Effects of high-intensity interval training on patients with inflammatory arthritis: a systematic review.

Abstract

Background: Despite reports of clinical benefits, concerns persist about the stress associated with high-intensity interval training (HIIT) in patients with inflammatory arthritis (IA). This review aimed to assess the effects of HIIT on disease activity, immune function, symptoms, cardiorespiratory fitness (CRF), and overall health-related quality of life (HRQoL) in patients with IA.

Methods: The PubMed, CINAHL, Cochrane Library, Web of Science, and Scopus databases were searched for eligible randomised controlled trials (RCTs). Data were extracted on the impacts of HIIT on IA conditions (i.e. rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA)). Cochrane risk of bias tool 2.0 and PEDro scale were used in this review. This review was registered with PROSPERO (CRD42024577039).

Results: Of 117 initial records, nine studies met the inclusion criteria, comprising 586 IA patients (HIIT = 285; controls = 301). Most studies (n = 8) reported stable disease activity, but one showed a slight decrease. Of four studies reporting pain/fatigue, pain scores remained unchanged in most studies (n = 3), except in one where there was a significant reduction in pain in the HIIT group (p < 0.05), and two studies reported a decrease in fatigue (p < 0.05). All studies evaluating CRF reported improvements, with one also indicating enhanced HRQoL. Body composition measures showed either reductions or no change, while imaging assessments in two studies revealed no significant differences.

Conclusion: HIIT appears safe for patients with IA and does not exacerbate disease activity. HIIT resulted in improvement in CRF parameters, alongside positive changes in HRQoL. However, more high-quality RCTs are needed due to limited research in this area.