BACKGROUND: Rheumatoid cachexia (RC) in rheumatoid arthritis is characterized by decreased muscle mass and increased fat mass due to chronic inflammation. Exercise may help counteract these adverse changes. OBJECTIVE: To assess the effects of exercise on fat mass (FM), lean body mass (LBM), and isometric knee extensor strength in rheumatoid arthritis patients. METHODS: A systematic review and meta-analysis included randomized controlled and controlled trials. A random-effects model was used to pool effect sizes. RESULTS: Six studies with 119 rheumatoid arthritis patients were analysed. Exercise programs (12 to 24 weeks) included resistance, proprioceptive, and water-based exercises. Exercise significantly reduced FM (SMD -0.20, 95% CI -1.20 to 0.79, p < 0.001), increased LBM (SMD 0.66, 95% CI -0.77 to 2.09, p < 0.001), and improved knee extensor strength (SMD 3.01, 95% CI 0.59 to 5.43, p < 0.001). CONCLUSION: Exercise reduces fat mass, increases lean body mass, and improves muscle strength in rheumatoid arthritis patients, helping to counteract rheumatoid cachexia.

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