Evidence summary (Added 2022)
Low mood and depression are common in patients with inflammatory rheumatic diseases. From the compelling body of evidence for the general population, being physically active has been shown to improved self-esteem and quality of life (1 ).
A recent study (2) involving 118 participants (86 with RA, 32 with SLE) studied an intervention involving one group receiving education and counselling by a physical therapist in weeks 1-8 and delayed group receiving the same intervention in weeks 10-17. Mood was part of the secondary outcomes. Although there was an improvement in mood, this was not statistically significant.
In RA specifically, one recent systematic review found that regular Tai Chi may lead to improved mood. Those attending 2 classes, lasting 60 minutes, each week had considerable improvements in mood after 12 weeks compared to a control group (3).
Quality of evidence:
Grade B – Moderate Quality for Tai Chi in RA – 1 good quality systematic review
Strength of recommendation
Grade 1 – Strong Recommendation in RA.
Conclusion:
Low mood and depression are common in rheumatoid arthritis. There is moderate evidence to suggest physical activity can help improve mood and depression scores across inflammatory rheumatic diseases. However, on further expert consultation and extrapolating the general population response in mood to physical activity, we have given this a grade 1 strong recommendation.
References:
- Department of Health & Social Care. UK Chief Medical Officers’ Physical Activity Guidelines: 2019.
- Li LC, Feehan LM, Xie H, Lu N, Shaw C, Gromala D, Aviña-Zubieta JA, Koehn C, Hoens AM, English K, Tam J, Therrien S, Townsend AF, Noonan G, Backman CL. Efficacy of a Physical Activity Counseling Program With Use of a Wearable Tracker in People With Inflammatory Arthritis: A Randomized Controlled Trial. Arthritis Care Res (Hoboken). 2020 Dec;72(12):1755-1765. doi: 10.1002/acr.24199. PMID: 32248626
- Imoto AM, Amorim FF, Palma H, Lombardi I, Salomon AL, Peccin MS, Silva HE, Franco ES, Göttems L, Santana LA. Evidence for the efficacy of Tai Chi for treating rheumatoid arthritis: an overview of systematic reviews. Sao Paulo Medical Journal. 2021 Mar 3;139:91-7.