Effects of a personalized exercise program on physical function in older patients with rheumatoid arthritis at high risk of sarcopenia: results of a randomized controlled trial

TL;DR

A 16-week personalized exercise program did not significantly improve physical function in older rheumatoid arthritis patients at high risk of sarcopenia, but showed some benefits in standing ability, grip strength, and mental health.

Contribution

This study evaluates the efficacy of a personalized exercise program in older rheumatoid arthritis patients at high risk of sarcopenia through a randomized controlled trial.

Findings

The 16-week personalized exercise program did not significantly improve total SPPB scores compared to the control group.

The intervention showed a tendency to improve chair-stand test performance, grip strength, and mental component scores.

There was a 0.2-point difference in SPPB scores between the intervention and control groups, but it was not statistically significant.

Abstract

Patients with rheumatoid arthritis (RA) are at a higher risk for sarcopenia than the general population. Exercise therapy can improve muscle strength in older adults; however, its efficacy in older patients with RA has not been fully established. This study aimed to evaluate the efficacy of a personalized exercise program on physical function in older patients with RA at high risk for sarcopenia.

A single-centre, parallel-group, two-arm, superiority randomized controlled trial was conducted in patients with RA aged 60–85 years who were at risk of sarcopenia. The intervention group (n = 69) underwent a 16-week personalized exercise program in addition to nutritional guidance and standard care, whereas the control group (n = 65) received only nutritional guidance and standard care. The primary outcome was the change in the total Short Physical Performance Battery (SPPB) scores from baseline to week 16.

A total of 140 patients were randomized. Of these, 134 initiated the assigned intervention. There was a 0.2-point difference in SPPB total score from baseline to week 16 between the intervention group (+ 0.4 points) and the control group (+ 0.2 points); 95% confidence interval: -0.1 to 0.5; p = 0.206. Regarding the secondary outcomes at week 16, there was a tendency for improvement in the chair-stand test, grip strength, and the mental component score.

The 16-week personalized exercise therapy did not improve the total SPPB scores. However, the intervention may improve standing ability, grip strength, and mental health-related quality of life in older patients with RA at high risk of sarcopenia.

This study was registered with UMINCTR (trial number: UMIN000044930).

The online version contains supplementary material available at 10.1186/s13075-026-03751-8.

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