Not yet taking people in TürkiyeNo phase

Land-Based Versus Water-Based Exercise in Axial Spondyloarthritis

Compares exercise on land and in water for adults with axial spondyloarthritis.

Key facts

Who runs it: Izmir University of Economics
Where: Izmir, TürkiyeSee the site
Trial code: NCT07833033
Registry title: Effects of Land- and Water-Based Exercise in Axial Spondyloarthritis
Status: Not yet recruiting
People taking part: 50 people, planned
Starts: 1 Dec 2026
Expected to end: 1 Oct 2028
Type of study: Interventional, 3 groupsOne group gets an existing treatment, for comparison.
Treatments tested: Land-Based Combined Exercise Program
Aquatic Combined Exercise Program
Home Exercise Program
Record updated: 22 September 2026

Who can take part

AI summary

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial is looking for adults with axial spondyloarthritis who do not exercise regularly. It compares land-based and water-based exercise.

Age: 18 to 70 years
Sex: All sexes can join.
Disease stage: Axial spondyloarthritis diagnosed by the ASAS classification criteria, with a BASDAI score between 3 and 4.
Earlier treatment: No change in tumor necrosis factor (TNF) inhibitor treatment in the previous 3 months. No regular cardiorespiratory or strengthening exercise (more than 1 session a week) in the previous 6 months.

Main reasons for not taking part

Regular exercise in the previous 6 months
Missing 4 consecutive exercise sessions
Any condition that needs a change in medical treatment
Other health conditions that may limit the ability to exercise

The registry criteria, word for word

Show all 10 criteriaShow less

Who can take part

Diagnosis of axial spondyloarthritis (axSpA) according to the Assessment of SpondyloArthritis International Society (ASAS) classification criteria
Willingness to participate in the study
BASDAI score between 3 and 4
Age between 18 and 70 years
No change in tumor necrosis factor (TNF) inhibitor treatment within the previous 3 months
No regular cardiorespiratory or strengthening exercise (>1 session/week) during the previous 6 months

Who cannot take part

Regular exercise participation within the previous 6 months
Any condition requiring a change in medical treatment
Missing 4 consecutive exercise sessions
Presence or identification of other comorbidities that may limit exercise capacity

Check if you might fit

Answer for yourself. This is not a decision: only the study team can say whether you can take part.

Are you between 18 and 70 years old?

Where in Türkiye

Izmir University of EconomicsIzmir, TürkiyeContact: Barış GürpınarNot yet recruiting

About the trial

What the trial wants to find out

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease characterized by pain, morning stiffness, restricted spinal mobility, and systemic manifestations. Exercise is an important component of axSpA management and has beneficial effects on pain, disease activity, quality of life, posture, and pulmonary function. Exercise may also modulate inflammatory responses by altering the expression of genes involved in pro- and anti-inflammatory pathways. However, evidence regarding the effects of different exercise environments on inflammatory gene expression in individuals with axSpA remains limited.

Read full original descriptionShow less

Both land-based and aquatic exercise programs are commonly used in the management of axSpA. Aquatic exercise may provide additional advantages through buoyancy and hydrostatic pressure, which reduce joint loading and facilitate exercise performance. Nevertheless, the comparative effects of land-based and aquatic combined exercise programs, particularly on inflammatory biomarkers and gene expression, have not been sufficiently investigated.

The aim of this randomized controlled trial is to compare the effects of land-based and aquatic combined exercise programs on postural control, disease-related outcomes, inflammatory biomarkers and gene expression, disease activity, quality of life, and pulmonary function in individuals with axSpA. Participants will be randomly allocated to a land-based exercise group, an aquatic exercise group, or a control group. Both exercise groups will complete a 45-minute combined program including aerobic, strengthening, and flexibility exercises twice weekly for 8 weeks. The control group will not participate in a structured exercise program and will receive educational videos. Outcomes will be assessed at baseline, immediately after the 8-week intervention, and at the 3-month follow-up.

The 3 groups in the trial

Land-Based Exercise GroupTreatment being tested
Participants will receive a supervised, land-based combined exercise program twice weekly for 8 weeks. Each session will include warm-up, high-intensity interval aerobic exercise, breathing combined with mobility exercises, strengthening exercises targeting major muscle groups, and cool-down. Exercise intensity will be monitored using heart rate.
Treatment: Land-Based Combined Exercise Program
Aquatic Exercise GroupTreatment being tested
Participants will receive a supervised, aquatic combined exercise program twice weekly for 8 weeks in a thermoneutral pool. Each session will include warm-up, high-intensity interval aerobic exercise, breathing combined with mobility exercises, water-resisted strengthening exercises targeting major muscle groups, and cool-down. Exercise intensity will be monitored using heart rate adjusted for water immersion.
Treatment: Aquatic Combined Exercise Program
Control GroupExisting treatment, for comparison
Participants will receive education on the effects of physical activity and exercise videos based on home exercise recommendations from the National Axial Spondyloarthritis Society (NASS). The materials will be provided online and in MP4 format, and participants will receive monthly text-message reminders encouraging them to continue the recommended exercises.
Treatment: Home Exercise Program