The Roles of Complementary Structured Exercise and Physical Therapy in The Aging and Older Adult IBD Patient Care Team

Structured exercise (SE) and physical therapy (PT) are integral components of disease management. Older adults with inflammatory bowel disease (IBD) represent a growing proportion of patients, and are at disproportionate risk of functional decline due to the combined effects of aging, chronic inflammation, malnutrition, and inactivity. Despite the well-established benefits of SE and PT, most gastroenterologists report feeling inadequately equipped to counsel and refer patients with physical function limitations, and thus these therapies remain underutilized. The purpose of this review is to synthesize the existing evidence and provide practical, actionable guidance for gastroenterologists to incorporate SE and PT into IBD care.

Initial studies suggest complementary SE and PT may significantly improve IBD-related musculoskeletal extraintestinal manifestations (EIMs), such as joint pain, fatigue, sarcopenia, frailty, and improve exercise confidence as compared with standard care alone. Additionally, multimodal prehabilitation strategies may significantly reduce severe postoperative complications and shorten hospital stays in older patients undergoing IBD-related surgery.

SE and PT are low-cost, low-risk interventions with benefits spanning multiple domains of physical function and morbidity in older adults with IBD. This article highlights pertinent SE and PT literature in the aging IBD population, including underlying pathophysiology, interventions, and scope of practice. Gastroenterologists are provided evidence-based, condition-specific assessments and PT referral pathways that can be implemented in routine practice. Integrating this into the multidisciplinary IBD care team may improve patients’ physical function and quality of life.