Patients With Axial Spondyloarthritis Generally Satisfied With Supervised Group Exercise

Patient opinion on education, periodic reassessments, and exercise monitoring may be helpful in designing new supervised group exercise programs.

According to survey data published in Arthritis Care & Research, patients with axial spondyloarthritis (axSpA) were generally satisfied with supervised group exercise programs, although many were amenable to proposed enhancements.

Patients from 4 regions of  The Netherlands (n=118) completed a cross-sectional survey regarding their experiences and satisfaction with axSpA-specific supervised group exercise. Participants were recruited through local patient associations affiliated with the Dutch Arthritis Society. The supervised group exercise classes offered in the 4 regions had all been in effect since the early 1990s and comprised 3 elements performed once weekly: land-based training, sports activities, and hydrotherapy. The survey also captured patient opinion on potential enhancements of their supervised group exercise program, including cardiorespiratory and strengthening exercise, monitoring exercise intensity, periodic reassessments, and patient education and supervision by physical therapists. Sociodemographic and clinical characteristics of patients were also reported.

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The survey was sent to 130 patients and returned by 118 (91%), with comparable response rates across all regions. Mean patient age was 60 years, and 64% were men. The majority of patients were satisfied with the current total intensity (75%), duration (84%), and load (76%) of their supervised group exercise program. Most participants also reported cardiorespiratory (72%) and strengthening (78%) exercise as receiving enough attention. The median overall grade of the program was 7 on an 11-point scale.

Proposed enhancements of supervised group exercise were well-received by most patients, with the introduction of heart rate monitoring (83%) and annual reassessments (82%) receiving the most positive appraisal. However, 37% of participants were not in favor of exercising more than once a week, independent of exercise form. Half of participants expressed a need for education on axSpA and exercise. Exercise duration of 1.5 hours performed once-weekly was most favored by respondents.  

Although survey participants reported overall satisfaction with supervised group exercise programs in The Netherlands, most also endorsed the introduction of new features. Patient opinion on education, periodic reassessments, and exercise monitoring may be helpful in designing new supervised group exercise programs. Further research is necessary to explore the efficacy of these proposed enhancements, when implemented.


Hilberdink B, van der Giesen F, Vliet Vlieland T, van Gaalen F, van Weely S. Supervised group exercise in axial spondyloarthritis: patients’ satisfaction and perspective on evidence-based enhancements [published online March 30, 2019]. Arthritis Care Res. doi:10.1002/acr.23892