Ankylosing spondylitis (AS) is a form of inflammatory arthritis that targets the joints of the spine. AS usually first appears between the ages of 15 and 45 and there is currently no cure.

Symptoms include back pain and stiffness, decreased spinal mobility, fatigue and functional limitations. People with AS can end up undertaking less physical activity, have lower work productivity and experience lower quality of life.

Physical activity is a key recommendation for management of AS and helps to keep the spine mobile. Despite this recommendation, evidence shows that people with AS tend to have poor levels of exercise. It’s therefore important to devise strategies to increase physical activities in people with AS.

Researchers looked at the efficacy of a three month behaviour change intervention, focused on increasing physical activity levels, in improving health-related physical fitness, AS related symptoms and attitudes towards exercise in people with AS.

Participants were aged between 18 and 64 years, had been diagnosed with AS and were on stable drug treatment. They were allocated to either the intervention or control group.

The intervention group received individually tailored consultations with a physiotherapist designed to motivate and support them to undertake physical activity. The consults focused on educating, identifying appropriate resources and goal setting. People in the intervention group also attended a follow up session to review their progress and provide further support.

People in the control group were advised to continue with their habitual physical activity routine and medication management. Assessments took place before the study commenced, at the conclusion of the intervention (three months) and three months afterwards. Outcomes assessed included physical activity levels, and AS outcomes associated with physical activity including spinal mobility.

The results showed that the three-month intervention increased habitual health-enhancing physical activity, which was sustained over the three month study period. The intervention was also reported to be agreeable to the intervention group participants.

Following the intervention, 70% of the intervention group were adhering to the aerobic physical activity guideline recommendations for people with AS. The intervention also showed a mild improvement in spinal mobility ratings.


This study suggests that goal setting, combined with education and sourcing appropriate resources can improve physical activity and associated symptoms in people with AS. It’s important to select exercises that are conducive to your specific experience of AS and also your abilities and interests.

Last Reviewed: 28/11/2019



O’Dwyer, T et al. (2016). Behaviour change intervention increases physical activity, spinal mobility and quality of life in adults with ankylosing spondylitis: a randomised trial. Journal of Physiotherapy