The effect of physical exercise on rheumatoid arthritis: An overview of systematic reviews and meta‐analysis

Hu, Huiling; Xu, Anqi; Gao, Chao; Wang, Zhenqing; Wu, Xue

doi:10.1111/jan.14574

Cited by 51 publications

(33 citation statements)

References 63 publications

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“…Compared with previously published reviews, this meta-analysis was more focused on aerobic patterns, incorporated more new studies, summarized the latest evidence of the effect of aerobic exercise programs in RA, and integrated more outcome indicators than have been analysed before, such as STS score and VO 2 max levels [ 17 , 25 , 61 , 62 ]. Meanwhile, this study has certain limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Exercise is a subset of physical activity that is planned, structured, repetitive and has as a final or an intermediate objective the improvement or maintenance of physical fitness [ 16 ]. Exercise modalities, including aerobic exercise, resistance training and strength training, have been proven to be beneficial to the disease management of RA [ 17 ]. Therapeutic exercise can increase biomolecular suppression of arthritis through the suppression of inflammatory cytokine expression, consequently suppressing joint destruction [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness and safety of aerobic exercise for rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials

Weng

et al. 2022

BMC Sports Sci Med Rehabil

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Background Rheumatoid arthritis (RA) can cause severe physical impairment and a reduced quality of life, and there is limited evidence for any effective intervention. Aerobic exercise may be beneficial for improving symptoms. Therefore, the purpose of this meta-analysis was to evaluate the effectiveness and safety of aerobic exercise for rheumatoid arthritis patients. Methods PubMed, The Cochrane Library, Web of Science, EMBASE, CNKI, WanFang Data and VIP databases were searched. Randomized controlled trials of the effectiveness and safety of aerobic exercise for rheumatoid arthritis were included. Risks of bias were assessed by two independent reviewers using the methods described in the RevMan 5.3, GRADEpro and the Cochrane Handbook. Meta-analyses were performed to investigate the effects of aerobic exercise on rheumatoid arthritis. Results A total of 13 RCTs were included, including 967 rheumatoid arthritis patients. The Meta-analysis results showed that aerobic exercise can improve functional ability [MD = − 0.25, 95% CI (− 0.38, − 0.11), P = 0.0002], relieve pain [SMD = − 0.46, 95% CI (− 0.90, − 0.01), P = 0.04], increase aerobic capacity [MD = 2.41, 95% CI (1.36, 3.45), P < 0.00001] and improve the Sit to Stand test score[MD = 1.60, 95% CI (0.07, 3.13), P = 0.04] with statistically significant differences. Conclusion Generally, aerobic exercise is beneficial and safe for RA patients and has a certain alleviating effect on the disease, such as functional ability improvement, pain relief and aerobic capacity increase. Limited by the quantity and quality of the included studies, future research with higher-quality studies needs to be conducted to verify the above conclusions. Trial registration: PROPERO registration number: CRD42021242953.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of aerobic exercise for rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials

Weng

et al. 2022

BMC Sports Sci Med Rehabil

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“…Subsequently, different exercise parameters make it difficult to accurately assess the impact of exercise in people with RA and as highlighted in a recent review the optimal intensity, frequency, mode and exercise duration for RA has yet to be determined. 63 Therefore, further research with clearly defined FITT, which examines how different exercise prescription (e.g., high versus low intensity exercise) impacts acutely on RA disease characteristics is required.…”

Section: Discussionmentioning

confidence: 99%

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

Balchin

Tan

Golding

et al. 2022

Therapeutic Advances in Musculoskeletal

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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.

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“…Regular physical exercise, such as aerobic and resistance and their combination, attenuates RA inflammation 15–17 . Physical exercise in an aquatic environment is used for RA patients as it improves aerobic fitness, muscle strength, joint mobility, functional fitness, and emotional well‐being, with reduced joint damage and the ability to suppress the inflammatory response 18,19 .…”

Section: Introductionmentioning

confidence: 99%

“…Regular physical exercise, such as aerobic and resistance and their combination, attenuates RA inflammation. [15][16][17] Physical exercise in an aquatic environment is used for RA patients as it improves aerobic fitness, muscle strength, joint mobility, functional fitness, and emotional well-being, with reduced joint damage and the ability to suppress the inflammatory response. 18,19 However, the effects of different types of exercises, especially the effects of combined training (CT) (resistance and aerobic exercise) on the disturbances caused by RA remain unclear.…”

mentioning

confidence: 99%

Effects of different physical training protocols on inflammatory markers in Zymosan‐induced rheumatoid arthritis in Wistar rats

Lima

Pedersen

Bomfim

et al. 2022

Cell Biochemistry & Function

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Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation and involvement of the synovial membrane, causing joint damage and deformities. No effective drug treatment is available, and physical exercise has been utilized to alleviate the inflammatory processes. This study aimed to investigate the effects of different exercise training protocols on Zymosan-induced RA inflammatory markers in the right knee of Wistar rats. The rodents were subjected to aerobic, resisted, and combined physical training protocols with variations in the total training volume (50% or 100% of resistance and aerobic training volume) for 8 weeks. All physical training protocols reduced cachexia and systemic inflammatory processes. The histological results showed an increase in the inflammatory influx to the synovial tissue of the right knee in all physical training protocols. The rats that underwent combined physical training with reduced volume had a lower inflammatory influx compared to the other experimental groups. A reduction in the mRNA expression of inflammatory genes and an increase in anti-inflammatory gene expression were also observed. The physical training protocol associated with volume reduction attenuated systemic and synovial inflammation of the right knee, reducing the impact of Zymosan-induced RA in rats.

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The effect of physical exercise on rheumatoid arthritis: An overview of systematic reviews and meta‐analysis

Abstract: Aims: To determine which outcomes will be improved by different exercise interventions and the evidence quality for each intervention. Design: Overview of systematic reviews and meta-analysis.

Cited by 51 publications

References 63 publications

Effectiveness and safety of aerobic exercise for rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials

Effectiveness and safety of aerobic exercise for rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials

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

Effects of different physical training protocols on inflammatory markers in Zymosan‐induced rheumatoid arthritis in Wistar rats

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