- A meta-analysis of randomized controlled trials (RCTs) finds that physical activity (PA) has a moderate effect on cardiovascular fitness and lower limb muscle strength, but no effect on flexibility in rheumatoid arthritis (RA), spondyloarthritis (SpA), and osteoarthritis (OA) of the hip (HOA) or knee (KOA).
Why this matters
- This meta-analysis shaped the 2018 European League Against Rheumatism (EULAR) Recommendations for Physical Activity in People with Inflammatory Arthritis and Osteoarthritis.
- EULAR's foremost recommendation supported PA as an integral part of standard of care throughout the disease course.
- Meta-analysis of 49 RCTs (n=3909) in patients with RA/SpA/HOA/KOA that met eligibility criteria after a search including PubMed/Medline, CENTRAL, EMBASE, and Web of Science.
- PA effects were calculated as standardized mean difference (SMD) between postintervention scores in the intervention vs the control group.
- SMD of 0.2 was considered small, 0.5 was moderate (clinically important), and 0.8 was large.
- Funding: EULAR.
- Aerobic exercises and resistance training had a moderate effect on cardiovascular fitness (SMD, 0.56; 95% CI, 0.38-0.75) and muscle strength (SMD, 0.54; 95% CI, 0.35-0.72).
- Combined strength/aerobic/flexibility exercises had no effect on flexibility (SMD, 0.12; 95% CI, −0.16 to 0.41).
- PA promotional interventions generated a small improvement in PA behavior (SMD, 0.21; 95% CI, 0.03-0.38).
- Moderate heterogeneity across studies.