Exercise Therapy Improves Muscle Mass in Patients With Rheumatoid Arthritis

man exercising on elliptical in gym
man exercising on elliptical in gym
In a meta-analysis, researchers investigated the effectiveness of exercise therapy on muscle mass gain in patients with rheumatoid arthritis and identified the factors for treatment efficacy in muscle mass gain.

Exercise therapy is effective in improving muscle mass and preventing sarcopenia in patients with rheumatoid arthritis (RA); however, the treatment effect is reduced in patients with a longer disease duration, according to findings from a meta-analysis published in Clinical Rehabilitation.

Patients with RA are at higher risk for sarcopenia, a condition associated with disability and poor quality of life. Exercise therapy can counteract a decline in muscle mass in older adults, though the extent to which exercise is effective in RA is unclear.

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Researchers conducted a systematic review of online databases for randomized control trials that investigated the effect of exercise therapy on muscle mass in adults with RA. Meta-analyses, risk for bias assessments, and meta-regression analyses (including heterogeneity of treatment effects across studies) were also conducted.

Nine randomized control trials published between 1994 and 2020 were included in the analysis. Scores for the trials ranged from 4/10 to 8/10 (median of 6/10), indicating fair to good methodologic quality. Pooled measures of muscle mass indicated that exercise therapy improved muscle mass (weighted mean effect size, 0.77; 95% CI, 0.30-1.24; P =.001; I2=77%). According to meta-regression analyses, disease duration significantly explained the heterogeneity in treatment effect on muscle mass (b=-0.006; R2=69.7%; P =.005).

Limitations of the study included differences in exercise regimens between the studies, small sample sizes, and short follow-up durations.

The researchers concluded, “… exercise therapy safely and potentially offsets muscle attenuation and prevents sarcopenia in patients with [RA].”


Liao CD, Chen HC, Huang SW, Liou TH. Exercise therapy for sarcopenia in rheumatoid arthritis: a meta-analysis and meta-regression of randomized control studies. Clin Rehabil. Published August 18, 2021. doi:10.1177/02692155211035539