Effects of physical activity on health-related outcomes in Sjögren’s syndrome: a systematic review and meta-analysis of randomized controlled trials

Introduction: Individuals with Sjögren's syndrome (SjD) experience notable health challenges, including chronic pain, fatigue, and depression; however, the potential benefits of physical activity in alleviating these issues remain unclear. We aim to systematically assess the comprehensive effects of physical activity on individuals with SjD. Methods: A comprehensive literature search was conducted in Medline, Embase, Scopus, Web of Science, Cochrane Library, SPORTDiscus, and ClinicalTrials.gov for studies published from inception to November 2025. Two independent reviewers screened the search results and extracted the data. Effect sizes were calculated as the standardized mean difference (SMDs) with 95% confidence intervals (CIs) using random-effects models. Methodological quality was assessed using the Cochrane Collaboration Risk of Bias Tool 2.0, and the certainty of evidence was evaluated with the GRADEpro online tool. Sensitivity, subgroup, and regression analyses were performed to explore potential sources of heterogeneity. Results: This analysis included six studies with a total of 277 participants with SjD. Compared to controls, physical activity interventions significantly improved cardiopulmonary function (SMD 0.59 95% CI 0.20 to 0.99), functional capacity (SMD 0.69 95% CI 0.33 to 1.05), general health status (SMD 0.46 95% CI 0.15 to 0.76), vitality (SMD 0.51 95% CI 0.15 to 0.86), and mental health (SMD 0.42 95% CI 0.13 to 0.72). However, no significant improvements were observed in pain, social aspects, fatigue, and the EULAR Sjögren's Syndrome Disease Activity Index. Discussion: The results highlight aerobic and resistance training are regarded as effective and practical exercise options. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024513141.