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 - Tập 8 Số 1 - Trang e002168 - 2022
James M. Gwinnutt1,2, M. Wieczorek3,4,5,6, Giulio Cavalli7,8, Andra Bălănescu9,10, Heike A. Bischoff‐Ferrari3,11,12,13,14,5, Annelies Boonen15,16,17,18, Savia de Souza19,20, Annette de Thurah21,22,23,24, Thomas E. Dorner25,26,27,28,29, Rikke Helene Moe30,31, Polina Putrik15,16,17,18, Javier Rodríguez‐Carrio32,33,34,35, Lucía Silva-Fernández36,37, Tanja Stamm38,27,39, Karen Walker‐Bone40,41, Joep Welling42, Mirjana Zlatković‐Švenda43,44,45,46, Françis Guillemin4,47,6, Suzanne Verstappen1,40,48,49,2,41
1Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health
2The University of Manchester
3Center on Aging and Mobility
4EA 4360 Apemac
5University of zurich;
6Université de Lorraine
7IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University
8Unit of Immunology, Rheumatology, Allergy and Rare Diseases
9′Carol Davila′ University of Medicine and Pharmacy
10Department of Internal Medicine and Rheumatology, "Sf. Maria" Hospital
11City Hospital Zurich - Waid
12Department of Aging Medicine and Aging Research
13University Clinic for Aging Medicine
14University Hospital Zurich and University of Zurich
15Care and Public Health Research Institute (CAPHRI)
16Department of Internal Medicine, Division of Rheumatology
17Maastricht University
18Maastricht University Medical Center
19Centre for Rheumatic Diseases,
20King's College London
21Aarhus University
22Aarhus University Hospital
23Department of Clinical Medicine
24Department of Rheumatology
25Centre for Public Health, Department of Social and Preventive Medicine
26Karl-Landsteiner Institute for Health Promotion Research
27Medical University of Vienna
28Railway and Mining Industries
29Social Insurance Fund for Public Service
30Diakonhjemmet Hospital
31National Advisory Unit for Rehabilitation in Rheumatology, Division of Rheumatology and Research
32Area of Immunology, Department of Functional Biology
33Department of Metabolism
34Instituto de Investigación Sanitaria del Principado de Asturias (ISPA)
35Universidad de Oviedo
36Hospital Universitari Son Espases
37Rheumatology Department
38Ludwig Boltzmann Institute for Arthritis and Rehabilitation
39Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems
40MRC Versus Arthritis Centre for Musculoskeletal Health and Work
41University of Southampton *
42NVLE Dutch Patient Organization for Systemic Autoimmune Diseases
43Department of Internal Medicine
44Institute of Rheumatology
45University of Belgrade School of Medicine
46University of East Sarajevo Faculty of Medicine Foča
47Inserm, CHRU Nancy, CIC-1433 Epidémiologie Clinique
48Manchester Academic Health Science Centre
49NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust

Tóm tắt

BackgroundA 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.MethodsThree 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.Results236 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.ConclusionThe current literature supports recommending exercise and the maintenance of a healthy body weight for people with RMDs.

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