2025 update of the EULAR recommendations for physical activity with inflammatory arthritis and osteoarthritis
Bibliographic record
Abstract
Introduction The 2018 European Alliance of Associations for Rheumatology (EULAR) recommendations for physical activity (PA) in people with inflammatory arthritis (IA), namely rheumatoid arthritis (RA) and spondyloarthritis (SpA), and hip and knee osteoarthritis (OA) were updated, as the World Health Organisation released updated guidelines for PA with emphasis on sedentary behavior in 2020 and moreover many new international studies in people with IA or OA have been published, including interventions targeting sedentary behavior reduction and interventions using technology and/or the combination of educational and behavioral strategies. Objective To perform a systematic literature review and update the 2018 EULAR recommendations for PA in people with IA and OA. Methods The EULAR Standardised Operating Procedures for developing recommendations were followed. A multidisciplinary task force with 24 members from 17 countries was established. The TF agreed on updating strategies for the 13 research questions associated with the original four overarching principles and ten recommendations. Systematic literature searches were conducted for literature published from 1 st April 2017 until 1 st August 2024 to identify new evidence. The retrieved evidence was discussed, the recommendations were updated, quality indicators were defined, and research and educational agendas were developed. Results The revised recommendations include three overarching principles and eleven recommendations on PA and sedentary behaviour. The mean level of agreement ranged from 9.0 to 9.8, the mean impact of recommendations was rated between 8.3 to 9.2, and the mean feasibility of implementation was rated somewhat lower between 7.2 to 8.5. The promotion of PA, including the reduction of sedentary behavior, should be an integral part of standard care throughout the course of the disease. The recommendations give orientation on how to integrate this principle into clinical care, considering a suitable prescription framework, individual resources, goals, possible delivery modes including digital technologies. Conclusions The updated EULAR recommendations for PA provide guidance in the development, conduct and evaluation of PA interventions and promotion in people with IA and OA. These recommendations should be implemented considering individual needs and national health systems. Publication History Article published online: 23 October 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.024 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.005 |
| Bibliometrics | 0.006 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.004 | 0.003 |
| Research integrity | 0.006 | 0.006 |
| Insufficient payload (model declined to judge) | 0.010 | 0.008 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".