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Background <p>Foot involvement is highly prevalent in rheumatoid arthritis (RA), affecting over 90% of patients during the disease course. However, the specific impact of structured exercise on foot pain and functional limitations remains insufficiently understood. This systematic review and meta-analysis aimed to evaluate the effectiveness of supervised exercise programs on foot-specific outcomes in adults with RA.</p> Methods <p>We conducted a systematic review and meta-analysis following PRISMA guidelines, searching five databases for randomized and controlled quasi-experimental trials evaluating supervised exercise interventions in adults with RA and foot involvement. Primary outcomes included foot pain and physical function measures. Data were pooled using random-effects models, and risk of bias was assessed using Cochrane tools. Analysis was performed with RevMan 5.4 and STATA 17.</p> Results <p>Thirteen studies (<i>n</i> = 548) were included; ten entered the meta-analysis. Exercise significantly reduced foot pain (SMD − 0.68, 95% CI − 0.89 to − 0.46; <i>p</i> &lt; 0.001) and improved function (Health Assessment Questionnaire SMD − 0.73, 95% CI − 0.96 to − 0.49; 6MWT MD + 47.6&#xa0;m, 95% CI 31.4 to 63.8; Time Up-and-Go SMD − 0.40, 95% CI − 0.59 to − 0.21). Aquatic exercise and Tai Chi showed larger pain reductions, while high-intensity interval training improved functional outcomes. Programs ≥ 12&#xa0;weeks yielded greater effects. Risk of bias ranged from low to some concerns; non-randomized studies showed moderate–serious confounding risk.</p> Conclusions <p>Supervised, structured exercise reduces foot pain and improves function in RA, with aquatic and combined modalities particularly beneficial. Findings support implementation within multidisciplinary care.</p>

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Effectiveness of physical exercise on foot pain and function in adults with rheumatoid arthritis: systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月21日

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  • Alejandro Cruz-López,
  • Ana María Rayo-Pérez,
  • Natalia Tovaruela-Carrión,
  • Priscila Távara-Vidalón,
  • Pedro V. Munuera-Martínez

摘要

Background

Foot involvement is highly prevalent in rheumatoid arthritis (RA), affecting over 90% of patients during the disease course. However, the specific impact of structured exercise on foot pain and functional limitations remains insufficiently understood. This systematic review and meta-analysis aimed to evaluate the effectiveness of supervised exercise programs on foot-specific outcomes in adults with RA.

Methods

We conducted a systematic review and meta-analysis following PRISMA guidelines, searching five databases for randomized and controlled quasi-experimental trials evaluating supervised exercise interventions in adults with RA and foot involvement. Primary outcomes included foot pain and physical function measures. Data were pooled using random-effects models, and risk of bias was assessed using Cochrane tools. Analysis was performed with RevMan 5.4 and STATA 17.

Results

Thirteen studies (n = 548) were included; ten entered the meta-analysis. Exercise significantly reduced foot pain (SMD − 0.68, 95% CI − 0.89 to − 0.46; p < 0.001) and improved function (Health Assessment Questionnaire SMD − 0.73, 95% CI − 0.96 to − 0.49; 6MWT MD + 47.6 m, 95% CI 31.4 to 63.8; Time Up-and-Go SMD − 0.40, 95% CI − 0.59 to − 0.21). Aquatic exercise and Tai Chi showed larger pain reductions, while high-intensity interval training improved functional outcomes. Programs ≥ 12 weeks yielded greater effects. Risk of bias ranged from low to some concerns; non-randomized studies showed moderate–serious confounding risk.

Conclusions

Supervised, structured exercise reduces foot pain and improves function in RA, with aquatic and combined modalities particularly beneficial. Findings support implementation within multidisciplinary care.