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Review
. 2022 Mar;8(1):e002168.
doi: 10.1136/rmdopen-2021-002168.

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

James M Gwinnutt  1 , Maud Wieczorek  2   3 , Giulio Cavalli  4 , Andra Balanescu  5 , Heike A Bischoff-Ferrari  3   6   7 , Annelies Boonen  8   9 , Savia de Souza  10 , Annette de Thurah  11   12 , Thomas E Dorner  13   14   15 , Rikke Helene Moe  16 , Polina Putrik  8   9 , Javier Rodríguez-Carrio  17   18 , Lucía Silva-Fernández  19 , Tanja Stamm  20   21 , Karen Walker-Bone  22 , Joep Welling  23 , Mirjana I Zlatković-Švenda  24   25 , Francis Guillemin  2   26 , Suzanne M M Verstappen  27   22   28
Affiliations
Review

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

James M Gwinnutt et al. RMD Open. 2022 Mar.

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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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of search strategy to identify published systematic reviews and meta-analyses. *EMBASE search excluded journals included in MEDLINE.
Figure 2
Figure 2
PRISMA flow chart for review of individual studies of exercise. *EMBASE search excluded journals included in MEDLINE. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 3
Figure 3
PRISMA flow chart for review of individual studies of weight. *EMBASE search excluded journals included in MEDLINE. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
See this image and copyright information in PMC

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