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Evidence Summary

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In people with rheumatoid arthritis, aerobic exercises and/or strength training improve some symptoms

Hu H, Xu A, Gao C, et al. The effect of physical exercise on rheumatoid arthritis: An overview of systematic reviews and meta-analysis. J Adv Nurs. 2021;77:506-22.

Review questions

In people who have rheumatoid arthritis, do different types of exercise improve symptoms?

Background

Rheumatoid arthritis is a chronic condition. It can cause inflammation, pain, stiffness, and fatigue. It can also cause deformity of the small joints, usually in the hands and feet.

There is no cure for rheumatoid arthritis, but its symptoms can sometimes be controlled. It is uncertain whether exercise can help control the symptoms of rheumatoid arthritis.

How the review was done

The researchers did a systematic review, searching for reviews that were published in English up to September 2019. They found 10 systematic reviews that included 97 individual studies and 7,190 people.

The key features of the studies were:

  • people were adults with rheumatoid arthritis;
  • types of exercise included aerobic exercise, strength training, aerobic exercise with strength training, aquatic exercise, and hand exercise; and
  • specific types of exercise were compared with other exercise, mobility exercise, usual care, or wait list.

What the researchers found

Compared with other exercise or physical activity, mobility exercise, usual care, or wait list:

  • aerobic exercise improved aerobic capacity (a measure of how efficiently your body uses oxygen during maximum-intensity exercise) by a large amount;
  • strength training improved pain and erythrocyte sedimentation rate (a blood test that indicates the presence of inflammation) by moderate amounts and improved 50-foot walking time by a small amount; and
  • aerobic exercise with strength training improved physical function and fatigue by small amounts.

Conclusion

In people with rheumatoid arthritis, aerobic exercise and/or strength training may improve some symptoms.

Effects of exercise in people with rheumatoid arthritis*

Type of exercise

Outcomes

Number of studies (number of people)

Effect† of exercise program

Quality of evidence

Aerobic exercise

Aerobic capacity (a measure of how efficiently your body uses oxygen during maximum-intensity exercise)

6 studies (282 people)

Large improvement

Very low

Strength training

Pain

3 studies (119 people)

Moderate improvement

Very low

Strength training

Erythrocyte sedimentation rate (a blood test that indicates the presence of inflammation)

2 studies (101 people)

Moderate improvement

Very low

Strength training

50-foot walking time

2 studies (50 people)

Large improvement

Very low

Aerobic exercise with strength training

Physical function

4 studies (399 people)

Small improvement

Moderate

Aerobic exercise with strength training

Fatigue

4 studies (455 people)

Small improvement

Low

*Only exercise types that had a positive effect are reported here.

†Amount of improvement with exercise compared with other exercise or usual care is based on standardized mean differences (SMDs), where SMD < 0.50 = small improvement; SMD 0.50 to 0.79 = moderate improvement; SMD ≥ 0.80 = large improvement.



Related Topics


Glossary

Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

Related Web Resources

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