researchers' surroundings and data collected using a single measure, the IBS-QOL scale. Future studies could investigate the effects of these training methods on a larger number of male and female participants using multiple measures to comprehensively reveal changes in the quality of life for IBS patients.

CONCLUSION

In conclusion, it can be said that engaging in moderate-intensity physical activity generally helps alleviate IBS, whether through MIWT or HT. Additionally, it improves the quality of life and psychological well-being of patients in various areas, including social relationships, body satisfaction, anxiety and discomfort, irregular eating habits, and sexual ability. All these aspects showed positive improvements after performing moderate-intensity workouts (MIWT and HT).

The study's results indicate that there is no significant difference between MIWT and HT in improving the quality of life for IBS patients, except for interference with activity, which was better in MIWT. Based on these findings, the researchers recommend using both methods or alternating between them to avoid monotony and enhance the quality of life. They also emphasize the importance of promoting a culture of physical exercise among IBS patients and raising awareness about the benefits of moderate-intensity exercises in reducing IBS symptoms and improving quality of life.

Disclosure of interest

The authors declare no conflict of interest.

Funding

No funding was received for the study.

Sidebar

Cite this article as:

Grine, W., Belfritas, Y., Kessouri, O. (2024). Effects of moderate-intensity weight training vs. home training on quality of life in non-athlete male patients with irritable bowel syndrome. Journal of Applied Sports Sciences, Vol. 2, рр. 22 - 32.

Corresponding author:

Walid Grine

Department of Sciences and Techniques of Physical and Sports Activities, University of Jijel, Algeria.

Email: [email protected]

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