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

Yasumori Sobue, Toshihisa Kojima, Hiromu Ito, Keiichiro Nishida, Isao Matsushita, Yuko Kaneko, Mitsumasa Kishimoto, Masataka Kohno, Takahiko Sugihara, Yohei Seto, Eiichi Tanaka, Takeo Nakayama, Shintaro Hirata, Atsuko Murashima, Akio Morinobu, Masaaki Mori, Masayo Kojima, Yutaka Kawahito, Masayoshi Harigai

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: This study aimed to evaluate the impact of exercise therapy on patient-reported outcomes (PROs) in rheumatoid arthritis (RA) as part of the process of updating the 2020 Japanese guidelines for the management of RA according to the Grading of Recommendations, Assessment, Development, and Evaluation system. Methods: We searched PubMed, Japana Centra Revuo Medicina Web, and the Cochrane Library (from 2009 to 2018) to identify articles that evaluated PROs of exercise therapy and RA disease activity. Results: A total of 662 articles were identified, including nine RCTs, and meta-analyses were performed on six RCTs on systemic exercise therapy and three RCTs on upper extremity exercise therapy. Analyzed exercise therapies were diverse, differing in target population, intervention method, and duration. Significant improvements were observed in the Health Assessment Questionnaire Disability Index (mean difference −0.35, 95% confidence interval (CI): −0.60 to −0.10), pain (standardized mean difference −2.04, 95% CI: −3.77 to −0.32), and SF-36. For upper extremity exercise therapy, significant improvements in PROs (Disabilities of the Arm, Shoulder, and Hand Questionnaire, Michigan Hand Outcome Questionnaire) were observed. Conclusion: Exercise therapy in RA treatment improves patient subjective assessment of pain, physical function, and quality of life.

Original languageEnglish
JournalModern rheumatology
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • Health Assessment Questionnaire
  • Japanese guidelines
  • exercise therapy
  • patient-reported outcomes
  • rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology

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