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Effects of physical exercise and body weight on disease-specific outcomes of people with rheumatic and musculoskeletal diseases (RMDs): systematic reviews and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs


Gwinnutt, James M; Wieczorek, Maud; Cavalli, Giulio; Balanescu, Andra; Bischoff-Ferrari, Heike A; Boonen, Annelies; de Souza, Savia; de Thurah, Annette; Dorner, Thomas E; Moe, Rikke Helene; Putrik, Polina; Rodríguez-Carrio, Javier; Silva-Fernández, Lucía; Stamm, Tanja; Walker-Bone, Karen; Welling, Joep; Zlatković-Švenda, Mirjana I; Guillemin, Francis; Verstappen, Suzanne M M (2022). Effects of physical exercise and body weight on disease-specific outcomes of people with rheumatic and musculoskeletal diseases (RMDs): systematic reviews and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs. RMD Open, 8(1):e002168.

Abstract

Background: A European League Against Rheumatism (EULAR) taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). This paper reviews the literature on the effects of physical exercise and body weight on disease-specific outcomes of people with RMDs.

Methods: Three systematic reviews were conducted to summarise evidence related to exercise and weight in seven RMDs: osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis (axSpA), psoriatic arthritis, systemic sclerosis and gout. Systematic reviews and original studies were included if they assessed exercise or weight in one of the above RMDs, and reported results regarding disease-specific outcomes (eg, pain, function, joint damage). Systematic reviews were only included if published between 2013-2018. Search strategies were implemented in the Medline, Embase, Cochrane Library of systematic reviews and CENTRAL databases.

Results: 236 articles on exercise and 181 articles on weight were included. Exercise interventions resulted in improvements in outcomes such as pain and function across all the RMDs, although the size of the effect varied by RMD and intervention. Disease activity was not influenced by exercise, other than in axSpA. Increased body weight was associated with worse outcomes for the majority of RMDs and outcomes assessed. In general, study quality was moderate for the literature on exercise and body weight in RMDs, although there was large heterogeneity between studies.

Conclusion: The current literature supports recommending exercise and the maintenance of a healthy body weight for people with RMDs.

Keywords: arthritis; epidemiology; patient reported outcome measures; physical therapy modalities

Abstract

Background: A European League Against Rheumatism (EULAR) taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). This paper reviews the literature on the effects of physical exercise and body weight on disease-specific outcomes of people with RMDs.

Methods: Three systematic reviews were conducted to summarise evidence related to exercise and weight in seven RMDs: osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis (axSpA), psoriatic arthritis, systemic sclerosis and gout. Systematic reviews and original studies were included if they assessed exercise or weight in one of the above RMDs, and reported results regarding disease-specific outcomes (eg, pain, function, joint damage). Systematic reviews were only included if published between 2013-2018. Search strategies were implemented in the Medline, Embase, Cochrane Library of systematic reviews and CENTRAL databases.

Results: 236 articles on exercise and 181 articles on weight were included. Exercise interventions resulted in improvements in outcomes such as pain and function across all the RMDs, although the size of the effect varied by RMD and intervention. Disease activity was not influenced by exercise, other than in axSpA. Increased body weight was associated with worse outcomes for the majority of RMDs and outcomes assessed. In general, study quality was moderate for the literature on exercise and body weight in RMDs, although there was large heterogeneity between studies.

Conclusion: The current literature supports recommending exercise and the maintenance of a healthy body weight for people with RMDs.

Keywords: arthritis; epidemiology; patient reported outcome measures; physical therapy modalities

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Department of Aging Medicine
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Rheumatology
Health Sciences > Immunology and Allergy
Life Sciences > Immunology
Uncontrolled Keywords:Immunology, Immunology and Allergy, Rheumatology
Language:English
Date:1 March 2022
Deposited On:27 Jan 2023 07:30
Last Modified:30 Jan 2024 02:41
Publisher:BMJ Publishing Group
ISSN:2056-5933
OA Status:Gold
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1136/rmdopen-2021-002168
PubMed ID:35361692
Project Information:
  • : FunderEuropean League Against Rheumatism
  • : Grant ID
  • : Project Title
  • : FunderSNSF
  • : Grant ID120380
  • : Project TitleSoziale Integration durch Sport bei jugendlichen Migranten/-innen
  • : FunderFP7
  • : Grant ID220385
  • : Project TitlePHATRAMAS - Mathematical theory of phase transitions: modeling, analysis and simulations
  • Content: Published Version
  • Language: English
  • Licence: Creative Commons: Attribution 4.0 International (CC BY 4.0)