Skip to main content

Advertisement

SpringerLink
Log in

Quality of reporting and nature of harms in clinical trials on supervised exercise in patients with rheumatoid arthritis or axial spondyloarthritis

  • Systematic Review
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

To describe the quality of reporting and the nature of reported harms in clinical studies on the effectiveness of supervised exercises in patients with rheumatoid arthritis (RA) or axial spondyloarthritis (axSpA). We performed a systematic review, searching eight databases up to February 2023. Randomized controlled trials (RCTs) evaluating supervised exercises in adults with RA or axSpA were considered eligible. Data on harms were extracted according to the CONSORT Harms 2022 Checklist. Among others, it was recorded if harms were prespecified or non-prespecified. Moreover, the nature of reported harms was listed. Forty RCTs were included for RA and 25 for axSpA, of which 29 (73%) and 13 (52%) reported information on harms. In 13 (33%) RCTs in RA and four (16%) in axSpA, the collection of harms outcomes was described in the methods section. Prespecified outcomes were reported by eight (RA) and two (axSpA) RCTs. Non-specified harms outcomes were reported by six (RA) and four (axSpA) RCTs. Prespecified harms outcomes included measures of pain, disease activity, inflammation, and structural joint changes. The nature of non-prespecified harms outcomes varied largely, with pain being most common. A considerable proportion of trials on supervised exercise in RA or axSpA does not or inadequately report harms outcomes. Pain was the most commonly reported prespecified or non-specified harm. For a considerate interpretation of the balance between benefits and harms of supervised exercise in RA or axSpA, use of the CONSORT Harms 2022 Checklist for the design, conduct and reporting of trials is advocated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The data supporting this article will be made available upon reasonable request to the corresponding author.

References

  1. Ye H, Weng H, Xu Y, Wang L et al (2022) Effectiveness and safety of aerobic exercise for rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials. BMC Sports Sci Med Rehabil 14:17. https://doi.org/10.1186/s13102-022-00408-2

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hu H, Xu A, Gao C et al (2021) The effect of physical exercise on rheumatoid arthritis: An overview of systematic reviews and meta-analysis. J Adv Nurs 77:506–522. https://doi.org/10.1111/jan.14574

    Article  PubMed  Google Scholar 

  3. Regnaux JP, Davergne T, Palazzo C et al (2019) Exercise programmes for ankylosing spondylitis. Cochrane Database Syst Rev 10:CD011321. https://doi.org/10.1002/14651858.CD011321.pub2

  4. Ortolan A, Webers C, Sepriano A et al (2023) Efficacy and safety of non-pharmacological and non-biological interventions: a systematic literature review informing the 2022 update of the ASAS/EULAR recommendations for the management of axial spondyloarthritis. Ann Rheum Dis 82:142–152. https://doi.org/10.1136/ard-2022-223297

    Article  PubMed  CAS  Google Scholar 

  5. Rausch Osthoff A-K, Juhl CB, Knittle K et al (2018) Effects of exercise and physical activity promotion: meta-analysis informing the 2018 EULAR recommendations for physical activity in people with rheumatoid arthritis, spondyloarthritis and hip/knee osteoarthritis. RMD Open 4:e000713. https://doi.org/10.1136/rmdopen-2018-000713

    Article  PubMed  PubMed Central  Google Scholar 

  6. England BR, Smith BJ, Baker NA et al (2023) 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis. Arthritis Rheumatol 75:1603–1615. https://doi.org/10.1002/acr.25117

    Article  Google Scholar 

  7. Ramiro S, Nikiphorou E, Sepriano A et al (2023) ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis 82:19–34. https://doi.org/10.1136/ard-2022-223296

    Article  PubMed  Google Scholar 

  8. de Jong Z, Vliet Vlieland TP (2005) Safety of exercise in patients with rheumatoid arthritis. Curr Opin Rheumatol 17:177–182. https://doi.org/10.1097/01.bor.0000151400.33899.88

    Article  PubMed  Google Scholar 

  9. Veldhuijzen van Zanten JJCS, Rouse PC, Hale ED et al (2015) Perceived barriers, facilitators and benefits for regular physical activity and exercise in patients with rheumatoid arthritis: a review of the literature. Sports Med 45:1401–1412. https://doi.org/10.1007/s40279-015-0363-2

    Article  PubMed  PubMed Central  Google Scholar 

  10. Halls S, Law R-J, Jones JG et al (2017) Health professionals’ perceptions of the effects of exercise on joint health in rheumatoid arthritis patients. Musculoskelet Care 15:196–209. https://doi.org/10.1002/msc.1157

    Article  Google Scholar 

  11. Ethgen M, Boutron I, Baron G et al (2005) Reporting of harm in randomized, controlled trials of nonpharmacologic treatment for rheumatic disease. Ann Intern Med 143:20–25. https://doi.org/10.7326/0003-4819-143-1-200507050-00006

    Article  PubMed  Google Scholar 

  12. Niemeijer A, Lund H, Stafne SN et al (2020) AEs of exercise therapy in randomised controlled trials: a systematic review and meta-analysis. Br J Sports Med 54:1073–1080. https://doi.org/10.1136/bjsports-2018-100461

    Article  PubMed  Google Scholar 

  13. von Heideken J, Chowdhry S, Borg J et al (2021) Reporting of harm in randomized controlled trials of therapeutic exercise for knee osteoarthritis: a systematic review. Phys Ther 101:pzab161. https://doi.org/10.1093/ptj/pzab161

    Article  Google Scholar 

  14. James KA, von Heideken J, Iversen MD (2021) Reporting of adverse events in randomized controlled trials of therapeutic exercise for hip osteoarthritis: a systematic review. Phys Ther 101:pzab195. https://doi.org/10.1093/ptj/pzab195

    Article  PubMed  PubMed Central  Google Scholar 

  15. Boutron I, Moher D, Altman DG et al (2008) Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Ann Intern Med 148:295–309. https://doi.org/10.7326/0003-4819-148-4-200802190-00008

    Article  PubMed  Google Scholar 

  16. Boutron I, Altman DG, Moher D et al (2017) CONSORT statement for randomized trials of nonpharmacologic treatments: a 2017 update and a CONSORT extension for nonpharmacologic trial abstracts. Ann Intern Med 167:40–47. https://doi.org/10.7326/M17-0046

    Article  PubMed  Google Scholar 

  17. Ioannidis JP, Evans SJ, Gotzsche PC et al (2004) Better reporting of harms in randomized trials: an extension of the CONSORT statement. Ann Intern Med 141:781–788. https://doi.org/10.7326/0003-4819-141-10-200411160-00009

    Article  PubMed  Google Scholar 

  18. Junqueira DR, Zorzela L, Golder S et al (2023) CONSORT Harms 2022 statement, explanation, and elaboration: updated guideline for the reporting of harms in randomised trials. BMJ 381:e073725. https://doi.org/10.1136/bmj-2022-073725

    Article  PubMed  Google Scholar 

  19. Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Open Med 3:e123–e130. https://doi.org/10.1371/journal.pmed.1000097

    Article  PubMed  PubMed Central  Google Scholar 

  20. Ouzzani M, Hammady H, Fedorowicz Z et al (2016) Rayyan-a web and mobile app for systematic reviews. Syst Rev 5:210. https://doi.org/10.1186/s13643-016-0384-4

    Article  PubMed  PubMed Central  Google Scholar 

  21. de Jong Z, Munneke M, Zwinderman AH et al (2003) Is a long-term high-intensity safe in patients with exercise program effective and rheumatoid arthritis? Results of a randomized controlled trial. Arthritis Rheum 48:2415–2424. https://doi.org/10.1002/art.11216

    Article  PubMed  Google Scholar 

  22. van den Ende CHM, Breedveld FC, le Cessie S et al (2000) Effect of intensive exercise on patients with active rheumatoid arthritis: a randomised clinical trial. Ann Rheum Dis 59:615–621. https://doi.org/10.1136/ard.59.8.615

    Article  PubMed  PubMed Central  Google Scholar 

  23. Pukšić S, Mitrović J, Čulo M-I et al (2021) Effects of yoga in daily life program in rheumatoid arthritis: a randomized controlled trial. Complement Ther Med 57:102639. https://doi.org/10.1016/j.ctim.2020.102639

    Article  PubMed  Google Scholar 

  24. McMeeken J, Stillmann B, Story I, Kent P (1999) The effects of knee extensor and flexor muscle training on the timed–up–and—go test in individuals with rheumatoid arthritis. Physiother Res Int 4:55–67. https://doi.org/10.1002/pri.1999.4.1.55

    Article  PubMed  CAS  Google Scholar 

  25. Wang C (2008) Tai Chi improves pain and functional status in adults with rheumatoid arthritis: results of a pilot single-blinded randomized controlled trial. Med Sport Sci 52:218–229. https://doi.org/10.1159/000134302

    Article  PubMed  Google Scholar 

  26. Hsieh L-F, Chen S-C, Chuang C-C et al (2009) Supervised aerobic exercise is more effective than home aerobic exercise in female Chinese patients with rheumatoid arthritis. J Rehabil Med 41:332–337. https://doi.org/10.2340/16501977-0330

    Article  PubMed  Google Scholar 

  27. Strasser B, Leeb G, Strehblow C et al (2011) The effects of strength and endurance training in patients with rheumatoid arthritis. Clin Rheumatol 30:623–632. https://doi.org/10.1007/s10067-010-1584-2

    Article  PubMed  Google Scholar 

  28. Ward L, Stebbings S, Athens J et al (2018) Yoga for the management of pain and sleep in rheumatoid arthritis: a pilot randomized controlled trial. Musculoskelet Care 16:39–47. https://doi.org/10.1002/msc.1201

    Article  Google Scholar 

  29. Sveaas SH, Bilberg A, Berg IJ et al (2019) High intensity exercise for 3 months reduces disease activity in axial spondyloarthritis (axSpA): a multicentre randomised trial of 100 patients. Br J Sports Med 54:292–297. https://doi.org/10.1136/bjsports-2018-099943

    Article  PubMed  Google Scholar 

  30. Xie Y, Guo F, Lu Y et al (2019) A 12-week Baduanjin Qigong exercise improves symptoms of ankylosing spondylitis: a randomized controlled trial. Complement Ther Clin Pract 36:113–119. https://doi.org/10.1016/j.ctcp.2018.12.007

    Article  PubMed  Google Scholar 

  31. Hansen TM, Hansen G, Langgaard AM et al (1993) Longterm physical training in rheumatoid arthritis. a randomized trial with different training programs and blinded observers. Scand J Rheumatol 22:107–112. https://doi.org/10.3109/03009749309099253

    Article  PubMed  CAS  Google Scholar 

  32. Lamb SE, Williamson EM, Heine PJ et al (2015) Exercises to improve function of the rheumatoid hand (SARAH): a randomised controlled trial. Lancet 385:421–429. https://doi.org/10.1016/S0140-6736(14)60998-3

    Article  PubMed  Google Scholar 

  33. Altan L, Korkmaz N, Dizdar M et al (2012) Effect of Pilates training on people with ankylosing spondylitis. Rheumatol Int 32:2093–2099. https://doi.org/10.1007/s00296-011-1932-9

    Article  PubMed  CAS  Google Scholar 

  34. Cetin SY, Calik BB, Ayanc A, Kabul EG (2020) The effectiveness of 10-Tai Chi movements in patients with ankylosing spondylitis receiving anti-tumor necrosis factor α therapy: a randomized controlled trial. Eur J Integr Med 39:101208. https://doi.org/10.1016/j.eujim.2020.101208

    Article  Google Scholar 

  35. Karahan AY, Tok F, Yildirim P et al (2016) The effectiveness of exergames in patients with ankylosing spondylitis: a randomized controlled trial. Adv Clin Exp Med 25:931–936. https://doi.org/10.17219/acem/32590

    Article  PubMed  Google Scholar 

  36. Baslund B, Lyngberg K, Andersen V et al (1993) Effect of 8 wk of bicycle training on the immune system of patients with rheumatoid arhtritis. J Appl Physiol 75:1691–1695. https://doi.org/10.1152/jappl.1993.75.4.1691

    Article  PubMed  CAS  Google Scholar 

  37. Lyngberg KK, Harreby M, Benizen H et al (1994) Elderly rheumatoid arthritis patients on steroid treatment tolerate physical training without an increase in disease activity. Arch Phys Med Rehabil 75:1189–1195. https://doi.org/10.1016/0003-9993(94)90003-5

    Article  PubMed  CAS  Google Scholar 

  38. Siqueira US, Orsini Valente LG, de Mello MT et al (2017) Effectiveness of aquatic exercises in women with rheumatoid arthritis: a randomized, controlled, 16-week intervention—the HydRA trial. Am J Phys Med Rehabil 96:167–175. https://doi.org/10.1097/PHM.0000000000000564

    Article  PubMed  Google Scholar 

  39. Fang H, Cai W, Pan Y et al (2016) Six-month home-based exercise and supervised training in patients with ankylosing spondylitis. Int J Clin Exp Med 9:6635–6641

    CAS  Google Scholar 

  40. Lemmey AB, Marcora SM, Chester K et al (2009) Effects of high-intensity resistance training in patients with rheumatoid arthritis: a randomized controlled trial. Arthritis Rheum 61:1726–1734. https://doi.org/10.1002/art.24891

    Article  PubMed  Google Scholar 

  41. McKenna SG, Donnelly A, Esbensen BA et al (2021) The feasibility of an exercise intervention to improve sleep (time, quality and disturbance) in people with rheumatoid arthritis: a pilot RCT. Rheumatol Int 41:297–310. https://doi.org/10.1007/s00296-020-04760-9

    Article  PubMed  Google Scholar 

  42. Sveaas SH, Berg IJ, Provan SA et al (2014) Efficacy of high intensity exercise on disease activity and cardiovascular risk in active axial spondyloarthritis: a randomized controlled pilot study. PLoS ONE 30:e108688. https://doi.org/10.1371/journal.pone.0108688

    Article  CAS  Google Scholar 

  43. Seneca T, Hauge EM, Maribo T (2015) Comparable effect of partly supervised and self-administered exercise programme in early rheumatoid arthritis—a randomised, controlled trial. Dan Med J 62:A5127

    PubMed  Google Scholar 

  44. Gurpinar B, Ilcin N, Savci S, Akkoc N (2021) Do mobility exercises in different environments have different effects in ankylosing spondylitis? Acta Reumatol Port 46:297–316

    PubMed  Google Scholar 

  45. Cima SR, Barone A, Porto JM, Carvalho de Abreu DC (2013) Strengthening exercises to improve hand strength and functionality in rheumatoid arthritis with hand deformities: a randomized, controlled trial. Rheumatol Int 33:725–732. https://doi.org/10.1007/s00296-012-2447-8

    Article  PubMed  Google Scholar 

  46. Flint-Wagner HG, Lisse J, Lohman TG et al (2009) Assessment of a sixteen-week training program on strength, pain, and function in rheumatoid arthritis patients. J Clin Rheumatol 15:165–171. https://doi.org/10.1097/RHU.0b013e318190f95f

    Article  PubMed  Google Scholar 

  47. de Souza MC, Jennings F, Morimoto H et al (2017) Swiss ball exercises improve muscle strength and walking performance in ankylosing spondylitis: a randomized controlled trial. Rev Bras Reumatol 57:45–55. https://doi.org/10.1016/j.rbre.2016.09.009

    Article  Google Scholar 

  48. Schünemann HJ, Brennan S, Akl EA et al (2023) The development methods of official GRADE articles and requirements for claiming the use of GRADE—a statement by the GRADE guidance group. J Clin Epidemiol 159:79–84. https://doi.org/10.1016/j.jclinepi.2023.05.010

    Article  PubMed  Google Scholar 

  49. Peter WF, Swart NM, Meerhoff GA et al (2021) Clinical practice guideline for physical therapist management of people with rheumatoid arthritis. Phys Ther 101:pzab127. https://doi.org/10.1093/ptj/pzab127

    Article  PubMed  Google Scholar 

  50. Gensler LS (2016) Physical activity in axial spondyloarthritis-tails from bench to bedside. Clin Rheumatol 35:1443–1445. https://doi.org/10.1007/s10067-016-3264-3

    Article  PubMed  Google Scholar 

  51. Thomas JL (2013) Helpful or harmful? Potential effects of exercise on select inflammatory conditions. Phys Sportsmed 41:93–100. https://doi.org/10.3810/psm.2013.11.2040

    Article  PubMed  Google Scholar 

  52. Slade SC, Dionne CE, Underwood M et al (2016) Consensus on exercise reporting template (CERT): explanation and elaboration statement. Br J Sports Med 50:1428–1437. https://doi.org/10.1136/bjsports-2016-096651

    Article  PubMed  Google Scholar 

  53. Ioannidis JP (2009) Adverse events in randomized trials: neglected, restricted, distorted, and silenced. Arch Intern Med 169:1737–1739. https://doi.org/10.1001/archinternmed.2009.313

    Article  PubMed  Google Scholar 

  54. Mayo-Wilson E, Fusco N, Hong H et al (2019) Opportunities for selective reporting of harms in randomized clinical trials: selection criteria for non-systematic adverse events. Trials 20:553. https://doi.org/10.1186/s13063-019-3581-3

    Article  PubMed  PubMed Central  Google Scholar 

  55. Williams M, Williamson EM, Heine PJ et al (2015) Strengthening and stretching for rheumatoid arthritis of the hand (SARAH). A randomised controlled trial and economic evaluation. Health Technol Assess 19:1–222. https://doi.org/10.3310/hta19190

    Article  PubMed  PubMed Central  Google Scholar 

  56. Williamson E, McConkey C, Heine P et al (2017) Hand exercises for patients with rheumatoid arthritis: an extended follow-up of the SARAH randomised controlled trial. BMJ Open 7:e013121. https://doi.org/10.1136/bmjopen-2016-013121

    Article  PubMed  PubMed Central  Google Scholar 

  57. Hall AM, Copsey B, Williams M et al (2017) Mediating effect of changes in hand impairments on hand function in patients with rheumatoid arthritis: exploring the mechanisms of an effective exercise program. Arthritis Care Res (Hoboken) 67:982–988. https://doi.org/10.1002/acr.23093

    Article  CAS  Google Scholar 

  58. Lemmey AB, Williams SL, Marcora SM et al (2012) Are the benefits of a high-intensity progressive resistance training program sustained in rheumatoid arthritis patients? A 3-year followup study. Arthritis Care Res (Hoboken) 64:71–75. https://doi.org/10.1002/acr.20523

    Article  PubMed  Google Scholar 

  59. de Jong Z, Munneke M, Zwinderman AH et al (2004) Long term high intensity exercise and damage of small joints in rheumatoid arthritis. Ann Rheum Dis 63:1399–1405. https://doi.org/10.1136/ard.2003.015826

    Article  PubMed  PubMed Central  Google Scholar 

  60. de Jong Z, Munneke M, Lems WF et al (2004) Slowing of bone loss in patients with rheumatoid arthritis by long-term high-intensity exercise: results of a randomized, controlled trial. Arthritis Rheum 50:1066–1076. https://doi.org/10.1002/art.20117

    Article  PubMed  Google Scholar 

  61. Munneke M, de Jong Z, Zwinderman AH et al (2005) Effect of a high-intensity weight-bearing exercise program on radiologic damage progression of the large joints in subgroups of patients with rheumatoid arthritis. Arthritis Rheum 53:410–417. https://doi.org/10.1002/art.21165

    Article  PubMed  Google Scholar 

  62. van den Hout WB, de Jong Z, Munneke M et al (2005) Cost-utility and cost-effectiveness analyses of a long-term, high-intensity exercise program compared with conventional physical therapy in patients with rheumatoid arthritis. Arthritis Rheum 53:39–47. https://doi.org/10.1002/art.20903

    Article  PubMed  Google Scholar 

  63. de Jong Z, Munneke M, Kroon HM et al (2009) Long-term follow-up of a high-intensity exercise program in patients with rheumatoid arthritis. Clin Rheumatol 28:663–671. https://doi.org/10.1007/s10067-009-1125-z

    Article  PubMed  Google Scholar 

  64. Sveaas SH, Dagfinrud H, Berg IJ et al (2020) High-intensity exercise improves fatigue, sleep, and mood in patients with axial spondyloarthritis: secondary analysis of a randomized controlled trial. Phys Ther 100:1323–1332. https://doi.org/10.1093/ptj/pzaa086

    Article  PubMed  PubMed Central  Google Scholar 

  65. Sveaas SH, Dagfinrud H, Johansen MW et al (2020) Longterm effect on leisure time physical activity level in individuals with axial spondyloarthritis: secondary analysis of a randomized controlled trial. J Rheumatol 47:1189–1197. https://doi.org/10.3899/jrheum.190317

    Article  PubMed  CAS  Google Scholar 

  66. Bilberg A, Dagfinrud H, Sveaas SH (2022) Supervised intensive exercise for strengthening exercise health beliefs in patients with axial spondyloarthritis: a multicenter randomized controlled trial. Arthritis Care Res (Hoboken) 74:1196–1204. https://doi.org/10.1002/acr.24556

    Article  PubMed  Google Scholar 

  67. Sveaas SH, Berg IJ, Fongen C et al (2018) High-intensity cardiorespiratory and strength exercises reduced emotional distress and fatigue in patients with axial spondyloarthritis: a randomized controlled pilot study. Scand J Rheumatol 47:117–121. https://doi.org/10.1080/03009742.2017.1347276

    Article  PubMed  CAS  Google Scholar 

Download references

Funding

This project is financially supported by the Ministry of Health, Welfare and Sport (Ministerie van Volksgezondheid, Welzijn en Sport), The Netherlands; the Netherlands Organisation for Health Research and Development (ZonMw; Project Numbers: 852004018, 852004019); the Dutch Arthritis Society (ReumaNederland); the Royal Dutch Society for Physical Therapy (Koninklijk Nederlands Genootschap voor Fysiotherapie KNGF).

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands

    Max M. H. Teuwen, Thea P. M. Vliet Vlieland, Salima F. E. van Weely, Anne-Kathrin Rausch Osthoff & Maaike G. J. Gademan

  2. Directorate of Research Policy, Leiden University Medical Center, Leiden, The Netherlands

    Jan W. Schoones

  3. School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland

    Anne-Kathrin Rausch Osthoff & Karin Niedermann

  4. Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark

    Carsten B. Juhl

  5. Department of Physiotherapy and Occupational Therapy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark

    Carsten B. Juhl

  6. Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands

    Maaike G. J. Gademan

  7. Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands

    Cornelia H. M. van den Ende

  8. Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands

    Cornelia H. M. van den Ende

Authors
  1. Max M. H. Teuwen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thea P. M. Vliet Vlieland
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Salima F. E. van Weely
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jan W. Schoones
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anne-Kathrin Rausch Osthoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Carsten B. Juhl
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Karin Niedermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Maaike G. J. Gademan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Cornelia H. M. van den Ende
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors have made substantial contributions to this project, spanning the conception, design, data acquisition, analysis, data interpretation, and/or the development of new software crucial to our work. MMHT, TPMVV, SFEW, JS, A-KRO, CBJ, KN, MGJG, and CHME made substantial contributions to the conception and design. MMHT, TPMVV, JWS and CHME made substantial contributions to the search strategy and selection of studies. MMHT, TPMVV and CHME have made significant contributions to the data extraction and analysis and interpretation of the data. Additionally, all authors were involved in drafting the manuscript and critically revising it to ensure the inclusion of important intellectual content. They have collectively approved the final version for publication. Moreover, the authors have agreed to be accountable for their respective roles in all aspects of the project, demonstrating their commitment to addressing any inquiries related to the accuracy or integrity of any part of the work with appropriate investigation and resolution. All authors take full responsibility for the integrity and accuracy of all aspects of their work.

Corresponding author

Correspondence to Max M. H. Teuwen.

Ethics declarations

Conflict of interest

The authors declare that they have no known conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Teuwen, M.M.H., Vlieland, T.P.M.V., van Weely, S.F.E. et al. Quality of reporting and nature of harms in clinical trials on supervised exercise in patients with rheumatoid arthritis or axial spondyloarthritis. Rheumatol Int 44, 25–39 (2024). https://doi.org/10.1007/s00296-023-05502-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-023-05502-3

Keywords

Search

Navigation