Non-Cochrane · intervention · PM42023229
Effects of physical activity on health-related outcomes in Sjögren's syndrome: a systematic review and meta-analysis of randomized controlled trials.
Gao Qianfei, Fan Congxian, Zhang Yeyun, et al. · Frontiers in immunology · 2026 · PubMed · doi:10.3389/fimmu.2026.1753791
Findings
Population Individuals with Sjögren's syndrome (all female in the included trials)
116 findings
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Functional capacity Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Intervention length (weeks) | Meta-regression coefficient 0.76 [-0.33, 1.85] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Disease activity (ESSDAI) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Sessions per week | Meta-regression coefficient 0.16 [-0.54, 0.86] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Vitality (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Session duration (minutes) | Meta-regression coefficient 0.35 [-0.63, 1.33] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Fatigue Change from baseline to end of intervention (8 to 28 weeks) · Region: Developing | SMD -0.28 [-1.73, 1.17] GRADE not reported 2 studies · 101 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Social aspects (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Sessions per week: 2 | SMD 0.32 [-0.06, 0.70] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Disease activity (ESSDAI) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Intervention length (weeks) | Meta-regression coefficient -0.09 [-0.41, 0.22] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Sessions per week: 2 | SMD 0.5 [0.23, 0.78] GRADE not reported 4 studies · 214 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | General health status Change from baseline to end of intervention (8 to 28 weeks) · Intervention length (weeks): 16 | SMD 0.39 [0.01, 0.78] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | General health status Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Sessions per week | Meta-regression coefficient 0.03 [-0.32, 0.37] GRADE not reported 4 studies · 172 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Session duration (minutes) | Meta-regression coefficient 0.06 [-0.01, 0.13] GRADE not reported 5 studies · 229 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Vitality (SF-36) Change from baseline to end of intervention (8 to 28 weeks) | SMD 0.51 [0.15, 0.86] Moderate Downgraded: imprecision 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Vitality (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Intervention length (weeks) | Meta-regression coefficient 0.09 [-0.16, 0.33] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Intervention length (weeks) | Meta-regression coefficient -0.02 [-0.21, 0.17] GRADE not reported 8 studies · 316 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Social aspects (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Intervention length (weeks): 16 | SMD 0.32 [-0.06, 0.70] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Vitality (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Sessions per week: 2 | SMD 0.56 [0.17, 0.95] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | General health status Change from baseline to end of intervention (8 to 28 weeks) · Session duration (minutes): NR | SMD 0.39 [0.01, 0.78] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Functional capacity Change from baseline to end of intervention (8 to 28 weeks) · Intervention length (weeks): 16 | SMD 0.59 [0.20, 0.98] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Fatigue Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Outcome measure (survey method) | Meta-regression coefficient -0.59 [-1.37, 0.18] GRADE not reported 4 studies · 139 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Fatigue Change from baseline to end of intervention (8 to 28 weeks) · Region: Developed | SMD -0.92 [-2.79, 0.95] GRADE not reported 2 studies · 38 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Outcome measure (survey method): HR peak | SMD 0.31 [-0.08, 0.69] GRADE not reported 2 studies · 105 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | General health status Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Intervention length (weeks) | Meta-regression coefficient 0.03 [-0.32, 0.37] GRADE not reported 4 studies · 172 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Sensitivity analysis (leave-one-out), omitting Minali 2020 | SMD 0.16 [-0.20, 0.52] GRADE not reported 4 studies · 166 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Social aspects (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Session duration (minutes) | Meta-regression coefficient 0.32 [-0.66, 1.30] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Disease activity (ESSDAI) Change from baseline to end of intervention (8 to 28 weeks) | SMD -0.09 [-0.41, 0.23] Moderate Downgraded: imprecision 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Fatigue Change from baseline to end of intervention (8 to 28 weeks) · Sessions per week: 3 | SMD -0.42 [-1.80, 0.96] GRADE not reported 3 studies · 83 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Intervention length (weeks): 28 | SMD 0.78 [0.10, 1.46] GRADE not reported 2 studies · 120 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Region: Developing | SMD 0.36 [-0.10, 0.83] GRADE not reported 4 studies · 198 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Outcome measure (survey method): SF_36_mental health | SMD 0.24 [-0.11, 0.59] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Sessions per week | Meta-regression coefficient 0.34 [-0.85, 0.40] GRADE not reported 5 studies · 229 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Disease activity (ESSDAI) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Region | Meta-regression coefficient -0.09 [-0.41, 0.22] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Fatigue Change from baseline to end of intervention (8 to 28 weeks) | SMD -0.57 [-1.57, 0.44] Low Downgraded: imprecision, inconsistency 4 studies · 139 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Session duration (minutes): NR | SMD 0.5 [0.23, 0.78] GRADE not reported 4 studies · 214 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Intervention length (weeks): 12 | SMD 0.53 [-0.55, 1.62] GRADE not reported 3 studies · 57 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Sensitivity analysis (leave-one-out), omitting Dardin 2022 | SMD 0.24 [-0.27, 0.76] GRADE not reported 4 studies |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Social aspects (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Region: Developing | SMD 0.32 [-0.06, 0.70] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Sessions per week | Meta-regression coefficient -0.23 [-0.84, 0.37] GRADE not reported 8 studies · 316 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Functional capacity Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Outcome measure (survey method) | Meta-regression coefficient 0.69 [0.33, 1.05] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Session duration (minutes): NR | SMD 0.72 [0.33, 1.11] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Region | Meta-regression coefficient -0.36 [-1.61, 0.89] GRADE not reported 5 studies · 217 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Vitality (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Session duration (minutes): NR | SMD 0.56 [0.17, 0.95] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Sensitivity analysis (leave-one-out), omitting Strömbeck 2007 | SMD 0.36 [-0.10, 0.83] GRADE not reported 4 studies |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Fatigue Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Sessions per week | Meta-regression coefficient -0.59 [-3.27, 2.08] GRADE not reported 4 studies · 139 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Fatigue Change from baseline to end of intervention (8 to 28 weeks) · Session duration (minutes): 45 | SMD -0.92 [-2.79, 0.95] GRADE not reported 2 studies · 38 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Region: Developing | SMD 0.41 [0.12, 0.70] GRADE not reported 5 studies · 259 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Vitality (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Intervention length (weeks): 16 | SMD 0.56 [0.17, 0.95] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Intervention length (weeks): 16 | SMD 0.5 [0.23, 0.78] GRADE not reported 4 studies · 214 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Disease activity (ESSDAI) Change from baseline to end of intervention (8 to 28 weeks) · Sessions per week: 2 | SMD -0.14 [-0.52, 0.24] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Disease activity (ESSDAI) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Outcome measure (survey method) | Meta-regression coefficient -0.09 [-0.41, 0.23] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Sessions per week: 3 | SMD 0.38 [-0.01, 0.76] GRADE not reported 3 studies · 109 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Session duration (minutes) | Meta-regression coefficient 0.18 [-0.23, 0.59] GRADE not reported 5 studies · 217 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Region: Developing | SMD 0.52 [0.10, 0.94] GRADE not reported 4 studies · 210 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | General health status Change from baseline to end of intervention (8 to 28 weeks) | SMD 0.46 [0.15, 0.76] Low Downgraded: risk of bias, imprecision 4 studies · 172 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Outcome measure (survey method) | Meta-regression coefficient -0.27 [-0.74, 0.21] GRADE not reported 5 studies · 217 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Sessions per week | Meta-regression coefficient -0.36 [-0.80, 0.09] GRADE not reported 5 studies · 217 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Disease activity (ESSDAI) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Session duration (minutes) | Meta-regression coefficient 0.02 [-0.56, 0.60] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Fatigue Change from baseline to end of intervention (8 to 28 weeks) · Intervention length (weeks): 12 | SMD -0.92 [-2.79, 0.95] GRADE not reported 2 studies · 38 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Social aspects (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Session duration (minutes): NR | SMD 0.32 [-0.06, 0.70] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Intervention length (weeks) | Meta-regression coefficient -0.16 [-0.71, 0.39] GRADE not reported 5 studies · 217 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Intervention length (weeks): 16 | SMD 0.24 [-0.17, 0.66] GRADE not reported 2 studies · 90 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Social aspects (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Region | Meta-regression coefficient 0.32 [-0.66, 1.30] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Functional capacity Change from baseline to end of intervention (8 to 28 weeks) · Region: Developing | SMD 0.59 [0.20, 0.98] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | General health status Change from baseline to end of intervention (8 to 28 weeks) · Region: Developing | SMD 0.39 [0.07, 0.71] GRADE not reported 3 studies · 153 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Sensitivity analysis (leave-one-out), omitting Miyamoto 2019 (estimate 1) | SMD 0.66 [0.17, 1.16] GRADE not reported 4 studies |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Outcome measure (survey method) | Meta-regression coefficient 0.02 [-0.26, 0.31] GRADE not reported 8 studies · 316 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Session duration (minutes): 45 | SMD 0.85 [0.33, 1.36] GRADE not reported 3 studies · 139 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Session duration (minutes) | Meta-regression coefficient 0.55 [-1.48, 2.58] GRADE not reported 8 studies · 316 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Region | Meta-regression coefficient 0.61 [-0.69, 0.82] GRADE not reported 5 studies · 229 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | General health status Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Region | Meta-regression coefficient 0.64 [-0.38, 1.67] GRADE not reported 4 studies · 172 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Sensitivity analysis (leave-one-out), omitting Garcia 2021 (estimate 2) | SMD 0.65 [0.13, 1.17] GRADE not reported 4 studies |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) | SMD 0.59 [0.20, 0.99] Low Downgraded: imprecision, inconsistency 5 studies · 229 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Social aspects (SF-36) Change from baseline to end of intervention (8 to 28 weeks) | SMD 0.27 [-0.08, 0.62] Moderate Downgraded: imprecision 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Functional capacity Change from baseline to end of intervention (8 to 28 weeks) | SMD 0.69 [0.33, 1.05] Moderate Downgraded: imprecision 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Outcome measure (survey method): SF_36_pain | SMD 0.59 [0.17, 1.01] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Functional capacity Change from baseline to end of intervention (8 to 28 weeks) · Session duration (minutes): NR | SMD 0.59 [0.20, 0.98] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | General health status Change from baseline to end of intervention (8 to 28 weeks) · Sessions per week: 2 | SMD 0.39 [0.01, 0.78] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Fatigue Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Intervention length (weeks) | Meta-regression coefficient -0.64 [-2.98, 1.70] GRADE not reported 4 studies · 139 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Region | Meta-regression coefficient 0.07 [-0.69, 0.82] GRADE not reported 8 studies · 316 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) | SMD 0.32 [-0.09, 0.72] Very low Downgraded: risk of bias, imprecision, inconsistency 5 studies · 217 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Social aspects (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Outcome measure (survey method): SF_36_social aspects | SMD 0.27 [-0.08, 0.62] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Session duration (minutes): 35 | SMD 0.24 [-0.17, 0.66] GRADE not reported 2 studies · 90 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | General health status Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Outcome measure (survey method) | Meta-regression coefficient -0.09 [-0.78, 0.59] GRADE not reported 4 studies · 172 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Vitality (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Region | Meta-regression coefficient 0.35 [-0.63, 1.33] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Outcome measure (survey method): SF_36_emotional | SMD 0.74 [0.34, 1.13] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) | SMD 0.42 [0.13, 0.72] Low Downgraded: risk of bias, imprecision 8 studies · 316 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Disease activity (ESSDAI) Change from baseline to end of intervention (8 to 28 weeks) · Region: Developing | SMD -0.09 [-0.41, 0.23] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Sessions per week: 3 | SMD 0.35 [-0.40, 1.11] GRADE not reported 4 studies · 102 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Fatigue Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Session duration (minutes) | Meta-regression coefficient -1.39 [-4.52, 1.75] GRADE not reported 4 studies · 139 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Vitality (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Region: Developing Unresolved: the two extractors disagree on this row. | SMD 0.56 [0.17, 0.95] GRADE not reported 2 studies · 19 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Social aspects (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Sessions per week | Meta-regression coefficient -0.32 [-1.30, 0.66] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Sensitivity analysis (leave-one-out), omitting Miyamoto 2019 | SMD 0.47 [0.08, 0.85] GRADE not reported 4 studies |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Sensitivity analysis (leave-one-out), omitting Garcia 2021 (estimate 1) | SMD 0.40 [0.09, 0.71] GRADE not reported 4 studies · 169 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Disease activity (ESSDAI) Change from baseline to end of intervention (8 to 28 weeks) · Outcome measure (survey method): ESSDAI | SMD -0.09 [-0.41, 0.23] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Intervention length (weeks) | Meta-regression coefficient -0.15 [-0.61, 0.31] GRADE not reported 5 studies · 229 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Sensitivity analysis (leave-one-out), omitting Strömbeck 2007 | SMD 0.52 [0.10, 0.94] GRADE not reported 4 studies |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Sessions per week: 3 | SMD -0.14 [-0.63, 0.36] GRADE not reported 2 studies · 64 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Sensitivity analysis (leave-one-out), omitting Kurt 2023 | SMD 0.35 [-0.17, 0.87] GRADE not reported 4 studies |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Session duration (minutes): 45 | SMD 0.53 [-0.55, 1.62] GRADE not reported 3 studies · 57 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Functional capacity Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Session duration (minutes) | Meta-regression coefficient 0.76 [-0.33, 1.85] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Disease activity (ESSDAI) Change from baseline to end of intervention (8 to 28 weeks) · Session duration (minutes): NR | SMD -0.14 [-0.52, 0.24] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Sessions per week: 2 | SMD 0.72 [0.33, 1.11] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Sensitivity analysis (leave-one-out), omitting Miyamoto 2019 (estimate 2) | SMD 0.71 [0.28, 1.14] GRADE not reported 4 studies |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Vitality (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Outcome measure (survey method): SF_36_vitality | SMD 0.51 [0.15, 0.86] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Sessions per week: 2 | SMD 0.78 [0.10, 1.46] GRADE not reported 2 studies · 120 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Functional capacity Change from baseline to end of intervention (8 to 28 weeks) · Outcome measure (survey method): functional capacity | SMD 0.69 [0.33, 1.05] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Mental health Change from baseline to end of intervention (8 to 28 weeks) · Region: Developed | SMD 0.53 [-0.55, 1.62] GRADE not reported 3 studies · 57 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | General health status Change from baseline to end of intervention (8 to 28 weeks) · Outcome measure (survey method): SF_36_ general health | SMD 0.48 [0.12, 0.84] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Social aspects (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Intervention length (weeks) | Meta-regression coefficient 0.08 [-0.16, 0.33] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Pain Change from baseline to end of intervention (8 to 28 weeks) · Intervention length (weeks): 16 | SMD 0.72 [0.33, 1.11] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Functional capacity Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Sessions per week | Meta-regression coefficient 0.76 [-0.33, 1.85] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Vitality (SF-36) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Sessions per week | Meta-regression coefficient -0.35 [-1.33, 0.63] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Outcome measure (survey method) | Meta-regression coefficient -0.53 [-1.23, 0.18] GRADE not reported 5 studies · 229 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Fatigue Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Region | Meta-regression coefficient -0.64 [-2.98, 1.70] GRADE not reported 4 studies · 139 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Functional capacity Change from baseline to end of intervention (8 to 28 weeks) · Univariate meta-regression on Region | Meta-regression coefficient 0.76 [-0.33, 1.85] GRADE not reported 3 studies · 126 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Functional capacity Change from baseline to end of intervention (8 to 28 weeks) · Sessions per week: 2 | SMD 0.59 [0.20, 0.98] GRADE not reported 2 studies · 107 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Cardiopulmonary function (VO2max and peak heart rate) Change from baseline to end of intervention (8 to 28 weeks) · Outcome measure (survey method): VO2 max | SMD 0.84 [0.27, 1.40] GRADE not reported 3 studies · 124 participants |
| Physical activity (resistance, aerobic, walking, pelvic floor and diaphragm exercise) | Control (no exercise, standard care, relaxation or low-intensity exercise) | Disease activity (ESSDAI) Change from baseline to end of intervention (8 to 28 weeks) · Intervention length (weeks): 16 | SMD -0.09 [-0.41, 0.23] GRADE not reported 3 studies · 126 participants |
Included primary studies 6
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Dardin 2022 The effects of resistance training in patients with primary Sjogren's syndrome. PMID:34748096 | 2022 | this review only | not stated | not extracted yet |
| Garcia 2021 Cardiovascular Effect of Physical Exercise on Primary Sjogren's Syndrome (pSS): Randomized Trial. PMID:34660630 | 2021 | this review only | not stated | not extracted yet |
| Kurt 2023 Investigation of the effects of pelvic floor training on pain, sexual dysfunction, and quality of life in female patients with primary… PMID:37337640 | 2023 | this review only | not stated | not extracted yet |
| Minali 2020 Effectiveness of resistance exercise in functional fitness in women with primary Sjögren's syndrome: randomized clinical trial. PMID:31244376 | 2020 | this review only | not stated | not extracted yet |
| Miyamoto 2019 Supervised walking improves cardiorespiratory fitness, exercise tolerance, and fatigue in women with primary Sjögren's syndrome: a… PMID:30604204 | 2019 | this review only | not stated | not extracted yet |
| Strömbeck 2007 Effects of exercise on aerobic capacity and fatigue in women with primary Sjogren's syndrome. PMID:17308315 | 2007 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with primary Sjögren's disease (2002 AECG or 2016 ACR/EULAR criteria), no age restriction | Women with primary Sjögren's syndrome (n=277; 141 intervention, 136 control; mean ages 46.08 to 62.7 years) |
| Intervention | Physical activity interventions | Resistance training (3 studies), walking exercise (1), aerobic capacity training (1), pelvic floor and diaphragm exercises (1) |
| Comparison | No treatment or any other treatment or procedure without structured or supervised physical activity | Standard treatment or no exercise (3 studies), regular or low-intensity home exercise (2), relaxation exercises (1) |
| Outcomes | Primary: cardiopulmonary function, functional capacity, pain. Secondary: general health status, vitality, social aspects, fatigue, mental health, ESSDAI | Cardiopulmonary function (5 entries, n=229), functional capacity (3, n=126), pain (5, n=217), general health status (4, n=172), vitality (3, n=126), social aspects (3, n=126), ESSDAI (3, n=126), fatigue (4, n=139), mental health (8, n=316) |
| Study designs | Randomized controlled trials | Randomized controlled trials (6) |
| Timing | Not specified | Intervention length 8 to 28 weeks; 2 to 5 sessions per week; 30 to 45 minutes per session |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: N/A · RCT: Yes | NRSI: N/A · RCT: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: No | NRSI: N/A · RCT: No | yes |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |