Physical activity for axial spondyloarthritis
Physical activity is an essential component of management for all patients with axial spondyloarthritis. The aim is to maintain and optimise physical function by improving the mobility of the spine and peripheral joints, as well as improving strength, posture, chest expansion and aerobic fitness. Exercise is also important for mental health.
Consistent participation in exercise is important, particularly for spinal mobility, and patients should be encouraged to participate in exercise they enjoy. In general, most types of exercise are safe for patients with axial spondyloarthritis. However, the appropriateness of high-impact exercise, contact sport, jarring activities or heavy lifting should be considered on a case-by-case basis; particularly in patients who have late complications of ankylosing spondylitis such as spinal ankylosis, impaired balance or mobility, osteoporosis or cardiorespiratory disease.
Mobility goals should be informed by the patient’s disease course. In early, well-controlled disease, an appropriate goal may be to restore full range of spinal mobility and normal posture. In more advanced disease, however, the goal may be to maintain the patient’s existing movement range.
Referral to a health professional with appropriate expertise (eg physiotherapist) may be beneficial to initiate and reinforce an exercise program. Some example exercises can be found on the website of the United Kingdom National Ankylosing Spondylitis Society.