title: Effectiveness of walking exercise as a bowel preparation for colonoscopy: a randomized controlled trial.
abstract: OBJECTIVE
  This prospective study was conducted to assess the effect of walking exercise on bowel cleansing before colonoscopy and to define a patient subgroup that would benefit from walking exercise.
  
  
  METHODS
  A total of 383 outpatients were randomized into two groups (G1 [n = 196]; walking exercise, G2 [n = 187]; nonexercise). Those randomized to G1 were instructed to drink 250 mL of polyethylene glycol (PEG) solution and then walk at least for 5 min at intervals of 10 min whereas those randomized to G2 were instructed to drink and then take rest in a waiting room until the entire 2.5-3 L volume was consumed. The amount of walking exercise in both groups was estimated using a step counter. A single endoscopist estimated the efficacy of cleansing in a single-blinded manner. Patient's demographics, various parameters related to bowel preparation, and the degree of patients discomfort caused by the walking exercise were assessed.
  
  
  RESULTS
  The number of step counts taken was significantly different for the two groups (p < 0.001). The degree of bowel cleansing in the G1 (n = 189) and G2 (n = 177) groups was significantly different (p < 0.01). However, the groups were similar in terms of all other data collected. By univariate analysis, walking exercise was especially beneficial to a subgroup of nonobese patients of age <65 yr, without history of abdominal surgery. Also, multivariate logistic regression analysis demonstrated that nonexercise (OR = 0.49; 95% CI = 0.31-0.79) was an independent risk factor for poor bowel cleansing. Most walking patients (97.3%) considered walking exercise more comfortable than taking the polyethylene glycol solution.
  
  
  CONCLUSIONS
  The walking exercise was found to improve colonoscopic bowel cleansing without significant patient discomfort.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Dong Hun
authors.initials: DH
authors.lastname: Park
authors.forename: Jae Woo
authors.initials: JW
authors.lastname: Kim
authors.forename: Myeong Gwan
authors.initials: MG
authors.lastname: Jee
authors.forename: Soon Koo
authors.initials: SK
authors.lastname: Baik
authors.forename: Sang Ok
authors.initials: SO
authors.lastname: Kwon
authors.forename: Dong Ki
authors.initials: DK
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D003113:Colonoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016138:Walking