Effects of Resistance Training on Inflammatory Markers, Cardiorespiratory Fitness, and Pulmonary Function in Patients with Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by systemic inflammation, progressive joint damage, and increased risk of cardiopulmonary complications. While pharmacological therapies target inflammatory pathways, resistance training has gained attention for its potential to improve physical and immunological outcomes. However, limited data exist regarding its isolated effects on inflammatory markers, cardiorespiratory fitness, and pulmonary function in RA patients. Objective: To evaluate the effects of a structured resistance training program on inflammatory markers, cardiorespiratory fitness, and pulmonary function in patients with RA. Methods: A single-blinded randomized controlled trial was conducted at Ittefaq Hospital, Lahore, enrolling 48 RA patients aged 40–65 years (n = 24 per group) using non-probability convenient sampling. Participants with stable disease and sedentary lifestyles were included, while those with comorbid conditions were excluded. Group A received 12 weeks of progressive resistance training thrice weekly, and Group B underwent conventional physiotherapy. Outcomes were assessed pre- and post-intervention using the 6-minute walk test (6MWT), spirometry (FVC, FEV1, FEV1/FVC), and inflammatory markers (CRP, ESR, WBC). Ethical approval was obtained in accordance with the Declaration of Helsinki. Statistical analysis was performed using SPSS v24, employing Shapiro-Wilk, Mann-Whitney U, and Wilcoxon tests (α = 0.05). Results: Significant within-group improvements were observed in Group A for 6MWT (mean rank increase from 13.5 to 36.5, p < 0.001), FVC (2.83 ± 0.20 L to 3.15 ± 0.22 L, p < 0.001), FEV1, and inflammatory markers (CRP and ESR, p < 0.001). Between-group differences post-intervention were not statistically significant (p > 0.05) but indicated clinically meaningful trends favoring the experimental group. Conclusion: Resistance training significantly enhances functional capacity, pulmonary function, and systemic inflammation in RA patients. These findings support the integration of resistance exercise as an effective, accessible intervention in clinical rehabilitation for improving quality of life and reducing disease burden.