A prospective study presented new evidence that a structured, test-based rehabilitation program combining strength, mobility, and aerobic training results in meaningful functional gains for patients with axial spondyloarthritis (axSpA). The 8-week intervention was tailored to each participant’s baseline physical capacity, reflecting a shift toward precision in nonpharmacologic care.

“AxSpA primarily affects the sacroiliac joints and spine, reducing trunk strength, mobility, and cardiorespiratory fitness,” the authors noted. While physical activity is a core component of axSpA management, few studies have integrated both aerobic and resistance training into a personalized, data-driven format.

The study enrolled 30 patients (mean age, 42 years; 14 men, 16 women) who completed baseline cardiopulmonary exercise testing (CPET) and trunk strength/mobility assessments using the David Back Concept system. Participants then underwent two weekly sessions of individualized aerobic interval training and resistance exercises based on one-repetition-maximum and ventilatory thresholds. All sessions were supervised for safety and accuracy.

After 8 weeks, trunk strength increased by 14.1% and mobility by 14.9% (both P<.001). Improvements were also seen in oxygen pulse (P=.004), ventilatory efficiency (P<.001), anaerobic threshold (P=.002), and mechanical efficiency (P=.021). BASDAI scores improved from 3.5 to 2.9 (P=.021), and chest expansion increased from 4.5 cm to 5.0 cm (P=.020). BASMI and BASFI trended favorably but did not reach statistical significance.

“Significant improvements were seen in trunk strength, mobility, and cardiorespiratory fitness after just 8 weeks,” the authors wrote. “These results support the role of individualized exercise interventions in enhancing patient outcomes and reducing functional limitations.”

“A combined, individually tailored exercise program, dependent on baseline objectively measured physical parameters, significantly improved cardiorespiratory fitness, trunk strength, and mobility in AxSpA patients,” the authors concluded. “These results support the role of individualized exercise interventions in enhancing patient outcomes and reducing functional limitations.”

Reference:

De Mits S, Willems T, Danneels L, et al. Individualized strength, mobility and aerobic rehabilitation training in axial spondyloarthritis (iSMART in axSpA) [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/individualized-strength-mobility-and-aerobic-rehabilitation-training-in-axial-spondyloarthritis-ismart-in-axspa/. Accessed October 17, 2025.