A supervised high-intensity interval training (HIIT) and strength exercise intervention significantly reduced fatigue and improved quality of life in patients with rheumatoid arthritis (RA), with benefits persisting through 12 months of follow-up.

Researchers conducted a secondary analysis of a randomised controlled trial to evaluate the effect of supervised HIIT on fatigue, mood, pain, and health-related quality of life in patients with RA recruited from hospitals in Sweden.

They included 87 patients with RA (mean age, 48 years; 84% women) who were randomly assigned to either an intervention group (n = 43) who performed supervised HIIT plus strength exercise two times per week for 12 weeks or a control group (n = 44) who received physiotherapy counselling on general physical activity.

The HIIT session on ergometric bicycles included both high- and low-intensity bouts, followed by strength exercise tailored as per individual physical capacity and session with a physiotherapist.

The primary outcome was multidimensional fatigue, assessed using the 20-item Multidimensional Fatigue Inventory (MFI-20) scale at baseline and 3, 6, and 12 months. The MFI-20 scale included five subscales: General Fatigue, Physical Fatigue, Mental Fatigue, Reduced Activity, and Reduced Motivation, with scores ranging from 4 to 20 and a higher score indicating greater fatigue.

Secondary outcomes included health-related quality of life and pain, assessed using the visual analog scale at baseline and 3, 6, and 12 months, with scores ranging from 0 to 100 and a higher score indicating worse pain and health.

At 3 months, the intervention vs control group showed significant improvements in General Fatigue (P < .0001), Physical Fatigue (P < .0001), Reduced Activity (P = .0003), and Reduced Motivation (P = .0032) subscale scores, as well as health-related quality of life (P = .0036).

These effects persisted at 6 months in favour of the intervention group, with sustained improvements seen in four subscale scores of the MFI-20 (P < .05) except Mental Fatigue subscale scores and health-related quality of life (P = .030).

At 12 months of follow-up, persistent beneficial effects were seen in the intervention group, with significant improvements seen in the Physical Fatigue subscale score (P = .0030), health-related quality of life (P = .0012), and pain (P = .0088).

"The pragmatic approach employed to deliver the exercise in the study, utilizing existing exercise equipment at the physiotherapy units of the respective hospitals and clinically active physiotherapists supervising the exercise makes the implementation of the exercise protocol in clinical practice feasible," the authors wrote.

This study was led by Annelie Bilberg, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. It was published online on September 18, 2025, in Arthritis Research & Therapy.

This study may have been underpowered to detect true changes in fatigue because no power calculation was performed for the primary outcome.

This study received open access funding from the University of Gothenburg and additional funding from the Swedish state through the ALF agreement, the Healthcare Board of Region Västra Götaland, the Swedish Rheumatology Association Research Grant, the Rune and Ulla Amlöv Foundation for Rheumatology Research, and the Norrbacka‑Eugenia Foundation. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

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Cite this: High-Intensity Exercise Programme Reduces Fatigue in Rheumatoid Arthritis - Medscape - September 29, 2025.