Resistance Training in Rheumatic Diseases: a Systematic Review of Evidence and Guidelines for Improving Patient Functionality

Abstract

Background: Rheumatic conditions like rheumatoid arthritis, osteoarthritis and ankylosing spondylitis cause chronic pain, joint stiffness and muscle loss (rheumatoid cachexia). These issues severely limit physical capacity and quality of life. In the past, doctors avoided prescribing resistance training, fearing it would worsen joint damage and inflammation. Modern clinical studies prove this traditional view is wrong.

Aim: This review summarizes recent scientific data on the safety, mechanisms and outcomes of strength exercises to provide practical guidelines for improving patient independence.

Material and Methods: We searched PubMed, Scopus and the Cochrane Library for peer-reviewed papers from 2015 to the present. We selected randomized controlled trials, systematic reviews and meta-analyses investigating structured weight training protocols.

Results: Evidence confirms progressive resistance training is highly safe and effective for rehabilitation. It does not induce inflammatory flares or cartilage erosion. Instead, it builds muscle strength, stabilizes joints and reduces fatigue. Resistance exercises counteract cachexia by expanding muscle volume and improving body composition. Patients show better functional performance, including faster walking speeds, sharper balance and easier chair rising. Successful programs use 2 or 3 weekly sessions at 60% - 80% 1RM, leading to high patient compliance and clear psychological benefits.

Conclusions: Weight training should be a standard part of modern rheumatology, not only an optional activity. Combining exercise physiology with standard pharmacological care is necessary to help patients regain physical autonomy and long-term quality of life in both daily life and sports culture.