Regular physical activity is a key component of axial spondyloarthritis disease management.
Regular exercise is associated with modestly lower disease activity among patients with axial spondyloarthritis (axSpA), supporting the role of physical activity as a key component of axSpA disease management, according to results of a study published in BMC Rheumatology
In a cross-sectional analysis, researchers pooled data from 1233 patients with axSpA enrolled in two multicenter registries: REGISPONSER in Spain and RESPONDIA across eight Latin American countries. Regular exercise was defined as self-reported habitual physical activity during the preceding year, and disease activity was measured using the Ankylosing Spondylitis Disease Activity Score (ASDAS).
Across datasets, regular exercise was associated with lower disease activity and a modest reduction in ASDAS (-0.153 points). Results were consistent across additional analyses, including a clinically expanded sensitivity analysis (-0.157 points). Results remained nearly unchanged after broader adjustment for disease duration, diagnostic delay, smoking, current therapies, and functional burden
These findings are consistent with current recommendations supporting regular physical activity as a core component of axial spondyloarthritis management and extend trial-based evidence to real-world habitual exercise behavior
Among men, exercise remained significantly associated with lower ASDAS in both primary and expanded models, with effect estimates of approximately -0.19 to -0.20 points. Among women, estimates were also negative but imprecise, with confidence intervals crossing the null. Exploratory analyses suggested larger exercise-related reductions among patients aged approximately 30 to 42 years and those with a BMI of 24 to 27 kg/m², but neither the age interaction (χ² = 6.52) nor BMI interaction (χ² = 5.41) was statistically significant. Associations between exercise and ASDAS reduction did not differ significantly by socioeconomic position (χ² = 0.68). Although statistically significant, the average ASDAS difference was below the 1.1-point threshold generally considered a clinically important improvement for an individual patient.
Study limitations include the cross-sectional design and possibility of reverse causation, reliance on a binary self-reported exercise measure without information on frequency, intensity, type, or adherence, and residual confounding and limited generalizability to women despite weighting and sensitivity analyses
“These findings are consistent with current recommendations supporting regular physical activity as a core component of axial spondyloarthritis management and extend trial-based evidence to real-world habitual exercise behavior,” the researchers concluded
Corredor DC, Pascual LÁC, Collantes-Estévez E, López-Medina C.Real-world exercise and disease activity in axial spondyloarthritis: does the association vary by age, BMI, or socioeconomic status?. BMC Rheumatol. Published online July 7, 2026. doi:10.1186/s41927-026-00672-6
