Dreher Matthias, Köppel Maximilian, Baumann Freerk T, Biehl Christoph, Schwarting Andreas
Schwerpunkt Rheumatologie und klinische Immunologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
Universitäres Centrum für Autoimmunität, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland.
Z Rheumatol. 2025 Aug 13. doi: 10.1007/s00393-025-01693-1.
Physical activity and targeted exercise have scientifically proven health benefits and are increasingly being used in the treatment of inflammatory rheumatic diseases. Studies and guidelines show that exercise is safe and effective, improves subjective well-being and positively influences objective clinical parameters.
The current literature was systematically reviewed to evaluate the evidence for the use of sport and exercise therapy in rheumatic diseases. Recommendations from international professional societies and recent studies were considered.
Exercise therapy plays a central role in the prevention and treatment of various chronic diseases, including inflammatory rheumatic conditions, such as rheumatoid arthritis, spondylarthritis, psoriatic arthritis and collagenosis. For some diseases, such as vasculitides, specific recommendations are still lacking. Different types of training (endurance, strength, flexibility, coordination) can be combined according to individual needs and capabilities. The design of the training type, intensity, frequency and duration must be individually adapted to the disease profile, comorbidities, medication and fitness level.
Sport and exercise therapy is not a one-size-fits-all approach but a personalized, evidence-based treatment concept. The therapy must consider the specific disease, its severity, comorbidities and the general health status of the patient. Overall, physical activity and exercise act as a safe broad spectrum medication that improves function, quality of life and comorbidities without increasing disease activity or causing flares.
体育活动和针对性锻炼对健康有益已得到科学证实，且越来越多地用于治疗炎性风湿性疾病。研究和指南表明，锻炼安全有效，可以改善主观幸福感，并对客观临床指标产生积极影响。
对当前文献进行系统综述，以评估运动和运动疗法在风湿性疾病中应用的证据。参考了国际专业协会的建议和近期研究。
运动疗法在预防和治疗各种慢性病中起着核心作用，包括类风湿性关节炎、脊柱关节炎、银屑病关节炎和胶原病等炎性风湿性疾病。对于某些疾病，如血管炎，仍缺乏具体建议。可以根据个人需求和能力组合不同类型的训练（耐力、力量、柔韧性、协调性）。训练类型、强度、频率和持续时间的设计必须根据疾病情况、合并症、药物治疗和健康水平进行个体化调整。
运动和运动疗法不是一种适用于所有人的方法，而是一种个性化的、基于证据的治疗理念。该疗法必须考虑特定疾病、其严重程度、合并症以及患者的总体健康状况。总体而言，体育活动和锻炼是一种安全的广谱药物，可改善功能、生活质量和合并症，而不会增加疾病活动或引发病情加重。
