Impact of Rehabilitation Therapy on Disease Activity, Function, and Quality of Life in Rheumatoid Arthritis: A Systematic Review.

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that leads to persistent joint inflammation and progressive disability. While treatment with disease-modifying anti-rheumatic drugs (DMARDs) remains the primary approach, rehabilitation therapies such as exercise and physical therapy provide long-term outcomes. This systematic review evaluates the impact of rehabilitation interventions on RA patients receiving DMARD therapy compared with standard care without therapy. Systematic literature research was conducted between January 2013 and July 2025 on PubMed, Cochrane Library, and Embase with predefined PRISMA guidelines. Randomized controlled trials, systematic reviews, and respective cohorts were included if they examined rehabilitation interventions, such as exercise or physical therapy, in addition to DMARDs, with outcomes related to disease activity, physical function, or quality of life. Risk of bias was assessed using Cochrane RoB 1.0 tools. Eight randomized controlled trials involving 930 participants met the inclusion criteria. Most participants were women in their mid-50s to early 60s, with disease duration ranging from four to 16 years. Across studies, rehabilitation interventions were associated with meaningful improvements in physical function, reflected by reductions of 0.3 to 0.6 points in Health Assessment Questionnaire scores. Several studies also reported decreases of 0.4 to 0.7 points in Disease Activity Score (DAS28-ESR [erythrocyte sedimentation rate]/CRP [C-reactive protein]), particularly with multidisciplinary programs and structured exercise regimens. Quality-of-life measures similarly demonstrated improvement. Rehabilitation to standard pharmacologic therapy may provide clinically significant benefits in disease control, functional capacity, and overall well-being. However, limitations included variability in reported outcomes and modest sample sizes, which restrict the generalizability of results. Overall, the evidence supports the incorporation of rehabilitation, particularly exercise and physical therapy, into standard care for RA patients as an effective complement to pharmacological management.