Eligible studies were randomised controlled trials of community-deliverable exercise interventions of at least four weeks duration offered to adults (18 years and older) with rheumatoid arthritis, osteoarthritis, fibromyalgia, lupus, gout or ankylosing spondylitis. Studies had to contain at least one exercise-only intervention group (aerobic, strength training) and a comparison group (no intervention, usual care, attention control). Primary outcomes of interest were pain reduction and/or improvement in physical function. Definitions of community-deliverable interventions and specific implementation guidelines along with operational definitions of pain and physical function were reported in the paper.
The included trials were conducted worldwide (two in UK). Most participants were women aged 50 and over and most had rheumatoid arthritis, osteoarthritis or fibromyalgia. Mean body mass index across the study groups was around 29kg/m². Mean times for symptom duration or time since diagnosis ranged from nine to 11 years. There was some evidence of concomitant medication use (including nonsteroidal anti-inflammatory drugs, analgesics, antidepressants, anxiolytics, muscle relaxants and pain medication). Where reported, exercise interventions were individual, group-based or a combination of both; they took place in facilities, at home or a combination of both. Intervention content varied in terms of mode, frequency and intensity. Pain and physical function were measured with a variety of self report, numerical rating and performance-based measures.
Two reviewers selected the studies for inclusion.