Author(s): DREILICH, J., TREBING, S., KUPJETZ, M., KILTZ, U., BARALIAKOS, X., ZIMMER, P., SCHÜTZ, C., JOISTEN, N., Institution: TECHNICAL UNIVERSITY DORTMUND, Country: GERMANY, Abstract-ID: 514

INTRODUCTION:
Physical exercise is recommended to relieve symptoms of pain, stiffness, and limitations in physical function in patients with axial spondyloarthritis. This systematic review summarizes the evidence on efficacy and safety of physical exercise on disease-related outcomes ranging from objective clinical measures to patient-reported outcomes.
METHODS:
This systematic review (inception to November 28th, 2023) was designed according to the PRISMA 2020 guidelines and prospectively registered at PROSPERO (CRD42023395570). The TESTEX tool was used to assess risk of bias.
RCTs investigating physical exercise in axSpA patients were searched in PubMed, Scopus, and Web of Science. Studies conducting aerobic, resistance or multimodal training interventions were considered eligible for inclusion. The comparator was declared as passive, standard care, or limited active control. Publication date and outcome measures were not restricted.
RESULTS:
Fourteen included RCTs with 560 patients comprised eight studies on multimodal, five on endurance and one on resistance exercise. Outcomes included disease activity, physical function, mobility, blood-based markers, as well as patient-reported outcomes and safety. Disease activity, physical function including cardiorespiratory fitness revealed to be most responsive to exercise. A median TESTEX score of twelve indicated overall high study quality and detailed reporting.
CONCLUSION:
For disease activity and physical function, physical exercise shows high potential to safely improve various symptoms in patients. However, exercise prescriptions, assessments and outcome measures revealed a large heterogeneity. In conclusion, this systematic review provides level I evidence for physical exercise-mediated symptom alleviation in patients as a solid basis for future multi-centre randomized controlled trials.