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已发表论文
运动干预对类风湿关节炎的影响：随机对照试验的系统评价和网络荟萃分析
Authors Zhang Y , He Z , Yin Z , Wang J, Gao W , Jie L
Received 30 May 2025
Accepted for publication 10 September 2025
Published 30 September 2025 Volume 2025:18 Pages 5109—5126
DOI https://doi.org/10.2147/JPR.S537227
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Michael A Ueberall
Yan Zhang,1 Zelin He,1 Zikang Yin,1 Ji Wang,2 Wanyi Gao,1 Ligang Jie1
1Department of Rheumatology and Clinical Immunology, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 2Department of Traditional Chinese Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
Correspondence: Ligang Jie, Department of Rheumatology and Clinical Immunology, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China, Email jieligang1976@smu.edu.cn
Objective: To compare the efficacy of various exercise modalities for Rheumatoid arthritis (RA) employing a network meta-analysis.
Methods: A systematic search was conducted across eight databases—PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and SinoMed—up to December 4, 2024, for randomized controlled trials on exercise for RA. The Cochrane Risk of Bias Assessment Tool (RoB 2) assessed study quality. A network meta-analysis was performed utilizing Stata 17.0. Our study measured outcomes through mean differences (MD) accompanied by 95% credible intervals (CIs) to quantify effect sizes, while interventions were ranked using surface under the cumulative ranking curve (SUCRA) probability scores, and the Confidence in Network Meta-Analysis (CINeMA) software to evaluate evidence certainty.
Results: A total of 34 trials included 2,435 RA patients and 10 exercise interventions: walking or jogging, relaxation training, resistance exercise, Pilates, aerobic exercise, aerobic exercise + resistance exercise, yoga, traditional Chinese exercise, cycling, and Pilates + walking or jogging. The NMA results indicated that Pilates was the most effective for pain relief (VAS: MD = − 2.17 cm, 95% CI: − 3.77 to − 2.57, SUCRA = 91.8%); aerobic exercise + resistance exercise was most effective for reducing morning stiffness duration (MD = − 8.23 min, 95% CI: − 9.06 to − 7.39, SUCRA = 100.0%); and traditional Chinese exercise was most effective for improving disease activity (DAS28-ESR: MD = − 0.68 scores, 95% CI: − 1.04 to − 0.32, SUCRA = 95.5%). Risk assessment showed 4 studies “low”, 4 “high”, and 26 “some concern” regarding bias. The CINeMA assessment indicated that most comparisons provided low or very low-quality evidence.
Conclusion: Exercise interventions are effective supplements for RA treatment, with specific exercises offering distinct benefits: Pilates for pain, aerobic exercise + resistance exercise for morning stiffness, traditional Chinese exercise for disease activity. Further high-quality studies are needed for validation.
Keywords: exercise, rheumatoid arthritis, network meta-analysis, systematic review, pain, pilates
1Department of Rheumatology and Clinical Immunology, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 2Department of Traditional Chinese Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
Correspondence: Ligang Jie, Department of Rheumatology and Clinical Immunology, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China, Email jieligang1976@smu.edu.cn
Objective: To compare the efficacy of various exercise modalities for Rheumatoid arthritis (RA) employing a network meta-analysis.
Methods: A systematic search was conducted across eight databases—PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and SinoMed—up to December 4, 2024, for randomized controlled trials on exercise for RA. The Cochrane Risk of Bias Assessment Tool (RoB 2) assessed study quality. A network meta-analysis was performed utilizing Stata 17.0. Our study measured outcomes through mean differences (MD) accompanied by 95% credible intervals (CIs) to quantify effect sizes, while interventions were ranked using surface under the cumulative ranking curve (SUCRA) probability scores, and the Confidence in Network Meta-Analysis (CINeMA) software to evaluate evidence certainty.
Results: A total of 34 trials included 2,435 RA patients and 10 exercise interventions: walking or jogging, relaxation training, resistance exercise, Pilates, aerobic exercise, aerobic exercise + resistance exercise, yoga, traditional Chinese exercise, cycling, and Pilates + walking or jogging. The NMA results indicated that Pilates was the most effective for pain relief (VAS: MD = − 2.17 cm, 95% CI: − 3.77 to − 2.57, SUCRA = 91.8%); aerobic exercise + resistance exercise was most effective for reducing morning stiffness duration (MD = − 8.23 min, 95% CI: − 9.06 to − 7.39, SUCRA = 100.0%); and traditional Chinese exercise was most effective for improving disease activity (DAS28-ESR: MD = − 0.68 scores, 95% CI: − 1.04 to − 0.32, SUCRA = 95.5%). Risk assessment showed 4 studies “low”, 4 “high”, and 26 “some concern” regarding bias. The CINeMA assessment indicated that most comparisons provided low or very low-quality evidence.
Conclusion: Exercise interventions are effective supplements for RA treatment, with specific exercises offering distinct benefits: Pilates for pain, aerobic exercise + resistance exercise for morning stiffness, traditional Chinese exercise for disease activity. Further high-quality studies are needed for validation.
Keywords: exercise, rheumatoid arthritis, network meta-analysis, systematic review, pain, pilates