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Open Access Highly Accessed Research article

Are persons with rheumatoid arthritis deconditioned? A review of physical activity and aerobic capacity

Tjerk Munsterman1, Tim Takken23 and Harriet Wittink4*

Author Affiliations

1 Physical Therapy Center, Martini Hospital Groningen, P.O. Box 30033, 9700 RM, Groningen, Netherlands

2 School of Clinical Health Sciences, Department of Physical Therapy Science, Utrecht University, Utrecht, the Netherlands

3 Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands

4 Research group Lifestyle and Health, Faculty of Health Care, Utrecht University of Applied Sciences, Bolognalaan 101, 3584 CJ, Utrecht, The Netherlands

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BMC Musculoskeletal Disorders 2012, 13:202  doi:10.1186/1471-2474-13-202

Published: 18 October 2012



Although the general assumption is that patients with rheumatoid arthritis (RA) have decreased levels of physical activity, no review has addressed whether this assumption is correct.


Our objective was to systematically review the literature for physical activity levels and aerobic capacity (VO2max). in patients with (RA), compared to healthy controls and a reference population. Studies investigating physical activity, energy expenditure or aerobic capacity in patients with RA were included. Twelve studies met our inclusion criteria.


In one study that used doubly labeled water, the gold standard measure, physical activity energy expenditure of patients with RA was significantly decreased. Five studies examined aerobic capacity. Contradictory evidence was found that patients with RA have lower VO2max than controls, but when compared to normative values, patients scored below the 10th percentile. In general, it appears that patients with RA spend more time in light and moderate activities and less in vigorous activities than controls.


Patients with RA appear to have significantly decreased energy expenditure, very low aerobic capacity compared to normative values and spend less time in vigorous activities than controls.

Rheumatoid arthritis; Cardiovascular disease; Physical activity; Aerobic capacity; Healthy controls