Physical Therapy and Rehabilitation Interventions for Pain and Dysfunction in Rheumatoid Arthritis: A Systematic Review

Rheumatoid arthritis (RA) is a chronic inflammatory condition associated with pain, stiffness, impaired physical function, joint damage, and reduced quality of life.Rehabilitation forms an integral part of RA management, with treatment approaches directed toward maintaining mobility, physical capacity, hand function, and participation in daily activities.This systematic review synthesized evidence from randomized controlled trials evaluating contemporary rehabilitation approaches for adults with RA.Searches were conducted in PubMed/MEDLINE, PEDro, CINAHL, Scopus, and the Cochrane Library for trials published between January 2016 and June 2026.The date range was selected to focus the review on contemporary rehabilitation approaches and digital health interventions while maintaining coverage of recent clinical evidence.In total, 15 randomized controlled trials met the predefined eligibility criteria.Interventions included aquatic exercise, aerobic and resistance training, high-intensity interval training, individualized exercise programs, hand exercise, manual therapy, mobilization with movement, therapeutic hand massage, and selected digital health and self-management approaches, including telehealth, smartphone-based care, and digital education programs.Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) framework.Findings varied according to the intervention, comparator, outcome, and assessment time point.Exercise-based approaches showed benefits in selected measures of physical capacity, fatigue, pain, and function, although effects were not consistently observed across all outcomes.Hand rehabilitation and manual therapy showed improvements in selected measures of hand function, strength, or pain, while some comparisons demonstrated no additional benefit.Digital and self-management approaches showed potential benefits for selected aspects of disease management, patient engagement, and quality of life.Because of substantial clinical and methodological heterogeneity across interventions, populations, comparators, outcomes, and follow-up periods, findings were synthesized using a structured narrative approach rather than quantitative meta-analysis.Overall, the findings indicate that contemporary physical therapy, rehabilitation, and selected digital or self-management approaches may provide potential benefits for selected outcomes in adults with RA.However, variation in intervention protocols, comparators, outcome measures, follow-up periods, and risk-of-bias judgments limits direct comparison across trials.Further well-designed randomized controlled trials with standardized outcome assessment and adequate follow-up are warranted.