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

J Adv Nurs. 2021 Feb;77(2):506-522. doi: 10.1111/jan.14574. Epub 2020 Nov 11.


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.

Data sources: PubMed, Cochrane, Web of Science, CINAHL, and Embase. Published from the establishment of the database to 3 September 2019.

Review methods: AMSTAR 2 and PRISMA were used to evaluate methodological and reporting quality. Evidence quality of the effect of each intervention was assessed according to GRADE guidelines. Meta-analysis of original studies was conducted for comparison of systematic reviews and to explore the effect of different exercise interventions on the same outcome.

Results: Ten systematic reviews were included in the overview. A significant improvement was seen in: aerobic exercise for aerobic capacity; strength training for erythrocyte sedimentation rate and 50-foot walking time; aerobic exercise combined with strength training for aerobic capacity, physical function, and fatigue; hand exercise for hand function.

Conclusions: For the maximum benefit of rheumatoid arthritis (RA) patients, different exercise methods should be selected according to the symptoms. For RA patients, any exercise is better than no exercise, but the intensity, frequency, and period of exercise for better results are not determined.

Impact: What problem did the study address is which outcomes will be improved by different exercise interventions. For maximum benefit for RA patients, different exercise methods should be selected according to symptoms. The research summarized the evidence of exercise rehabilitation of RA and will help RA patients or their caregivers choose the appropriate type of exercise, which will play a positive role on the rehabilitation of patients with RA.

目的: 确定不同运动干预措施的结果以及不同干预措施的证据质量。 设计: 系统评估与荟萃分析概述。 数据来源: PubMed、Cochrane、科学网、CINAHL和Embase数据库中自建库之日至2019年9月3日的数据。 评估方法: 采用AMSTAR 2和PRISMA 评估方法学质量和报告质量。根据GRADE指南评估了每种干预措施效果的证据质量。开始原始研究荟萃分析,比较系统评估结果,探索基于同一结果的不同运动干预措施的效果。 结果: 概述中包含10次系统评估。在以下方面取得了重大进展:进行有氧运动,提高有氧运动能力;开展力量训练,提升红细胞沉积率及50英尺步行时间;有氧运动与力量训练结合,提升有氧运动能力、身体机能并减轻疲劳;通过手部锻炼提升手部功能。 结论: 为实现类风湿性关节炎(RA)患者的最大福祉,应根据症状选取相应的运动方式。针对类风湿性关节炎患者,运动总比不运动好,但是可以达到更好治疗效果的运动强度、频率和时长尚未确定。 影响: 本研究要解决的问题是探究不同运动干预措施的结果。为实现类风湿性关节炎患者的最大福祉,应根据症状选取相应的运动方式。本研究总结了类风湿性关节炎的运动性康复证据,将帮助类风湿性关节炎患者或照护人员选择相应的运动方式,协助类风湿性关节炎患者积极康复。.

Keywords: aerobic capacity; exercise; nursing; overview of systematic reviews; pain; physical function; rheumatoid arthritis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Arthritis, Rheumatoid* / therapy
  • Exercise Therapy
  • Exercise*
  • Fatigue
  • Humans