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

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


BACKGROUND: A task force of the European League Against Rheumatism (EULAR) was convened to develop recommendations on lifestyle behaviors in rheumatic and musculoskeletal (MMR) diseases. This article reviews the literature on the effects of exercise and body weight on the disease-specific outcomes of people with MMR.

METHODS: Three systematic reviews were conducted to summarize 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 any of the above RMDs and reported results regarding disease-specific outcomes (eg, pain, function, joint damage) . Systematic reviews were only included if they were published between 2013 and 2018. Search strategies were implemented in Medline, Embase, the Cochrane Library of Systematic Reviews and CENTRAL databases.

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

CONCLUSION: Current literature supports the recommendation of exercise and maintenance of healthy body weight for people with MMR.

PMID:35361692 | DOI: 10.1136/rmdopen-2021-002168

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