Background Exercise is considered important in the management of patients with rheumatic diseases, but the effect of high intensity exercises on disease activity is unknown. Objective To investigate the effectiveness of high intensity exercises on disease activity in patients with axial spondyloarthritis (axSpA). Method Assessor blinded multicentre randomised controlled trial. 100 patients (aged from their 20s to their 60s) with axSpA were randomly assigned to an exercise group or to a no-intervention control group. The exercise group performed cardiorespiratory and muscular strength exercises at high intensity over 3 months. The control group received standard care and was instructed to maintain their usual physical activity level. Primary outcome was disease activity measured with the Ankylosing Spondylitis (AS) Disease Activity Scale (ASDAS, higher score=worst) and the Bath AS Disease Activity Index (BASDAI, 0–10, 10=worst). Secondary outcomes were inflammatory markers, physical function and cardiovascular (CV)-health. There was patient involvement in the design and reporting of this study. Results 97 of the 100 (97%) randomised patients completed the measurements after the intervention. There was a significant treatment effect of the intervention on the primary outcome (ASDAS: −0.6 [–0.8 to –0.3], p<0.001 and BASDAI: −1.2 [–1.8 to –0.7], p<0.001). Significant treatment effects were also seen for inflammation, physical function and CV-health. Conclusion High intensity exercises reduced disease symptoms (pain, fatigue, stiffness) and also inflammation in patients with axSpA. It improves patients’ function and CV health. This debunks concerns that high intensity exercise might exacerbate disease activity in patients with axSpA. Trial registration number NCT02356874.

中文翻译：

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3 个月的高强度运动可降低中轴性脊柱关节炎 (axSpA) 的疾病活动度：一项 100 名患者的多中心随机试验

背景 运动被认为对风湿病患者的管理很重要，但高强度运动对疾病活动的影响尚不清楚。目的探讨高强度运动对中轴性脊柱关节炎（axSpA）患者疾病活动度的影响。方法 评估者盲法多中心随机对照试验。100 名 axSpA 患者（年龄从 20 多岁到 60 多岁）被随机分配到运动组或无干预对照组。运动组进行了3个月以上的高强度心肺和肌肉力量锻炼。对照组接受标准护理并被指示保持他们通常的身体活动水平。主要结局是使用强直性脊柱炎 (AS) 疾病活动量表 (ASDAS，较高的分数=最差）和巴斯 AS 疾病活动指数（BASDAI，0-10，10=最差）。次要结果是炎症标志物、身体功能和心血管 (CV) 健康。患者参与了这项研究的设计和报告。结果 100 名随机化患者中有 97 名 (97%) 在干预后完成了测量。干预对主要结局有显着的治疗效果（ASDAS：-0.6 [–0.8 至 –0.3]，p<0.001 和 BASDAI：-1.2 [–1.8 至 –0.7]，p<0.001）。在炎症、身体功能和 CV 健康方面也看到了显着的治疗效果。结论 高强度运动减少了 axSpA 患者的疾病症状（疼痛、疲劳、僵硬）和炎症。它可以改善患者的功能和心血管健康。这揭穿了高强度运动可能会加剧 axSpA 患者疾病活动的担忧。试验注册号 NCT02356874。