Volume 30, Issue 174, August 2026

Optimizing Exercise in Rheumatoid Arthritis: A Systematic Comparison of Aerobic, Resistance, Flexibility, and Lifestyle Approaches

Julia Dzięcioł^1♦, Julia Sawicka¹, Szymon Chmiela¹, Paulina Kisielewska¹, Kinga Dzioba¹, Zuzanna Banaś¹, Weronika Dmoch¹, Gabriela Kamińska¹, Natalia Bołtralik¹

¹Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland

^♦Corresponding author
Julia Dzięcioł Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland

ABSTRACT

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation, pain, fatigue, and reduced joint function. While pharmacotherapy is essential, growing evidence supports exercise as an adjunct therapy. This systematic review evaluates the effects of various exercise modalities on disease activity, function, fatigue, pain, and quality of life in rheumatoid arthritis. Aim: This study aims to systematically review research investigating the effects of regular exercise across various modalities on disease activity, physical function, fatigue, and quality of life (QoL) in RA, and how it may enhance pharmacologic treatment. Methods: We reviewed the available literature using the PRISMA checklist and guidelines in which we conducted an electronic search in PubMed, Embase, and Cochrane library from 1994 to 2024. We involved 17 studies that fulfilled the inclusion criteria and analyzed them by qualitative synthesis of clinical/patient reported outcomes. Results: Aerobic training was associated with improvements in cardiovascular fitness, Disease Activity Score-28 (DAS-28), and energy levels. Resistance training increased muscular strength and physical capacity, and reduced inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Flexibility exercises improved joint mobility and helped with pain control. Everyday lifestyle activities, such as walking, were linked to lower fatigue and greater independence in daily life. Conclusion: Exercise is generally safe for people with rheumatoid arthritis (RA) and can improve both clinical outcomes and how patients feel in everyday life. Adapting exercise plans to individual needs may also help make pharmalogical treatments more effective overall.

Keywords: Rheumatoid arthritis, Physical activity, Exercise, Functional capacity, Inflammation, Quality of life, Systematic review

Medical Science, 2026, 30, e145ms3837

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Published: 12 August 2026