Acute effects of exercise on pain symptoms, clinical inflammatory markers and inflammatory cytokines in people with rheumatoid arthritis: a systematic literature review

Abstract

Background: Exercise is advocated in the treatment of rheumatoid arthritis (RA). However, uncertainty around the acute effects of exercise on pain and inflammation may be stopping people with RA from exercising more regularly. Objectives: To determine the acute effects of exercise on pain symptoms, clinical inflammatory markers, and inflammatory cytokines in RA. Design: A systematic review of the literature. Data sources and methods: Five databases were searched (PubMed, Cochrane Library, CINAHL, Scopus and SPORTDiscus); inclusion criteria were studies with acute exercise, a definite diagnosis of RA and disease characteristics assessed by clinical function (i.e., disease activity score, health assessment questionnaire and self-reported pain), clinical markers associated with inflammation (i.e., c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)), and inflammatory cytokines (i.e., interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-α)). Results: From a total of 1544 articles, initial screening and full text assessment left 11 studies meeting the inclusion criteria. A total of 274 people were included in the studies (RA = 186; control = 88). Acute bouts of aerobic, resistance, and combined aerobic and resistance exercise did not appear to exacerbate pain symptoms in people with RA. Conclusion: Post-exercise responses for pain, clinical inflammatory markers and inflammatory cytokines were not different between people with or without RA. Exercise prescription was variable between studies, which limited between-study comparisons. Therefore, future investigations in people with RA are warranted, which combine different exercise modes and intensities to examine acute effects on pain symptoms and inflammatory markers. Registration: The PROSPERO international prospective register of systematic reviews – CRD42018091155.

The Effects of Exercise Training on Functional Capacity and Quality of Life in Patients with Rheumatoid Arthritis: A Systematic Review

“…Finally, Coelho-Oliveira AC et al [ 48 ] investigated the effect of acute whole-body vibration exercise under the hands, on handgrip strength, range of motion, and electromyography signals of women with RA, and demonstrated that it promotes neuromuscular modifications during the handgrip of women with stable RA. On the contrary, a recent systematic literature review that investigated the acute effects of exercise on pain symptoms, clinical inflammatory markers, and inflammatory cytokines in RA concluded that post-exercise responses for pain, clinical inflammatory markers and inflammatory cytokines were not different between people with or without RA [ 49 ].…”

Clinical effect and biological mechanism of exercise for rheumatoid arthritis: A mini review

“…In general, inflammatory cytokine level decreases within a few hours after an exercise (83,84). However, evidence of the acute effect of exercise on inflammatory response in patients with RA is inconsistent (85). Two observational studies examined the acute effect of a single-session exercise on inflammatory cytokine (e.g., IL-6) in patients with RA; one of the studies found no significant change in IL-6 (86), whereas the other observed IL-6 level sharply increased in the first one hour, then gradually decreased, and returned to pre-exercise level in 24 hours (87).…”

Target Role of Monocytes as Key Cells of Innate Immunity in Rheumatoid Arthritis

“…Throughout the course of the pathology, bone erosion occurs and predominantly surrounds the peripheral synovial joints. The clinical symptoms of RA include pain, edema development, and tenderness of the synovial joints located symmetrically and peripherally [3]. A great deal of progress has been made in the treatment of RA with antagonists of proinflammatory cytokines, such as tumor necrosis factor (TNF), interleukin-6 (IL-6), and IL-1β.…”