Evidence summary (Added 2022)
Both aerobic and resistance training exercises and yoga have been shown in extensive systematic reviews to reduce disease activity scores in patients with rheumatoid arthritis (1-4) Further, there is robust evidence suggesting that physical activity appears to be general safe in patients with RA, without causing any major adverse side effects (5,6).
Quality of evidence:
Grade A – High quality – Numerous systematic reviews with meta-analysis showing good improvement in disease activity in RA .
Strength of recommendation
Grade 1 – Strong recommendation in RA – consistent benefits seen across studies
There is a strong evidence that physical activity and exercise interventions have been shown to improve validated disease activity scores in RA.
- Burghardt RD, Kazim MA, Rüther W, Niemeier A, Strahl A. The impact of physical activity on serum levels of inflammatory markers in rheumatoid arthritis: a systematic literature review. Rheumatol Int. 2019 May;39(5):793-804. doi: 10.1007/s00296-019-04284-x. Epub 2019 Mar 21. PMID: 30899988.
- Wang L, Gao C, Zhu D, Chen LH. [Effect of functional exercises on patients with rheumatoid arthritis: a meta-analysis]. Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Dec 18;50(6):991-997. Chinese. PMID: 30562770.
- Wen Z, Chai Y. Effectiveness of resistance exercises in the treatment of rheumatoid arthritis: A meta-analysis. Medicine. 2021 Apr 2;100(13).
- Ye X, Chen Z, Shen Z, Chen G, Xu X. Yoga for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Frontiers in medicine. 2020 Nov 27;7:876.
- Santos EJF, Duarte C, Marques A, Cardoso D, Apóstolo J, da Silva JAP, Barbieri-Figueiredo M. Effectiveness of non-pharmacological and non-surgical interventions for rheumatoid arthritis: an umbrella review. JBI Database System Rev Implement Rep. 2019 Jul;17(7):1494-1531. doi: 10.11124/JBISRIR-D-18-00020. PMID: 31169776
- Sobue Y, Kojima T, Ito H, Nishida K, Matsushita I, Kaneko Y, Kishimoto M, Kohno M, Sugihara T, Seto Y, Tanaka E. Does exercise therapy improve patient-reported outcomes in rheumatoid arthritis? A systematic review and meta-analysis for the update of the 2020 JCR guidelines for the management of rheumatoid arthritis. Modern rheumatology. 2021 Feb 9:1-4.