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July 17, 2026PLoS ONEOpen Access

Structured exercise moderately reduces depressive symptoms and anxiety, improving quality of life in rheumatoid arthritis.

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Why the study?

Does structured exercise reduce depressive symptoms, anxiety, and improve quality of life in adults with rheumatoid arthritis?

Population

15 trials involving 1652 adults with rheumatoid arthritis

Comparison

Structured exercise interventions vs Non-exercise control conditions

Design

Meta-analysis

Key result

Structured exercise reduced depressive symptoms (SMD -0.49; 95% CI -0.70 to -0.28; P<0.001) and anxiety, and improved quality of life in adults with rheumatoid arthritis.

Authors

YXYan XiaoJZJinghui ZhongKZKebao Zhang

Discussion

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Member takes

Overview

Structured exercise should be integrated into RA care to ease depressive symptoms; reinforces its adjunct role beyond physical outcomes.

Key Points

  • Evaluate the effectiveness of exercise-based interventions on depressive symptoms, anxiety, and quality of life in adults with rheumatoid arthritis.
  • Systematic review of randomized controlled trials comparing structured exercise with non-exercise controls.
  • Conducted searches in multiple databases including PubMed, Embase, and CENTRAL up to November 26, 2025.
  • Used random-effects meta-analysis to assess outcomes, with bias evaluated using the Cochrane tool.
  • Structured exercise reduced depressive symptoms (SMD −0.49; 95% CI −0.70 to −0.28; P < 0.001).
  • Low-certainty evidence suggested reduced anxiety (SMD −0.45; 95% CI −0.65 to −0.25; P < 0.001).
  • Improvements in health-related quality of life were observed (SMD 0.45; 95% CI 0.18 to 0.71; P = 0.001).

Study Design

Type

Meta-Analysis (n=1,652)

Structured PICO

Does structured exercise reduce depressive symptoms, anxiety, and improve quality of life in adults with rheumatoid arthritis?

P
Population
1,652 adults with rheumatoid arthritis across 15 randomized controlled trials comparing structured exercise interventions with non-exercise control conditions.
I
Intervention
Structured exercise interventions
C
Comparator
Non-exercise control conditions
O
Outcome
Depressive symptomspatient reported

Main Result

Standardized Mean Difference: -0.49 (95% CI -0.7–-0.28)

p-value: p=<0.001

Structured exercise probably reduces depressive symptoms and may reduce anxiety and improve quality of life in adults with rheumatoid arthritis, supporting its use as an adjunct to comprehensive care.

Limitations

  • Need for larger, better-reported trials with longer follow-up to clarify durability, clinical importance, and optimal delivery
  • Need for larger, better-reported trials
  • Need for longer follow-up to clarify durability, clinical importance, and optimal delivery

Cite This Study

Xiao et al. (2026) conducted a meta-analysis in rheumatoid arthritis (n=1,652). Structured exercise vs. non-exercise control conditions was evaluated on depressive symptoms (SMD -0.49, 95% CI -0.70 to -0.28, p=<0.001). Structured exercise reduced depressive symptoms (SMD -0.49; 95% CI -0.70 to -0.28; P<0.001) and anxiety, and improved quality of life in adults with rheumatoid arthritis.

synapsesocial.com/papers/6a59c764a58755010b4723behttps://doi.org/10.1371/journal.pone.0352173
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