Physical activity of older patients with rheumatoid arthritis


Fedorchenko Y. Zimba O. Qumar A.B. Yessirkepov M. Kocyigit B.F.
July 2025Springer Science and Business Media Deutschland GmbH

Rheumatology International
2025#45Issue 7

Rheumatoid arthritis (RA) in older adults presents a complex clinical challenge, exacerbated by age-related comorbidities, musculoskeletal degeneration, and psychosocial factors, all contributing to significant mobility limitations and reduced quality of life. This narrative review synthesizes current evidence on rehabilitation interventions to enhance physical function in RA patients, focusing on walking, aquatic therapy, sauna and massage therapies, and yoga. A comprehensive search of Medline/PubMed, Scopus, Web of Science, and DOAJ (up to May 2025) identified studies highlighting the efficacy of structured physical activity (PA) in reducing disease activity, fatigue, and pain, while improving functional capacity and mental health. Walking interventions, including high-intensity interval protocols, demonstrate immunomodulatory and cardiometabolic benefits, with significant reductions in Disease Activity Score (DAS28) and inflammatory markers. Aquatic therapy, leveraging water’s buoyancy, improves functional outcomes and reduces depressive symptoms, while sauna and massage therapies offer pain relief and enhanced flexibility. Yoga, as a mind–body practice, significantly lowers disease activity and enhances physical function and psychological well-being. Wearable technologies, such as actigraphy and pedometry, support personalized exercise regimens by providing real-time data for dynamic goal-setting. The European Alliance of Associations for Rheumatology (EULAR) and American College of Rheumatology (ACR) guidelines advocate for tailored exercise integration into RA management. Despite these benefits, adherence remains challenging due to pain, fatigue, and psychological barriers, necessitating individualized, biopsychosocial approaches. This review provides practical recommendations for rheumatology specialists to implement evidence-based rehabilitation strategies, emphasizing multidisciplinary care to optimize mobility and quality of life in older adults with RA.

Cerebrovascular disease , Elderly , Mobility impairment , Older adults , Physical activity , Physical function , Physical Inactivity , Rheumatoid arthritis

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Department of Pathophysiology, Ivano-Frankivsk National Medical University, Ivano-Frankivs’k, Ukraine
Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
Department of Health Policy and Management, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Center for Life and Health Sciences, National Academy of Sciences Under the President of the Republic of Kazakhstan, Almaty, Kazakhstan
Department of Chemical Disciplines, Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
Department of Physical Medicine and Rehabilitation, University of Health Sciences, Adana City Research and Training Hospital, Dr. Mithat Ozsan Boulevard, Kisla District, 4522 Street, No: 1, Adana, 01060, Turkey

Department of Pathophysiology
Department of Clinical Rheumatology and Immunology
National Institute of Geriatrics
Department of Internal Medicine N2
Department of Health Policy and Management
Center for Life and Health Sciences
Department of Chemical Disciplines
Department of Physical Medicine and Rehabilitation

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