Effects of lifestyle physical activity and sedentary behaviour interventions on disease activity and patient- and clinician- important health outcomes in rheumatoid arthritis: a systematic review with meta-analysis.
Brady SM Veldhuijzen van Zanten JJCS Dinas PC Nightingale TE Metsios GS Elmsmari SMA Duda JL Kitas GD Fenton SAM
Brady SM
Veldhuijzen van Zanten JJCS
Dinas PC
Nightingale TE
Metsios GS
Elmsmari SMA
Duda JL
Kitas GD
Fenton SAM
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Affiliation
University of Birmingham; The Dudley Group NHS Foundation Trust; University of Thessaly et al
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Publication date
06/09/2023
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Abstract
Lifestyle physical activity (PA) is defined as any type of PA undertaken as part of daily life. It can include engagement in activities of daily living (i.e., household chores, gardening, walking to work), incidental PA, walking and/or reducing sedentary or sitting behaviours (SB). Regular PA is recommended for people with Rheumatoid Arthritis (RA) to reduce disease activity and systemic inflammation, as well as to improve patient- and clinician-important health outcomes. However, there is no summarised evidence of the effectiveness of interventions specifically targeting lifestyle PA and SB in this population. The aims of this systematic review with meta-analysis were to evaluate interventions targeting lifestyle PA and/or SB on 1) disease activity 2) PA, SB and 3) patient- and clinician-important outcomes in people with RA. Methods: Eight databases [Medline, Cochrane Library CENTRAL, Web of Science, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Scopus, Excerpta Medica database and Physiotherapy Evidence Database] were searched from inception-August 2022. Inclusion criteria required interventions to target lifestyle PA and/or SB, conducted in adults with RA, assessing patient- and/or clinician-important outcomes. Results: Of 880 relevant articles, 16 interventions met the inclusion criteria. Meta-analyses showed statistically significant effects of interventions on disease activity (standardised mean difference = -0.12 (95% confidence interval = -0.23 to -0.01, I 2 = 6%, z = 2.19, p = .03), moderate-to-vigorous PA, light/leisure PA, steps, functional ability, and fatigue. Whereas, no intervention effects were visualised for total PA, pain, anxiety or quality of life. Conclusions: Lifestyle PA interventions led to increased PA, reductions in SB and improvements in disease activity and other patient- and/or clinician-important health outcomes in people with RA. Future interventions should be less heterogenous in content, structure, focus and outcome measures used to aid understanding of the most effective intervention components for improving health. More SB interventions are needed to determine their effectiveness at producing clinical benefits. � 2023. BioMed Central Ltd., part of Springer Nature.
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Brady SM, Veldhuijzen van Zanten JJCS, Dinas PC, Nightingale TE, Metsios GS, Elmsmari SMA, Duda JL, Kitas GD, Fenton SAM. Effects of lifestyle physical activity and sedentary behaviour interventions on disease activity and patient- and clinician- important health outcomes in rheumatoid arthritis: a systematic review with meta-analysis. BMC Rheumatol. 2023 Sep 6;7(1):27. doi: 10.1186/s41927-023-00352-9. PMID: 37674187; PMCID: PMC10481589.
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Article