Annals of physical and rehabilitation medicine · 2026 · 系統性回顧＋統合分析（依標題推測）
Effects of exercise interventions on clinical outcomes in pre-clinical and early rheumatoid arthritis: a systematic review and meta-analysis.
全身性肌肉骨骼・風濕・疼痛 · 類風濕性關節炎
中文閱讀摘要
統合分析顯示運動改善早期類風濕性關節炎肌力、手部功能及疼痛，但未顯著改善疾病活動度，且多數研究偏倚風險較高。
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原始摘要
Background
Exercise reduces health complications related to early rheumatoid arthritis (RA). No previous review has systematically evaluated the effects of exercise in pre-clinical and early RA.
Objective
This systematic review and meta-analysis aimed to assess the effectiveness of exercise in pre-clinical and early RA and to identify which intervention characteristics are associated with better clinical outcomes.
Methods
We searched PubMed/MEDLINE, Scopus, and Web of Science up to January 2026 for randomized controlled trials examining effects of exercise in pre-clinical and early RA on: (i) inflammation markers and disease activity, (ii) muscle strength, cardiovascular fitness, functional capacity, and body composition, and (iii) pain, fatigue and quality of life. Effect sizes (ES) with 95% confidence intervals (95% CI) were calculated using random-effects meta-analyses. Meta-regressions and RoB 2 risk-of-bias assessments were conducted.
Results
Fifteen studies involving 1154 participants with early RA were identified. Most studies showed a moderate-to-high risk of bias. No randomized trials were identified in pre-clinical populations. Exercise improved hand status (ES = 0.33; 95% CI, 0.10-0.57; P = 0.001), self-reported functional capacity (ES = 0.36; 95% CI, 0.00-0.73; P = 0.049), muscle strength (ES = 0.66; 95% CI, 0.16-1.15; P = 0.022), and pain (ES = 0.66; 95% CI, 0.00-1.22; P = 0.049). No effects appeared for disease activity (ES = 0.17; 95% CI, -0.05-0.40; P = 0.101), morning stiffness (ES = 0.13; 95% CI, -0.25-0.52; P = 0.351), test-based functional capacity (ES = 0.38; 95% CI, -0.12-0.89; P = 0.112), and quality of life (ES = 0.42; 95% CI, -0.18-1.02; P = 0.134). Sensitivity analyses revealed benefits for test-based functional capacity (P = 0.047) and morning stiffness (P = 0.024). Meta-regression showed no moderating effect of disease duration, intervention type, or supervision (P ≥ 0.089).
Conclusions
Exercise confers modest benefits in strength, hand function, functional capacity, pain, and morning stiffness in early RA, supporting its integration alongside pharmacologic care. Major evidence gaps remain for cardiovascular fitness, fatigue, mental health, inflammation, and the pre-clinical population. Well-designed preventive and early-phase trials are needed.
Trial registration
PROSPERO identifier: CRD42024522163.
至 Europe PMC 閱讀完整來源 ↗ · 擷取日期 2026-10-19
書目、來源與全文狀態
- DOI
- 10.1016/j.rehab.2026.102115
- PMID／PMCID
- 42013636
- 作者
- Courel-Ibáñez J, Buendía-Romero Á, Vetrovsky T
- 首次發表日期
- 2026-04-20Europe PMC 提供，部分日期可能依年份或月份推定。
- 卷／期／頁碼或文章編號
- 69 ／ 5 ／ 102115
- 書目來源與查核日期
- Europe PMC · 2026-10-19僅核對書目欄位與來源連結；不代表已評讀研究品質。
- 全文與授權
- 來源尚未確認免費全文。 來源授權標示：cc by。
可回溯引用
Courel-Ibáñez J, Buendía-Romero Á, Vetrovsky T. Effects of exercise interventions on clinical outcomes in pre-clinical and early rheumatoid arthritis: a systematic review and meta-analysis. Annals of physical and rehabilitation medicine. 2026;69(5):102115. PMID: 42013636. doi:10.1016/j.rehab.2026.102115
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