Overview of Cochrane Systematic Reviews of rehabilitation interventions for persons with rheumatoid arthritis: a mapping synthesis.
Ayşe A Küçükdeveci, Burak K Turan, Chiara Arienti and 1 others
PMID 36727299WHAT IT FOUND
Exercise programs improve muscle strength and fatigue in rheumatoid arthritis but do not consistently reduce pain or improve physical function.
Hand exercises help hand function without worsening disease activity. Balneotherapy and Tai Chi evidence is too weak to guide practice.
Key findings
01Hand exercises improved hand function in the medium and long term compared to no exercise, but showed little or no effect on grip strength or pain.
02Short-term land-based aerobic capacity and muscle strength training improved muscle strength at 12 weeks but had no effect on pain or physical function.
03Physical activity interventions improved fatigue more effectively than control at the end of the intervention period.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The overview only included Cochrane Systematic Reviews, potentially missing other high-quality evidence. Major rehabilitation areas like orthoses, physical modalities, and therapeutic patient education were not covered because no recent CSRs existed for them. The search was limited to the term 'rheumatoid arthritis' and did not include 'inflammatory arthritis', which might have missed relevant reviews. Many findings were based on low or very low-quality evidence, particularly for Tai Chi and balneotherapy.
Declared interests
The study was conducted in collaboration with Cochrane Rehabilitation for the WHO Rehabilitation Program. No specific commercial funding or conflicts of interest for the authors were declared in the text provided, though the work was part of a WHO guideline development process.
The easy way to misread this
Do not conclude that exercise is ineffective for pain because the primary outcomes for pain were often null or inconclusive; the evidence specifically supports exercise for improving muscle strength, hand function, and fatigue, and confirms it is safe.