Effect of Aerobic Exercise Training on Fatigue in Rheumatoid Arthritis: A Meta‐Analysis

• Published in: Arthritis care & research (2010) Vol. 67; no. 8; pp. 1054 - 1062
• Main Authors: Rongen‐van Dartel, S. A. A., Repping‐Wuts, H., Flendrie, M., Bleijenberg, G., Metsios, G. S., van den Hout, W. B., van den Ende, C. H. M., Neuberger, G., Reid, A., van Riel, P. L. C. M., Fransen, J.
• Format: Journal Article
• Language: English
• Published: United States 01.08.2015
• Subjects: Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - rehabilitation; Exercise; Exercise Therapy - methods; Fatigue - etiology; Fatigue - rehabilitation; Humans; Randomized Controlled Trials as Topic
• ISSN: 2151-464X; 2151-4658
• DOI: 10.1002/acr.22561

Objective Rheumatoid arthritis (RA) fatigue is not being well‐managed currently, and evidence of effective interventions is limited. Aerobic exercise may provide benefit to treat fatigue in RA. Therefore, the purpose of this meta‐analysis is to analyze the effect of aerobic land‐based exercise on fatigue in RA. Methods A literature search was conducted using PubMed, Cochrane Library, Embase, and trial registers to identify randomized controlled trials (RCTs) with a supervised land‐based aerobic exercise program performed with an intensity between 50% and 90% of maximal heart rate, of at least 15 minutes' duration, performed at least 2 times a week, and lasting for a time period of at least 4 consecutive weeks. Risk of bias was assessed using the Cochrane tool. A meta‐analysis of fatigue outcomes was performed by calculating the standardized mean difference (SMD) using a random‐effects model. Results Five RCTs were included. None of the trials selected patients with RA for having fatigue. Risk of bias was low in 3 RCTs and unclear in 2. Land‐based aerobic exercise programs had a positive effect on fatigue in RA compared to no exercise at 12 weeks, SMD −0.31 (95% confidence interval [95% CI] −0.55, −0.06). At 24 weeks, the effect of aerobic land‐based exercise was smaller and not statistically significant: SMD −0.15 (95% CI −0.33, 0.02). Conclusion There is evidence with low risk of bias that an aerobic exercise program is effective in reducing fatigue among patients with RA, especially in the short term; however, effects are small. To substantiate the evidence, RCTs should be performed in patients with RA selected for having fatigue.