Article (Scientific journals)
EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis: 2025 update.
Rausch Osthoff, Anne-Kathrin; Vlieland, Theodora P M Vliet; Ferreira, Ricardo J O et al.
2026In Annals of the Rheumatic Diseases
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Keywords :
Physical activity, exercises, osteoarthritis, sedentarity
Abstract :
[en] [en] OBJECTIVES: The 2018 European Alliance of Associations for Rheumatology (EULAR) recommendations for physical activity (PA) in people with inflammatory arthritis (IA) and osteoarthritis (OA) required revision as new studies have been published on interventions using technology and/or the combination of educational and behavioural strategies to promote PA or reduce sedentary behaviour (SB). Moreover, the World Health Organisation released updated general PA guidelines in 2020 with an emphasis on reducing SB. This work aimed to update the 2018 EULAR recommendations for PA in IA and OA. METHODS: The EULAR Standardised Operating Procedures for developing recommendations were followed. A multidisciplinary task force (TF) was established. Systematic literature searches related to 13 research questions were conducted in August 2024. Recommendations were updated, and the TF members rated their level of agreement and estimated impact and implementability (0-10 scale, with 10 highest). RESULTS: The revised recommendations include 4 overarching principles and 11 recommendations on PA and SB including inter alia PA promotion as standard care, measurements of PA, and intervention modalities considering dose, adaptations and the application of (technology-based) behaviour change techniques. The mean level of agreement for the recommendations ranged from 9.0 to 9.8, the mean impact between 8.3 and 9.2, and the mean feasibility of implementation between 7.2 and 8.5. In addition, quality indicators, research and educational agendas were defined. CONCLUSIONS: The updated EULAR recommendations for PA should guide the development, conduct and evaluation of PA interventions and promotion, including the reduction of SB, in people with IA and OA. These recommendations should be implemented with consideration of individual needs, environmental conditions, and the broader national health care context.
Disciplines :
Rheumatology
Author, co-author :
Rausch Osthoff, Anne-Kathrin;  Zurich University of Applied Sciences, School of Health Sciences, Institute of Physiotherapy, Winterthur, Switzerland. Electronic address: anne-kathrin.rausch@zhaw.ch
Vlieland, Theodora P M Vliet;  Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands, Department of Physical Therapy, Leiden University of Applied Sciences, Health Faculty, Leiden, The Netherlands
Ferreira, Ricardo J O;  Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEUL), Universidade de Lisboa, Lisbon, Portugal, Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal, Rheumatology Department, Unidade Local de Saúde de Coimbra, Coimbra, Portugal
Amarnani, Raj;  Sport and Exercise Medicine Department, Homerton University Hospital NHS Foundation Trust, London, UK
Battista, Simone;  School of Health and Society, Centre for Human Movement and Rehabilitation, University of Salford, Salford, Greater Manchester, UK
Orlinov, Denislav;  Department of Physical Therapy, Faculty of Medicine, University of Iceland, Reykjavik, Iceland, Arthritis Research Canada, Vancouver, BC, Canada
Boyadzhieva, Vladimira;  University Hospital "St. Iv. Rilski" - Clinic of Rheumatology, Medical University Sofia, Sofia, Bulgaria
Brodin, Nina;  Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden, Department of Orthopaedics, Danderyd Hospital, Stockholm, Sweden
Cox, Ashley;  Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, UK
Davergne, Thomas;  Team METHODS, CRESS UMR1153, University of Paris Cité, Paris, France
Duruöz, Tuncay;  Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Türkiye
Esbensen, Bente Appel;  Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Fongen, Camilla;  Center for Treatment of Rheumatic and Musculoskeletal Disease (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
Günther, Klaus-Peter;  Department of Orthopaedic Surgery, University Hospital and Faculty of Medicine, Eberhard Karls University Tübingen, Tübingen, Germany
Henrotin, Yves  ;  Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation > Pathologie générale et physiopathologie - Techniques particulières de kinésithérapie
Juhl, Carsten;  Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark, Department of Physiotherapy and Occupational Therapy, University of Copenhagen, Herlev and Gentofte Hospital, Copenhagen, Denmark
Kennedy, Norelee;  University of Limerick, School of Allied Health, Faculty of Education and Health Sciences and Health Research Institute, Limerick, Ireland
Kiltz, Uta;  Rheumazentrum Ruhrgebiet, Herne, Germany, Ruhr University, Bochum, Germany
Knittle, Keegan;  University of Jyväskylä, Faculty of Sport and Health Sciences, Jyväskylä, Finland
Metsios, George;  Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Thesssaly, Greece
Nurmohamed, Michael;  Amsterdam Rheumatology and immunology Center, Reade Amsterdam, The Netherlands
Pazos, Victoria Romero;  Patient Research Partner EULAR, Spain
Swinnen, Thijs W;  Department of Quality Management, Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium
Thomsen, Tanja;  Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
Warburton, Louise;  Keele University, Primary Health Care Sciences, Keele, UK
Niedermann, Karin ;  Zurich University of Applied Sciences, School of Health Sciences, Institute of Physiotherapy, Winterthur, Switzerland
More authors (16 more) Less
Language :
English
Title :
EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis: 2025 update.
Publication date :
25 April 2026
Journal title :
Annals of the Rheumatic Diseases
ISSN :
0003-4967
eISSN :
1468-2060
Publisher :
Elsevier BV, United States
Peer reviewed :
Peer Reviewed verified by ORBi
Funders :
EULAR - European League Against Rheumatism
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