Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2025 Apr 1;64(4):1817-1825.
doi: 10.1093/rheumatology/keae323.

One-year effectiveness of long-term exercise therapy in people with axial spondyloarthritis and severe functional limitations

Maria A T van Wissen  1 , Cornelia H M van den Ende  2   3 , Maaike G J Gademan  1   4 , Max M H Teuwen  1 , Wilfred F Peter  1   5 , Elien A M Mahler  6 , Dirkjan van Schaardenburg  5 , Floris A van Gaalen  7 , Anneke Spoorenberg  8 , Wilbert B van den Hout  9 , Astrid M van Tubergen  10   11 , Theodora P M Vliet Vlieland  1 , Salima F E van Weely  1   12
Affiliations
Randomized Controlled Trial

One-year effectiveness of long-term exercise therapy in people with axial spondyloarthritis and severe functional limitations

Maria A T van Wissen et al. Rheumatology (Oxford). .

Abstract

Objective: To evaluate the effectiveness of long-term, personalized, supervised exercise therapy on functional ability compared with usual care in people with axial spondyloarthritis (axSpA) and severe functional limitations.

Methods: Participants were randomly 1:1 assigned to the intervention [maximal 64 sessions, with 14 additional optional sessions of supervised active exercise therapy (e.g. aerobic and muscle strengthening) with individualized goal-setting, education and self-management regarding physical activity] or usual care (care determined by clinician(s) and participants themselves). Primary endpoint was the change in the Patient-Specific Complaints activity ranked 1 [PSC1 (0-10)] at 52 weeks. Secondary endpoints were the PSC activities ranked 2 and 3, the Bath Ankylosing Spondylitis Functional Index, 6-min walk test, Patient Reported Outcome Measurement Information System-Physical Function-10 and the Short Form-36 Physical and Mental Component Summary Score (SF-36 PCS and MCS). Statistical comparisons comprised independent student t-tests and linear mixed models, based on intention-to-treat.

Results: 214 participants [49% female, age 52 (s.d. 12) years], were randomized to the intervention (n = 110) or usual care (n = 104) group. In the intervention group 93% started treatment, using on average 40.5 sessions (s.d. 15.1). At 52 weeks, the difference in change in PSC1 between groups favoured the intervention group [mean difference (95% CI); -1.8 (-2.4 to -1.2)]. Additionally, all secondary outcomes, except the SF-36 MSC, showed significantly greater improvements in the intervention group with effect sizes ranging from 0.4 to 0.7.

Conclusion: Long-term, supervised exercise therapy proved more effective than usual care in improving functional disability and physical quality of life in people with axSpA and severe functional limitations.

Trial registration: Netherlands Trial Register NL8238, included in the International Clinical Trial Registry Platform (ICTRP) (https://trialsearch.who.int/Trial2.aspx?TrialID=NL8238).

Keywords: exercise; physical function; physical therapy; randomized trial; spondyloarthritis.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Flowchart
See this image and copyright information in PMC

References

    1. Dougados M, Baeten D.. Spondyloarthritis. Lancet 2011;377:2127–37. - PubMed
    1. Kiltz U, Essers I, Hiligsmann M. et al. Which aspects of health are most important for patients with spondyloarthritis? A best worst scaling based on the ASAS health index. Rheumatology (Oxford) 2016;55:1771–6. - PubMed
    1. National Institute for Health and Care Excellence (NICE). Spondyloarthritis. 2018. https://www.nice.org.uk/guidance/qs170/resources/spondyloarthritis-pdf-7... (27 October 2023, date last accessed). - PubMed
    1. Ramiro S, Nikiphorou E, Sepriano A. et al. ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis 2023;82:19–34. - PubMed
    1. Ward MM, Deodhar A, Gensler LS. et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/spondyloarthritis research and treatment network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Care Res (Hoboken) 2019;71:1285–99. - PMC - PubMed

Publication types