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Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: Meta‐analysis of randomized controlled trials
Author(s) -
Baillet Athan,
Zeboulon Nadine,
Gossec Laure,
Combescure Christophe,
Bodin LouisAntoine,
Juvin Robert,
Dougados Maxime,
Gaudin Philippe
Publication year - 2010
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.20146
Subject(s) - medicine , aerobic exercise , cardiorespiratory fitness , physical therapy , randomized controlled trial , quality of life (healthcare) , meta analysis , visual analogue scale , rheumatoid arthritis , rehabilitation , rheumatology , sports medicine , nursing
Objective Several lines of evidence have emphasized an improvement in aerobic capacity and muscle strength after physical exercise programs in rheumatoid arthritis (RA) patients. Our objective was to evaluate the efficacy of aerobic exercises in RA on quality of life, function, and clinical and radiologic outcomes by a systematic literature review and a meta‐analysis. Methods A systematic literature search was performed in the Medline, EMBase, and Cochrane databases up to July 2009 and in the abstracts presented at rheumatology scientific meetings during the last 5 years. Randomized controlled trials (RCTs) comparing aerobic exercises with non‐aerobic interventions in RA patients were included. Outcomes studied were postintervention quality of life, function assessed by the Health Assessment Questionnaire (HAQ), a pain visual analog scale (VAS), joint count, the Disease Activity Score in 28 joints (DAS28), and radiologic damage. Efficacy was assessed by standardized mean differences (SMDs; difference between groups of mean outcome variation from baseline/SD at baseline) of aerobic exercises versus non‐aerobic rehabilitation. Heterogeneity was tested. SMDs were pooled by a meta‐analysis using the inverse of variance model. Results Fourteen RCTs, including 1,040 patients, met the inclusion criteria. Exercise improved the postintervention quality of life (SMD 0.39, P < 0.0001), HAQ score (SMD 0.24, P = 0.0009), and pain VAS (SMD 0.31, P = 0.02). Exercise in this RA population appeared safe, since global compliance, DAS28, and joint count were similar in both groups. Conclusion Cardiorespiratory aerobic conditioning in stable RA appears to be safe and improves some of the most important outcome measures. However, the degree of the effect of aerobic exercise on the abovementioned parameters is small.