An Approach to Physical Activity & Exercise in Axial Spondyloarthritis

The mainstay of physical therapy treatment is active intervention, such as prescription of, and instruction in, therapeutic exercise that is tailored to each patient’s specific needs.^18,19 Further, evidence has demonstrated that supervised physical therapy care has greater efficacy than home-based physical therapy, and that long-term, personalized and supervised exercise is more beneficial than usual care for patients with severe functional limitations due to axSpA, showing the value of one-to-one patient instruction on how to correctly perform exercise programs and support in behavior changes to optimize adherence over the long term.^3,18,20

Conclusion

Guiding physical activity is a very important aspect in the management of axSpA because of its proven effects on general health, as well as specific disease-related outcomes. The management of axSpA demands more than pharmacological therapy and calls for an all-encompassing strategy that considers the physical and psychosocial aspects related to the disease. We propose that a holistic management approach is more likely to lead to better outcomes and a more empowered journey toward health and well-being for patients with axSpA.

Yvonne M. van der Kraan, BSc, is an MD/PhD student at the department of rheumatology and clinical immunology at the University Medical Center Groningen, the Netherlands, and did an Assessment of SpondyloArthritis research fellowship on the translation and cross-cultural adaptation of the mSQUASH at the University of California, San Francisco. Her PhD focuses on chronic pain in patients with axial spondyloarthritis beyond inflammation.

Andrew Lui, PT, DPT, is a clinical professor in the department of physical therapy and rehabilitation science at the University of California, San Francisco. He is vice chair of faculty development and faculty affairs in this department and cares for patients with rheumatic and neurologic diagnoses.

Anneke Spoorenberg, MD, is an associate professor and a rheumatologist in the department of rheumatology and clinical immunology at the University Medical Center Groningen, with a focus on spondyloarthropathy.

Suzanne Arends, PhD, is an assistant professor and clinical epidemiologist in the department of rheumatology and clinical immunology at the University Medical Center Groningen. Her interest is in clinical/translational research on disease activity, outcome, and effect of treatment in rheumatic diseases. She is the principal investigator of the international mSQUASH project.

Lianne S. Gensler, MD, is a professor of medicine, director of the Ankylosing Spondylitis Clinic, and director of the Rheumatology Fellowship Program at the University of California, San Francisco.

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