Abstract
There is convincing evidence to suggest that exercise interventions can significantly improve disease-related outcomes as well as comorbidities in rheumatic and musculoskeletal diseases (RMDs). All exercise interventions should be appropriately defined by their dose, which comprises of two components: a) the FITT (frequency, intensity, time and type) and b) the training (ie, specificity, overload, progression, initial values, reversibility, and diminishing returns) principles. In the published RMD literature, exercise dosage is often misreported, which in “pharmaceutical treatment terms”, this would be the equivalent of receiving the wrong medication dosage. Lack of appropriately reporting exercise dosage in RMDs, therefore, results in limited clarity on the effects of exercise interventions on different outcomes while it also hinders reproducibility, generalisability and accuracy of research findings. Based on the collective but limited current knowledge, the main purpose of the present Position Statement is to provide specific guidance for RMD researchers to help improve the reporting of exercise dosage and help advance research into this important field of investigation. We also propose the use of the IMPACT-RMD toolkit, a tool that can be used in the design and reporting phase of every trial.
Highlights
Rheumatic and musculoskeletal diseases (RMDs) are a group of non-communicable diseases characterised by debilitating symptoms, such as pain, fatigue, inflammation, and/or joint damage
The most prevalent RMDs, based on the European Alliance of Associations for Rheumatology (EULAR) Position Statement, are osteoarthritis (OA), rheumatoid arthritis (RA), osteoporosis, low back pain, ankylosing spondylitis, psoriatic arthritis, gout, fibromyalgia, and connective tissue diseases, such as Systemic Lupus Erythematosus and systemic sclerosis
Despite earlier clinical practice approaches to avoid exercise in fear of exacerbating disease symptoms, exercise is considered an important intervention for improving symptoms in RMDs, to the point that the EULAR is actively promoting the use of exercise and physical activity in recent recommendations[3,4] and promotes the implementation of physical activity at scale.[5]
Summary
Position Statement on Exercise Dosage in Rheumatic and Musculoskeletal Diseases: The 5ole of the IMPACT-RMD Toolkit. Metsios1,2,3 , Nina Brodin[4], Thea P.M. Vliet Vlieland[5 ], Cornelia H.M. Van den Ende[6 ], Antonios Stavropoulos-Kalinoglou[7 ], Ioannis Fatouros[8 ], Martin van der Esch[9 ], Sally A.M. Fenton[10 ], Katerina Tzika[3], Rikke Helene Moe[11 ], Jet J.C.S. Veldhuijzen van Zanten[10 ], Yiannis Koutedakis3,8 , Thijs Willem Swinnen[12], Aristidis S. Veskoukis[1 ], Carina Boström[4 ], Norelee Kennedy[13 ], Elena Nikiphorou[14], George E.
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