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Combating Physical Inactivity: Rheumatic Diseases and COVID-19

Physical inactivity is common during periods of self-isolation, but for patients with rheumatic disease, there are crucial benefits to be gained from maintaining an active lifestyle throughout the COVID-19 pandemic. In these patients, structured physical activity improves disease symptoms, cardiovascular risk factors, physical capacity and function, and quality of life1. Common rheumatic diseases include osteoarthritis, rheumatoid arthritis and many others.

Unfortunately, hypoactive behaviour is already highly prevalent in these patients. Previous studies show 38–72% are physically inactive, and sedentary time ranges between 8.3–14.0 hours/day, which is higher than the general population2. Further, patients with rheumatic disease commonly have a higher risk of serious infections, which poses an added challenge when considering ways to remain active. In patients with arthritis, inactivity is associated with poor disease-related outcomes (such as high disease activity, pain and fatigue) and increased cardiometabolic risk factors.

Exercise is advocated by EULAR (European League Against Rheumatism) as an integral part of standard care for patients with rheumatic disease3. Home-based exercise programs designed for the general population should be carefully customized and prescribed for patients with osteoarthritis and rheumatoid arthritis. The American College of Rheumatology also provides exercise guidelines for patients with arthritis:

Exercise and arthritis can and should coexist. Now more than ever, it’s critical to raise awareness about the importance of physical activity for maintaining good physical health for those with rheumatic disease. Health care providers and caregivers should continue to educate those with these diseases as an effort to promote less pain, more energy, improved sleep and better day-to-day function.


  1. Pinto, Ana Jéssica, et al. "Combating physical inactivity during the COVID-19 pandemic." Nature Reviews Rheumatology (2020): 1-2.

  2. Pinto, Ana Jéssica, et al. "Physical inactivity and sedentary behavior: Overlooked risk factors in autoimmune rheumatic diseases?." Autoimmunity reviews 16.7 (2017): 667-674.

  3. Osthoff, Anne-Kathrin Rausch, et al. "2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis." Annals of the rheumatic diseases 77.9 (2018): 1251-1260.

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