Ann Rheum Dis
Move more, sit less: EULAR updates physical activity guidance for arthritis care
Clinical Takeaway: Advise all patients with inflammatory arthritis or osteoarthritis (OA) to meet WHO-aligned activity targets (≥150 min/week moderate or 75 min vigorous plus strength training) while actively reducing sedentary time—integrate individualized physical activity counseling into routine care at every visit.
EULAR’s 2025 update places physical activity at the center of arthritis management, reframing it from adjunctive advice to a core component of standard care across the disease course. The recommendations—published in Annals of the Rheumatic Diseases—include four overarching principles and 11 actionable statements, reflecting new evidence on behavioral strategies, digital tools, and sedentary risk since the 2018 guideline.
A major shift is the explicit focus on reducing sedentary behavior alongside increasing exercise. The task force emphasizes that prolonged sitting carries independent health risks—even among patients who meet exercise targets—prompting a new dedicated recommendation on breaking up inactivity throughout the day.
Clinicians are now urged to routinely assess and promote physical activity as part of comprehensive care, with shared responsibility across the care team. Recommended activity mirrors WHO guidance: at least 150 minutes of moderate-intensity or 75 minutes of vigorous aerobic activity weekly, plus muscle strengthening ≥2 days/week, with flexibility to accumulate activity in short bouts for patients with pain or fatigue.
The update also prioritizes individualized, adaptable interventions—tailored to disease activity, functional status, and patient preferences—and highlights the use of behavior change techniques and technology (eg, wearables, digital coaching) to improve adherence. Structured programs should address all exercise domains: aerobic fitness, strength, flexibility, and neuromotor skills.
Notably, the guideline underscores that physical activity is safe and beneficial even during active disease when appropriately adapted, and should not be delayed while awaiting “ideal” symptom control. Pharmacologic therapy remains essential, but the authors stress that optimal outcomes depend on integrating lifestyle and behavioral interventions alongside drug treatment.
“Promoting physical activity should be an integral part of standard care,” the authors emphasize, underscoring the strong consensus and high agreement across recommendations.
Overall, the new guidance reinforces a paradigm shift: treating arthritis requires not only controlling inflammation with medications but also systematically prescribing—monitoring, and supporting—movement as medicine.
Source: Rausch Osthoff AK, et al. (2026, April 25). Ann Rheum Dis. EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis: 2025 update