SP0085 The evidence for physical activity in inflammatory arthritis and osteoarthritis

Abstract

Objective: To evaluate the effectiveness of physical activity in people with rheumatoid arthritis, spondyloarthritis and osteoarthritis. Methods: A Systematic review and meta-analysis were performed searching he databases Pubmed/Medline, CENTRAL, Embase, Web of Science, Emcare, PsycInfo up to April 2017. We included randomised controlled trials (RCT)s in adults (≥18 years) with rheumatoid arthritis (RA), spondyloarthritis (SpA) and osteoarthritis (OA) investigating the effect of exercise or physical activity (PA) promotion on cardiovascular fitness, muscle strength, flexibility, neuromotor performance, and daily PA. Additionally we applied public health recommendations for PA based on the American College of Sports Medicine (ACSM) principles for effective interventions. Outcomes included assessments done directly after the intervention; If suitable, pooled in a meta-analysis using a random-effect model presented as standardised mean difference (SMD). Study registration in PROSPERO (CRD42017082131). Results: The systematic review included 63 RCTs, of which 44 (3469 people with RA, SpA, OA) were included in the meta-analysis. Moderate effects were found of aerobic exercises and resistance training on cardiovascular fitness (SMD 0.6 (95% CI 0.38 to 0.81)) and muscle strength (SMD 0.54 (95% CI 0.35 to 0.72)) respectively, but no effect of combined exercises on flexibility (SMD 0.12 (95% CI -0.16 to 0.41)). PA promotion interventions produced a small increase in PA behaviour (SMD 0.21 (95% CI 0.03 to 0.38)). Conclusion: Exercising and PA promotion according to public recommendations for PA were effective on cardiovascular fitness and muscle strength, with moderate, and thus clinically relevant effect sizes in people with SpA, RA and OA.