Effects of home-based exercise on disease activity, spinal mobility, functionality and systemic inflammatory indices in ankylosing spondylitis: A randomized controlled trial

BackgroundExercise is a component of ankylosing spondylitis (AS) management, with home-based programs widely used due to their feasibility. However, their clinical effects and impact on novel inflammatory biomarkers such as SII and SIRI remain unclear.ObjectıveThis study evaluated the effects of a 6-week home-based exercise program on disease activity, spinal mobility, functional status, systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) in patients with AS, with a 4-week post-intervention follow-up.MethodsPatients with AS were randomly assigned to a control group (n = 23) receiving pharmacological treatment alone or a home exercise group (n = 27) receiving pharmacological treatment plus a 6-week home-based exercise program. The home exercise group performed a program including spinal range of motion (ROM), stretching, and breathing exercises based on ASAS/EULAR recommendations, 5 days/week, 1 set of 10 repetitions, for approximately 40 min per day. Outcomes included the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Disease Activity Score C-reactive protein (ASDAS-CRP) and erythrocyte sedimentation rate (ASDAS-ESR), SII and SIRI. Assessments were performed at baseline (T0), after treatment (T1) and 4 weeks after T1 (T2).ResultsThe home exercise group showed a trend toward within-group improvement in BASMI at T1 (p = 0.047), not significant after Bonferroni correction, and significant improvement at T2 (p < 0.001); however, no significant Group × Time interaction or between-group difference was observed. No significant within-group changes were observed in BASDAI, BASFI, ASDAS, SII, or SIRI. In controls, BASDAI decreased at T1 and T2 (p = 0.136 and 0.060), but not after Bonferroni correction. No significant between-group differences were observed.ConclusıonA 6-week home exercise program was associated with a within-group improvement in spinal mobility at 4-week follow-up, while the control group showed a within-group reduction in BASDAI that did not remain significant after Bonferroni correction. BASFI, ASDAS, SII, and SIRI remained unchanged, and no significant between-group differences were observed in any outcome. Future studies should clarify whether structured home exercise can provide sustained and clinically meaningful improvements in spinal mobility and disease activity.