Yan Zhang, Zelin He, Zikang Yin, Ji Wang, Wanyi Gao, Ligang Jie
{"title":"运动干预对类风湿关节炎的影响：随机对照试验的系统回顾和网络荟萃分析。","authors":"Yan Zhang, Zelin He, Zikang Yin, Ji Wang, Wanyi Gao, Ligang Jie","doi":"10.2147/JPR.S537227","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of various exercise modalities for Rheumatoid arthritis (RA) employing a network meta-analysis.</p><p><strong>Methods: </strong>A systematic search was conducted across eight databases-PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and SinoMed-up to December 4, 2024, for randomized controlled trials on exercise for RA. The Cochrane Risk of Bias Assessment Tool (RoB 2) assessed study quality. A network meta-analysis was performed utilizing Stata 17.0. Our study measured outcomes through mean differences (MD) accompanied by 95% credible intervals (CIs) to quantify effect sizes, while interventions were ranked using surface under the cumulative ranking curve (SUCRA) probability scores, and the Confidence in Network Meta-Analysis (CINeMA) software to evaluate evidence certainty.</p><p><strong>Results: </strong>A total of 34 trials included 2,435 RA patients and 10 exercise interventions: walking or jogging, relaxation training, resistance exercise, Pilates, aerobic exercise, aerobic exercise + resistance exercise, yoga, traditional Chinese exercise, cycling, and Pilates + walking or jogging. The NMA results indicated that Pilates was the most effective for pain relief (VAS: MD = -2.17 cm, 95% CI: -3.77 to -2.57, SUCRA = 91.8%); aerobic exercise + resistance exercise was most effective for reducing morning stiffness duration (MD = -8.23 min, 95% CI: -9.06 to -7.39, SUCRA = 100.0%); and traditional Chinese exercise was most effective for improving disease activity (DAS28-ESR: MD = -0.68 scores, 95% CI: -1.04 to -0.32, SUCRA = 95.5%). Risk assessment showed 4 studies \"low\", 4 \"high\", and 26 \"some concern\" regarding bias. The CINeMA assessment indicated that most comparisons provided low or very low-quality evidence.</p><p><strong>Conclusion: </strong>Exercise interventions are effective supplements for RA treatment, with specific exercises offering distinct benefits: Pilates for pain, aerobic exercise + resistance exercise for morning stiffness, traditional Chinese exercise for disease activity. Further high-quality studies are needed for validation.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"5109-5126"},"PeriodicalIF":2.5000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495934/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of Exercise Interventions for Rheumatoid Arthritis: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials.\",\"authors\":\"Yan Zhang, Zelin He, Zikang Yin, Ji Wang, Wanyi Gao, Ligang Jie\",\"doi\":\"10.2147/JPR.S537227\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare the efficacy of various exercise modalities for Rheumatoid arthritis (RA) employing a network meta-analysis.</p><p><strong>Methods: </strong>A systematic search was conducted across eight databases-PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and SinoMed-up to December 4, 2024, for randomized controlled trials on exercise for RA. The Cochrane Risk of Bias Assessment Tool (RoB 2) assessed study quality. A network meta-analysis was performed utilizing Stata 17.0. Our study measured outcomes through mean differences (MD) accompanied by 95% credible intervals (CIs) to quantify effect sizes, while interventions were ranked using surface under the cumulative ranking curve (SUCRA) probability scores, and the Confidence in Network Meta-Analysis (CINeMA) software to evaluate evidence certainty.</p><p><strong>Results: </strong>A total of 34 trials included 2,435 RA patients and 10 exercise interventions: walking or jogging, relaxation training, resistance exercise, Pilates, aerobic exercise, aerobic exercise + resistance exercise, yoga, traditional Chinese exercise, cycling, and Pilates + walking or jogging. The NMA results indicated that Pilates was the most effective for pain relief (VAS: MD = -2.17 cm, 95% CI: -3.77 to -2.57, SUCRA = 91.8%); aerobic exercise + resistance exercise was most effective for reducing morning stiffness duration (MD = -8.23 min, 95% CI: -9.06 to -7.39, SUCRA = 100.0%); and traditional Chinese exercise was most effective for improving disease activity (DAS28-ESR: MD = -0.68 scores, 95% CI: -1.04 to -0.32, SUCRA = 95.5%). Risk assessment showed 4 studies \\\"low\\\", 4 \\\"high\\\", and 26 \\\"some concern\\\" regarding bias. The CINeMA assessment indicated that most comparisons provided low or very low-quality evidence.</p><p><strong>Conclusion: </strong>Exercise interventions are effective supplements for RA treatment, with specific exercises offering distinct benefits: Pilates for pain, aerobic exercise + resistance exercise for morning stiffness, traditional Chinese exercise for disease activity. 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Effect of Exercise Interventions for Rheumatoid Arthritis: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials.
Objective: To compare the efficacy of various exercise modalities for Rheumatoid arthritis (RA) employing a network meta-analysis.
Methods: A systematic search was conducted across eight databases-PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and SinoMed-up to December 4, 2024, for randomized controlled trials on exercise for RA. The Cochrane Risk of Bias Assessment Tool (RoB 2) assessed study quality. A network meta-analysis was performed utilizing Stata 17.0. Our study measured outcomes through mean differences (MD) accompanied by 95% credible intervals (CIs) to quantify effect sizes, while interventions were ranked using surface under the cumulative ranking curve (SUCRA) probability scores, and the Confidence in Network Meta-Analysis (CINeMA) software to evaluate evidence certainty.
Results: A total of 34 trials included 2,435 RA patients and 10 exercise interventions: walking or jogging, relaxation training, resistance exercise, Pilates, aerobic exercise, aerobic exercise + resistance exercise, yoga, traditional Chinese exercise, cycling, and Pilates + walking or jogging. The NMA results indicated that Pilates was the most effective for pain relief (VAS: MD = -2.17 cm, 95% CI: -3.77 to -2.57, SUCRA = 91.8%); aerobic exercise + resistance exercise was most effective for reducing morning stiffness duration (MD = -8.23 min, 95% CI: -9.06 to -7.39, SUCRA = 100.0%); and traditional Chinese exercise was most effective for improving disease activity (DAS28-ESR: MD = -0.68 scores, 95% CI: -1.04 to -0.32, SUCRA = 95.5%). Risk assessment showed 4 studies "low", 4 "high", and 26 "some concern" regarding bias. The CINeMA assessment indicated that most comparisons provided low or very low-quality evidence.
Conclusion: Exercise interventions are effective supplements for RA treatment, with specific exercises offering distinct benefits: Pilates for pain, aerobic exercise + resistance exercise for morning stiffness, traditional Chinese exercise for disease activity. Further high-quality studies are needed for validation.
期刊介绍：
Journal of Pain Research is an international, peer-reviewed, open access journal that welcomes laboratory and clinical findings in the fields of pain research and the prevention and management of pain. Original research, reviews, symposium reports, hypothesis formation and commentaries are all considered for publication. Additionally, the journal now welcomes the submission of pain-policy-related editorials and commentaries, particularly in regard to ethical, regulatory, forensic, and other legal issues in pain medicine, and to the education of pain practitioners and researchers.
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