{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T16:57:30Z","timestamp":1788195450951,"version":"build-2803163510"},"reference-count":75,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,11,29]]},"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Background\/purpose<\/jats:title><jats:p>Given conflicting findings, the purpose of this study was to use the meta-analytic approach to examine the effects of exercise (aerobic, strength training or both) on anxiety in adults with arthritis and other rheumatic diseases (AORD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Randomised controlled exercise intervention trials \u22654weeks in adults \u226518 years of age with osteoarthritis, rheumatoid arthritis or fibromyalgia were included. Studies were located by searching eight electronic databases, cross-referencing and expert review. Dual selection and data abstraction of studies were performed. Hedge\u2019s standardised effect size (ES) was calculated for each result and pooled using the recently developed inverse heterogeneity model. Two-tailed<jats:italic>z<\/jats:italic>-alpha values \u22640.05 and non-overlapping 95% CI were considered statistically significant. Heterogeneity was estimated using Q and<jats:italic>I<jats:sup>2<\/jats:sup><\/jats:italic>with alpha values \u22640.10 for Q considered statistically significant. Small-study effects were examined using funnel plots and Egger\u2019s regression test. In addition, the number needed to treat (NNT), percentile improvement and meta-regression were conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 639 citations screened, 14 studies representing 926 initially enrolled participants (539 exercise, 387 control) met the criteria for inclusion. Length of training (mean\u00b1SD) averaged 15.8\u00b16.7 weeks, frequency 3.3\u00b11.3 times per week and duration 28.8\u00b114.3\u2009min per session. Overall, statistically significant reductions in anxiety were found (exercise minus control changes ES=\u22120.40, 95%\u2009CI \u22120.65 to \u22120.15, tau<jats:sup>2<\/jats:sup>=0.14; Q=40.3, P=0.0004;<jats:italic>I<jats:sup>2<\/jats:sup><\/jats:italic>=62.8%). The NNT was 6 with a percentile improvement of 15.5% and an estimated 5.3\u2009million inactive US adults with AORD improving their anxiety if they started exercising regularly. Statistically significant small-study effects were observed (P&lt;0.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Exercise is associated with reductions in anxiety among adults with selected types of AORD. However, a need exists for additional, well-designed, randomised controlled trials on this topic.<\/jats:p><\/jats:sec><jats:sec><jats:title>PROSPERO registration number<\/jats:title><jats:p>CRD42016048728.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019138","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T15:54:02Z","timestamp":1568908442000},"page":"e019138","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Community-deliverable exercise and anxiety in adults with arthritis and other rheumatic diseases: a systematic review with meta-analysis of randomised controlled trials"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0595-4148","authenticated-orcid":false,"given":"George A","family":"Kelley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristi S","family":"Kelley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh F","family":"Callahan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,2,17]]},"reference":[{"key":"2024051710421698000_8.2.e019138.1","doi-asserted-by":"crossref","first-page":"246","DOI":"10.15585\/mmwr.mm6609e1","article-title":"Vital signs: prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation - 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