| Abstract ID |
| 20260070 |
| Category |
| Sports Medicine: Exercise Medicine |
| Preferable Presentation |
| Poster |
| Title |
| BEYOND MOVEMENT: STRUCTURED EXERCISE THERAPY AND CLINICAL OUTCOMES IN AXIAL SPONDYLOARTHRITIS |
| Author |
|
| Presenter |
| madinatul munawwaroh |
| Abstract |
| Background: Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that causes pain, stiffness, functional limitation, and reduced physical fitness. Although pharmacological therapy is essential, structured exercise therapy is increasingly considered as a crucial component of comprehensive management. In clinical practice, uncertainty remains regarding optimal exercise prescription, particularly in patients with active disease and musculoskeletal comorbidities. However, evidence regarding optimal exercise prescription based on frequency, intensity, time, and type (FITT) remains heterogeneous. Objectives: To present an evidence-based case report informed by a scoping review, aiming to comprehensively map current evidence on the effects of structured exercise therapy on clinical outcomes and physical fitness in adults with axSpA, and to contextualize these findings to guide individualized clinical decision-making, focusing on FITT characteristics to guide clinical practices. Study design: This study was conducted as an Evidence-Based Case Report (EBCR) supported by a scoping review. A comprehensive search was performed across five databases—PubMed, Scopus, Cochrane, ProQuest, and Sage Journals—until December 31st, 2025. Inclusion criteria were randomized controlled trials (RCT) involving adults with axial spondyloarthritis that compared structured exercise therapy with usual care and reported clinical outcomes, symptom improvement, or physical fitness, published between 2015 and 2025 in English or Bahasa. The scoping review was conducted in accordance with the PRISMA-ScR guideline. All included studies were critically appraised using the Centre for Evidence-Based Medicine (CEBM) Oxford Critical Appraisal Tool for Therapy Studies. Data were extracted and synthesized narratively by two independent reviewers. Results: Five RCTs were included. Structured exercise therapy was associated with improvements in disease activity (ASDAS, BASDAI), pain, fatigue, morning stiffness, functional status (BASFI), spinal mobility (BASMI), and physical fitness (VO₂max, 6-minute walk distance, and muscle strength). Aerobic exercise was most frequently performed three to five times per week for at least 30 minutes per session at moderate intensity. Resistance training was typically performed at low to moderate intensity, two to three times a week with progressive loading, involving major muscle groups. Flexibility and mobility exercises were implemented three times a week in the included studies, although daily practice is commonly recommended. In the presented case, a supervised structured exercise program aligned with these FITT parameters was feasible, well tolerated, and associated with early clinical improvement. One high-intensity aerobic protocol demonstrated reductions in inflammatory markers but was associated with reported adverse events. Conclusions: Structured exercise therapy appears beneficial for patients with axSpA. Programs combining aerobic, resistance, mobility, and flexibility exercises, performed at low to moderate intensity, two to three times a week for a minimum of 12 weeks, are supported by current evidence. This case-based synthesis highlights the importance of integrating evidence from clinical trials with individual patient characteristics to optimize exercise prescription in axSpA. Further trials with larger sample sizes, clearly defined FITT components, and comprehensive safety reporting are needed to guide clinical practice. Keywords: axial spondyloarthritis; clinical outcomes; physical fitness; scoping review; structured exercise therapy |