The Effect of Exercise Training on Inflammatory Markers in Patients with Osteoarthritis and Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

Osteoarthritis (OA) and rheumatoid arthritis (RA) are associated with the development of chronic inflammation, increase of pro-inflammatory cytokine and decrease of anti-inflammatory cytokine. However, the effects of exercise training on inflammatory markers in these patients are not understood. The aim of this study is to investigate the effect of exercise on inflammatory markers in patients with OA and RA.

A systematic search was conducted in PubMed, Scopus, Web of Science and Google Scholar databases for English and Persian published articles until March 1, 2024. Meta-analysis was conducted for the studies of exercise training against the control group on the inflammatory markers including IL-6, TNF-α and CRP. To determine the effect size, standardized mean difference (SMD) and 95% confidence interval (CIs) were used using CMA3 software.

15 studies involving 660 subjects with OA and RA were included in the meta-analysis. The results showed that exercise training resulted in a significant decrease in TNF-α [-0.43 (CI: -1.76 to -0.15), P = 0.02] and CRP [-0.91, (CI: -1.47 to -0.35 CI), P = 0.001], while the effect of exercise training on the reduction of IL-6 [-0.40 (CI: -0.91 to 0.10), P = 0.12] was not significant.

Exercise training may lead to the reduction of inflammatory markers in patients with OA and RA. Improvement of inflammation with exercise training may be the reason for the beneficial effect of exercise training in these patients.