Evidence summary (Added 2022)
Fatigue is a common symptom in inflammatory rheumatic disease and can be particularly challenging to manage.
In rheumatoid arthritis, a recent systematic review and meta-analysis of 5 randomised controlled trials found that land-based aerobic exercise is associated with statistically significant reductions in fatigue and, in particular, in the short term (1). However, the authors concluded that given the scarcity of data and set cut off points, it may be unlikely that a substantial number of participants with RA could obtain clinically relevant reductions in fatigue.
Quality of evidence:
Grade B – Moderate quality evidence in RA
Strength of recommendation
Grade 2 – Weak Recommendation for RA given scarcity of data identified in only 1 systematic review.
Fatigue is a challenging symptom and there is evidence to suggest that in RA, physical activity and exercise interventions can help with these symptoms. In RA, aerobic exercise is likely to have some short-term benefits in improving fatigue however further evidence is needed to support this.
- Kelley GA, Kelley KS, Callahan LF. Aerobic Exercise and Fatigue in Rheumatoid Arthritis Participants: A Meta-Analysis Using the Minimal Important Difference Approach. Arthritis Care Res (Hoboken). 2018 Dec;70(12):1735-1739. doi: 10.1002/acr.23570. PMID: 29609204; PMCID: PMC6168432.