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IRD IA – Improves disease activity

Evidence summary (Added 2022)

Both aerobic and resistance training exercises and yoga have been shown in extensive systematic reviews to reduce disease activity scores in patients with rheumatoid arthritis (1-4) Further, there is robust evidence suggesting that physical activity appears to be general safe in patients with RA, without causing any major adverse side effects (5,6).

Quality of evidence:
Grade A – High quality – Numerous systematic reviews with meta-analysis showing good improvement in disease activity in RA .

Strength of recommendation

Grade 1 – Strong recommendation in RA – consistent benefits seen across studies

There is a strong evidence that physical activity and exercise interventions have been shown to improve validated disease activity scores in RA.


  1. Burghardt RD, Kazim MA, Rüther W, Niemeier A, Strahl A. The impact of physical activity on serum levels of inflammatory markers in rheumatoid arthritis: a systematic literature review. Rheumatol Int. 2019 May;39(5):793-804. doi: 10.1007/s00296-019-04284-x. Epub 2019 Mar 21. PMID: 30899988.
  2. Wang L, Gao C, Zhu D, Chen LH. [Effect of functional exercises on patients with rheumatoid arthritis: a meta-analysis]. Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Dec 18;50(6):991-997. Chinese. PMID: 30562770.
  3. Wen Z, Chai Y. Effectiveness of resistance exercises in the treatment of rheumatoid arthritis: A meta-analysis. Medicine. 2021 Apr 2;100(13).
  4. Ye X, Chen Z, Shen Z, Chen G, Xu X. Yoga for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Frontiers in medicine. 2020 Nov 27;7:876.
  5. Santos EJF, Duarte C, Marques A, Cardoso D, Apóstolo J, da Silva JAP, Barbieri-Figueiredo M. Effectiveness of non-pharmacological and non-surgical interventions for rheumatoid arthritis: an umbrella review. JBI Database System Rev Implement Rep. 2019 Jul;17(7):1494-1531. doi: 10.11124/JBISRIR-D-18-00020. PMID: 31169776
  6. Sobue Y, Kojima T, Ito H, Nishida K, Matsushita I, Kaneko Y, Kishimoto M, Kohno M, Sugihara T, Seto Y, Tanaka E. Does exercise therapy improve patient-reported outcomes in rheumatoid arthritis? A systematic review and meta-analysis for the update of the 2020 JCR guidelines for the management of rheumatoid arthritis. Modern rheumatology. 2021 Feb 9:1-4.