Objective: Although physical activity is an evidence‐based intervention that reduces disease‐related symptoms and comorbidity in rheumatoid arthritis (RA), the effect of physical activity on self‐reported function and quality of life (QoL) has not yet been analyzed. The present study synthesizes the evidence for the effectiveness of physical activity on QoL and self‐reported function in adults with RA, spondyloarthritis (SpA), and psoriatic arthritis (PsA).Methods: The databases PubMed, Embase, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify relevant randomized controlled trials (RCTs). Screening, risk of bias assessment (using the RoB 2.0 tool), and data extraction were independently performed by 2 or more of the authors. Meta‐analyses were conducted with a random‐effects model.Results: Systematic review included 55 RCTs, and meta‐analysis included 37 RCTs. Of the 55 studies included, 76%, 20%, and 4% were designed to investigate RA, SpA, and PsA, respectively. In the RA studies, effects of physical activity on QoL and function were found compared to the group of inactive controls; no effects were found compared to the group of active controls. In the SpA studies, the effects of physical activity on QoL were in favor of the control group. Effects of physical activity on function were found compared to the group of inactive controls and sustained in fatigue and pain when compared to the group of active controls. In the PsA studies, no effects on QoL were found, but effects on function were noted when compared to the group of inactive controls. The effect size was below 0.30 in the majority of the comparisons.Conclusion: Physical activity may improve QoL and self‐reported function in individuals with RA, SpA, and PsA. However, larger trials are needed, especially in SpA and PsA.

Background Besides pharmacological treatment, regular exercise is one of the cornerstones of care in rheumatoid arthritis (RA). In many of the earlier studies of exercise in RA, the intensity of the exercise did not reach the current recommendations or is not described in satisfactory detail. This narrative review is based on randomised controlled trials with a detailed description of the exercise type, frequency, duration and intensity. Results There is moderate-quality evidence that short-term land-based aerobic exercise of moderate to high intensity augments oxygen uptake but does not improve muscle strength. Short-term water-based aerobic exercise of moderate to high intensity augments oxygen uptake; short term land-based aerobic and muscle strengthening exercise of moderate to high intensity augments oxygen uptake and muscle strength. Long-term land-based aerobic and muscle strengthening exercise of moderate to high intensity reduces activity limitations and improves both oxygen uptake and muscle strength. Conclusions Clinicians should recommend that patients with RA participate in various types of exercise.

There is convincing evidence to suggest that exercise interventions can significantly improve disease-related outcomes as well as comorbidities in rheumatic and musculoskeletal diseases (RMDs). All exercise interventions should be appropriately defined by their dose, which comprises of two components: a) the FITT (frequency, intensity, time and type) and b) the training (ie, specificity, overload, progression, initial values, reversibility, and diminishing returns) principles. In the published RMD literature, exercise dosage is often misreported, which in “pharmaceutical treatment terms”, this would be the equivalent of receiving the wrong medication dosage. Lack of appropriately reporting exercise dosage in RMDs, therefore, results in limited clarity on the effects of exercise interventions on different outcomes while it also hinders reproducibility, generalisability and accuracy of research findings. Based on the collective but limited current knowledge, the main purpose of the present Position Statement is to provide specific guidance for RMD researchers to help improve the reporting of exercise dosage and help advance research into this important field of investigation. We also propose the use of the IMPACT-RMD toolkit, a tool that can be used in the design and reporting phase of every trial.

Purpose: To describe content validity, concurrent validity, sensitivity to change, internal consistency and the outcome distribution of the Patient Specific Functional Scale (PSFS) in patients with proximal humeral fracture. Method: Fifty-three patients with proximal humeral fracture treated conservatively or surgically with plate and screw or intramedullary nail were recruited 6 weeks (±1 week) post-trauma or post-surgery. The following assessments were used: the PSFS, patient global score, shoulder function assessment, grip strength and Western Ontario Osteoarthritis of the shoulder Index (WOOS), before start of (n = 53) and after (n = 22) 2–3 months of group rehabilitation. Results: In total, 96% of the activities stated in the PSFS was classified in the International Classification of Functioning, Disability and Health activity component and 62% were found in the WOOS. Correlations between measures were low. The PSFS was highly sensitive to change to a period of group rehabilitation. All questions of the PSFS contributed to the total score. Both floor and ceiling effects could be noted. Conclusion: The PSFS shows satisfying measurement properties and may be a useful complement in the evaluation of individual changes during a period of rehabilitation after proximal humeral fracture.