The Influence of Physical Therapy on Microbiotic Dysbiosis in Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disorder caused by genetic and environmental factors. It causes joint inflammation due to an increase in pro‐inflammatory T‐ lymphocytes. Natural bacteria residing in the gut microbiota have a regulatory role on the immune system. Alterations in the gut microbiome occur due to dietary changes, illness and other disturbances leading to dysbiosis of the gut microbiome. In patients with RA, studies have shown increases in Prevotella copri , which induces differentiation into pro‐inflammatory T‐lymphocytes causing a symbiotic imbalance. The use of exercise has shown to modulate the composition and functions of the human gut microbiota; however, few studies have explored the effects of exercise on the human gut microbiota. The purpose of the study was to examine the effects of alterations in the gut microbiota on the development of RA and the influence of physical therapy (PT) intervention in relieving inflammation. Using the Oxford Center for Evidence‐Based Medicine, levels of evidence of literature were assessed. Results of the study revealed patients with RA were found to have different microbiota composition and diversity. The effect of physical therapy interventions in the form exercise resulted in increased concentrations of short chain fatty acids and butyrate‐producing bacteria which assist in regulating anti‐inflammatory phenotypes and provide protection against microbial dysbiosis. Also, improvements in cardiorespiratory fitness were positively correlated with lower pro‐inflammatory biomarkers. The researchers conclude microbial dysbiosis contributes to the progression of RA, and PT interventions may promote microbiome symbiosis and may improve inflammation through aerobic exercise‐based interventions.