Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: Meta‐analysis of randomized controlled trials

Abstract

Objective. Several lines of evidence have emphasized an improvement in aerobic capacity and muscle strength after physical exercise programs in rheumatoid arthritis (RA) patients. Our objective was to evaluate the efficacy of aerobic exercises in RA on quality of life, function, and clinical and radiologic outcomes by a systematic literature review and a meta-analysis. Methods. A systematic literature search was performed in the Medline, EMBase, and Cochrane databases up to July 2009 and in the abstracts presented at rheumatology scientific meetings during the last 5 years. Randomized controlled trials (RCTs) comparing aerobic exercises with non-aerobic interventions in RA patients were included. Outcomes studied were postintervention quality of life, function assessed by the Health Assessment Questionnaire (HAQ), a pain visual analog scale (VAS), joint count, the Disease Activity Score in 28 joints (DAS28), and radiologic damage. Efficacy was assessed by standardized mean differences (SMDs; difference between groups of mean outcome variation from baseline/SD at baseline) of aerobic exercises versus non-aerobic rehabilitation. Heterogeneity was tested. SMDs were pooled by a meta-analysis using the inverse of variance model. Results. Fourteen RCTs, including 1,040 patients, met the inclusion criteria. Exercise improved the postintervention quality of life (SMD 0.39, P < 0.0001), HAQ score (SMD 0.24, P ‫؍‬ 0.0009), and pain VAS (SMD 0.31, P ‫؍‬ 0.02). Exercise in this RA population appeared safe, since global compliance, DAS28, and joint count were similar in both groups. Conclusion. Cardiorespiratory aerobic conditioning in stable RA appears to be safe and improves some of the most important outcome measures. However, the degree of the effect of aerobic exercise on the abovementioned parameters is small.

Physical Activity to Reduce Fatigue in Rheumatoid Arthritis: A Randomized Controlled Trial

“…We also found, similar to other published studies, that many individuals with RA have very low levels of physical activity (10,11) in spite of the demonstrated safety of exercise and published guidelines recommending physical activity for persons with RA (12). Although studies have examined the impact of exercise interventions on RA outcomes, most have focused on pain or function (13)(14)(15)(16)(17). Two recent systematic reviews found that physical activity did have beneficial effects on fatigue (18,19), but most exercise interventions have been resource intensive, requiring specially trained personnel, highly structured activities, and/or attendance at classes or a specified facility.…”

Physical Activity in Rheumatoid Arthritis: A Systematic Review

“…[14][15][16][17][18][19][20] However; much less research has been conducted in the broader category of physical activity.…”

Land- and water-based exercises in rheumatoid arthritis patients: a series of case reports

“…Other compelling evidence advocating the importance of aerobic exercises for RA sufferers was that of a systematic review and meta-analysis by Baillet and colleagues. 14 The study found that aerobic exercises improve some of the most important RA patient outcomes: function, quality of life and pain. Moreover, it appears that aerobic exercise decreases radiological damage and pain.…”