Effects of exercise in primary Sjögren’s syndrome: a systematic review and meta-analysis of randomized clinical trials

To systematically review the effects of exercise interventions on pain, fatigue, quality of life, disease activity, aerobic capacity, and dryness in primary Sjögren's syndrome (pSS), and to determine the most effective type of exercise. A literature search was conducted using Web of Science, PubMed/MEDLINE, ProQuest, SCOPUS, Cochrane Library, and PEDro databases. Randomized clinical trials (RCTs) examining the effects of exercise interventions in patients with pSS were included. Methodological quality was assessed using the Risk of Bias version-2 tool and PEDro scale. Five RCTs, including 269 female patients with pSS were analyzed. High-quality studies indicated that exercise interventions significantly improved pain (p = 0.008), fatigue (p < 0.00001), quality of life (p = 0.0003), and aerobic capacity (p = 0.009) compared to controls. Sensitivity analysis indicated that resistance exercise was particularly effective, significantly improving pain (p < 0.00001), fatigue (p < 0.00001), quality of life (p < 0.00001), and disease activity (p = 0.02). Exercise interventions may offer significant benefits in reducing pain and fatigue, as well as improving quality of life and aerobic capacity, in patients with pSS compared to no-treatment. Resistance exercise appears to be more effective than other exercise models.