Author(s): QOOJA, S., ROBERTS, M., MCGINTY, O., BHIMA, P., GACKI, B., LOUGHREY, A., BAKER, C., MOORTHY, A., BISHOP, N., Institution: LOUGHBOROUGH UNIVERSITY , Country: UNITED KINGDOM, Abstract-ID: 778

INTRODUCTION:
Physical activity is advised for patients living with axial spondyloarthritis (axSpA) for better management of symptoms; however, the existing treatment guidelines regarding the intensity and type of the exercise lacking sufficient detail. Thus, the aim of this study was to provide insight into this aspect of condition management through an adjunctive therapeutic approach.
METHODS:
20 participants taking Disease-Modifying Antirheumatic Drugs (DMARDs) were randomly allocated to either a usual care group or to an exercise (walking) group. Those in the usual care arm were given a mobility and stretch exercise booklet, and those in the exercise group were asked to do brisk walking 30 minutes per day for 5 days per week (aiming for a heart rate of 110-130 BPM, according to a digital health band that was provided). Both groups were asked to continue the activities for 3 months and visited Loughborough University on a monthly basis for data collection visits. During visits, participants were asked to fill out questionnaires about their symptoms; Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and a Visual Analogue Scale (VAS) were used to collect data about condition-related symptoms (pain, fatigue, stiffness, etc.) Venous blood samples were then taken for immunophenotyping (monocytes and T-cells). Data were compared between groups and over time.
RESULTS:
Mixed-effects models adjusted for age and sex showed no significant group×time interactions for BASDAI (p=0.514), BASFI (p=0.107), or spinal pain (p=0.153), indicating no confirmed differential change over the study period. Nevertheless, the pattern of adjusted means suggested that the exercise group experienced greater reductions in spinal pain relative to usual care, although these observations were exploratory and should be interpreted cautiously in the absence of significant interaction effects. Although some changes in patient-reported outcomes were significantly associated with alterations in immune cell percentages (classical/intermediate/non-classical monocytes; CD4%, CD8%, and senescent CD4/CD8%), after correction for multiple comparisons with the Benjamini-Hochberg procedure, none remained significantly correlated (FDR-adjusted p-values > 0.05; minimum FDR q = 0.167).
CONCLUSION:
Brisk walking did not improve BASDAI, BASFI, or spinal pain over time compared to mobility and stretch exercises, but exploratory patterns in adjusted means suggested potential symptom improvement, particularly for spinal pain, in larger group samples and post-3 months.