Background/Purpose: The current ASAS recommendations for the management of the ankylosing spondylitis suggest, beside pharmacological therapy, a significant part of physical therapy with supervised exercises. The importance and the beneficial impact of the physiotherapy and spa-therapy is known for a long time and numerous studies confirmed this. The impact of the aerobic fitness on the disease is not clear. The objective of this work is, after a systematic review of the literature and meta-analysis, to evaluate the impact of an aerobic fitness program on disease activity, defined by the BASDAI, and the function, defined by the BASFI, in case of axial spondyloarthritis.

Methods: A systematic review of the literature, following the prisma recommandations, was performed by two reviewers on the PubMed and Embase databases with the following keywords: (“Ankylosing spondylitis”OR “Spondyloarthritis”) AND (“Physical activity” OR “Aerobic fitness”). The diagnosis axial spondyloarthritis was meeting the New York criteria and/or the ASAS criteria. Aerobic fitness was defined as an exercise performed at 50–90% of the maximal heart rate or between 50% and 80% VO2 pick.

Results: 520 abstracts were identified and, 93 abstracts were analysed. 8 studies were meeting the selection criteria and 6 were finally included in this work because of the presence of a control group. Both groups were similar in terms of age, sex ratio, disease duration. Aerobic fitness provides in the intervention group (148 patients) a positive impact on the BASDAI (weighted mean difference (WMD): – 0.52 [95% CI -0.9; -0.13]) (I²: 10.3%, P=0.35). When compared to a control group (152 Patients) aerobic exercise does not provide a more positive impact on the BASDAI (WMD : – 0.25 [95% CI -0.83; 0.32]) (I²: 0%, P=0.41). Aerobic exercise does not provide in the intervention group a positive impact on the BASFI (WMD: – 0.31 [95% CI -0.73; 0.1]) (I²: 0 %, P=0.79). When compared to a control group, aerobic fitness does not provide a more positive impact on the BASFI (WMD -0.41 [95% CI -1.09; 0.27]) (I²: 0 %, P= 0.62)

Conclusion: Aerobic exercise did not provide beneficial effects neither on disease activity nor on physical function when compared to a control group.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-aerobic-fitness-on-axial-spondyloarthritis-activity-systematic-review-and-meta-analysis-of-controlled-studies/