Changing physical activity behavior among individuals with inflammatory arthritis - an umbrella review of current behaviors, behavioral determinants, and behavior change interventions

Sep 30, 2026

Internationally recommended physical activity remains underutilized among individuals with inflammatory arthritis, limiting symptom management, quality-of-life improvement, and cardiovascular risk reduction. This umbrella review synthesizes current evidence on physical activity levels and patient characteristics, relevant behavioral determinants, and the effectiveness and characteristics of behavior change interventions. Searches across major databases identified 32 reviews and 421 original articles, revealing lower activity and intensity with identified barriers and facilitators, including roles for motivation, self-efficacy, and supportive intervention components.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Introduction

Methods

Results

Conclusions

Keywords

Ester et al. BMC Rheumatology (2026) 10:3 [https://doi.org/10.1186/s41927-025-00601-z](https://doi.org/10.1186/s41927-025-00601-z) BMC Rheumatology RESEARCH Open Access Changing physical activity behavior among individuals with inflammatory arthritis: an umbrella review of current behaviors, behavioral determinants, and behavior change interventions Manuel Ester 1,2,3,7*, Daniel Gillespie 1,4, Saania Zafar 1,5, Racheal Githumbi 1,5, Kiran Dhiman 1, Kamala Adhikari5,6 and Claire Barber6,1,2,3 Abstract Introduction Physical activity is internationally recommended as an effective component of inflammatory arthritis (IA) care. It contributes to managing IA symptoms, enhancing quality of life, and reducing cardiovascular disease risk. However, many individuals with IA are insufficiently active to realize these multi-faceted benefits. Supporting physical activity behavior change remains a major challenge within IA care. Therefore, we conducted an umbrella review to understand current evidence on: (1) physical activity levels and associated patient characteristics,(2) barriers and facilitators, and (3) effectiveness and characteristics of physical activity behavior change interventions. Methods An umbrella review approach captured review-level evidence and provided big picture insights on the physical activity behavior change research landscape in IA. A systematic search for physical activity, IA, review articles, and physical activity outcomes was completed using EMBASE, MEDLINE, CINAHL, and SPORTDiscus. Article selection was completed by 3 authors using Covidence, followed by data extraction of article characteristics, research methods, populations and interventions, and key findings. After assessing study overlap between reviews and methodological quality (AMSTAR-2), a narrative synthesis was completed to summarize evidence on each of the 3 topics of interest. Results 32 reviews covering 421 original articles, were included in the umbrella review. Of these, 7 were related to topic 1, 6 to topic 2, 15 to topic 3, and 4 to more than one topic. Individuals with IA frequently reported lower physical activity levels or decreased intensity compared to adults without IA. Physical function, education level, motivation, and physical activity history were associated with current physical activity in rheumatoid arthritis and spondyloarthritis. Behavioral barriers (symptoms, safety concerns) and facilitators (effective treatment, self-efficacy) were noted. Interventions using digital technology, health coaching, and other components can effectively increase *Correspondence: Manuel Ester manuel.ester@ucalgary.ca Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Ester et al. BMC Rheumatology (2026) 10:3 Page 2 of 16 physical activity behaviors, though comparative effectiveness data was lacking. AMSTAR-2 overall confidence ratings were low

FAQs

What topics does the umbrella review investigate?

It examines current evidence on physical activity levels and associated patient characteristics, behavioral barriers and facilitators, and the effectiveness and characteristics of physical activity behavior change interventions.

How does physical activity in people with inflammatory arthritis compare to those without?

Individuals with inflammatory arthritis frequently report lower physical activity levels and decreased intensity compared with adults without inflammatory arthritis.

What kinds of interventions showed potential to improve physical activity behaviors?

Interventions using digital technology, health coaching, and additional components can effectively increase physical activity behaviors, although comparative effectiveness data were lacking.

Sep 30, 2026

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