Longitudinal Outcomes and Prognostic Risk of Normalized Airflow Obstruction in a Korean General Population Cohort.

Inflammatory bowel disease (IBD) is a chronic and recurrent inflammatory illness of the gastrointestinal tract that comprises Crohn’s disease (CD) and ulcerative colitis (UC). It is frequently linked to exhaustion, weight loss, diarrhea, and stomach discomfort (; ). The global burden of IBD has increased substantially since 2017 and continues to rise, underscoring its growing importance as a global public health challenge (; ). Newly industrialized regions have experienced a rapid rise in incidence. In contrast, high-income regions have entered a phase of compounding prevalence, where relatively stable incidence and low mortality have resulted in a growing number of people living with chronic disease (). Recent population-based surveillance further supports this trend, with prevalence reaching as high as 671 per 100,000 population in some heavily affected populations in 2024 (). Taken together, these findings indicate that IBD is imposing an increasingly substantial and sustained burden on healthcare systems worldwide (; ). Exercise therapy is a low-risk, modifiable lifestyle intervention that has received increasing attention in the management of chronic diseases and related comorbidities, including chronic kidney disease, depression, breast cancer, coronary artery disease, and functional gastrointestinal disorders (). One of the primary pathogenic mechanisms in IBD is inflammation, and immunological responses are significantly influenced by metabolic control. It is believed that exercise reduces inflammation by causing immune cells to generate anti-inflammatory cytokines and mediators (). Consequently, a growing number of randomized controlled trials have examined the effects of structured exercise interventions on various outcomes in patients with IBD, including symptom control, inflammatory markers, and health-related quality of life. Network meta-analysis (NMA) provides an advantage over conventional pairwise meta-analysis because it allows simultaneous comparisons among multiple interventions, even when direct head-to-head trials are limited. Therefore, this study aimed to synthesize the available evidence on different exercise modalities in patients with IBD. It also compared their associations with quality of life, disease activity, fatigue, and inflammatory biomarkers, and evaluated their relative rankings within the current evidence network.