Regular physical activity is increasingly recommended for individuals with rheumatic and musculoskeletal diseases (RMD) as well as the general population. EULAR - The European Alliance of Associations for Rheumatology - has issued guidelines for physical activity in individuals with inflammatory arthritis and osteoarthritis. These guidelines also address ways to help individuals engage in healthy and sustainable work.

At the 2025 annual congress of EULAR in Barcelona, several sessions focused on the importance of physical activity for individuals with various RMDs, as well as the challenges in implementing these programs in real-world settings.

Past trials have shown that long-term, personalized supervised exercise therapy is more effective than standard care after one year for individuals with severe functional limitations due to rheumatoid arthritis (RA) or axial spondyloarthritis (axSpA). David Ueckert and colleagues conducted a study to assess the long-term effects of this intervention on physical function and quality of life in this population. The results at 2 years showed significant improvements in all outcome measures for both RA and axSpA, except for the mental component score in the SF-36. These findings suggest that the benefits of personalized exercise therapy are sustained over time, even with reduced use of supervised therapy in the second year.

Research also explored the impact of a multimodal, physiotherapist-led intervention on work-related outcomes and cost-utility compared to usual care in adults with RA or axSpA and reduced work ability. The intervention, which included various components such as patient education, exercise therapy, and referral to work-related professionals, showed potential cost-effectiveness and improved quality-adjusted life years.

Fatigue management is a top priority for patients and healthcare providers. Higher levels of physical activity have been linked to lower fatigue levels, while the role of sedentary behavior remains less clear. A study by Sally Fenton and colleagues found that patterns of physical activity and sedentary behavior throughout the day were associated with different aspects of fatigue in individuals with RA. These findings can inform the design of fatigue management interventions for this population.

Additionally, combined exercise programs incorporating aerobic and resistance training have shown benefits for individuals with systemic sclerosis (SSc). A clinical trial in 170 people with SSc revealed that a supervised exercise program led to improvements in fatigue, pain, depression, quality of life, and fitness levels. Exercise may serve as a non-pharmacological intervention to manage SSc symptoms and prevent symptom worsening.

Barriers to physical activity vary across populations, with differences in healthcare systems, cultural norms, and environmental factors. A study comparing barriers and facilitators for physical activity across Turkey, Switzerland, France, and the Netherlands highlighted unique challenges in each country. Tailored interventions are needed to address these differences and promote physical activity in individuals with RMDs.

In the Netherlands, a study identified key facilitators and barriers to implementing long-standing, personalized exercise therapy for individuals with RA and axSpA. Clear communication, eligibility criteria, and access to qualified therapists were identified as facilitators, while unclear eligibility criteria and lack of awareness about the effectiveness of exercise were barriers to referral.

These studies underscore the importance of physical activity and exercise therapy for individuals with RMDs, emphasizing the need for increased awareness, education, and access to these interventions. By addressing challenges such as referral pathways, cost concerns, and patient motivation, healthcare providers can integrate physical activity as a standard component of care for individuals with RMDs.