Dmytro Fedkov, Daria Koliadenko, Liubov Petelytska, Christine Peine, Felix Lang, Abdullah Khalil, Oleg Iaremenko
In this real-world IA cohort, structured, disease-activity-tailored exercise and adapted yoga content delivered statistically significant benefits. However, overall PA_AP engagement showed no gains in functional or disease-activity outcomes, suggesting that more personalised, progressive, clinically guided digital physical-activity modules could offer greater therapeutic value. Key Points • Non-personalised physical-activity action plans produced only minor short-term changes in function and disease activity, with no consistent clinically meaningful improvement. • Two structured and partially individualised modules (tailored exercise training and adapted yoga) showed modest but statistically significant symptomatic benefits, particularly for pain and PGA. • Digital exercise tools may be most effective when they provide symptom-responsive adaptation, personalised progression, and physiotherapy-informed calibration rather than generic, non-progressive programmes.
BACKGROUND: Physical activity is a key component of inflammatory arthritis (IA) management, yet real-world evidence on digital exercise-support tools remains limited.
OBJECTIVES: To examine whether physical-activity action plan (PA_AP) engagement over 12 weeks is associated with changes in the Health Assessment Questionnaire (HAQ), pain, physical component score (PCS), patient global assessment (PGA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Functional Index (BASFI).
METHODS: This retrospective cohort study included adults with IA using a digital application. Associations between PA_AP engagement and 12-week outcomes were estimated using ANCOVA models adjusting for age, sex, diagnosis, and baseline values. Exploratory analyses assessed individual PA_APs.
RESULTS: Among 2924 users, paired 12-week data were available for HAQ (n = 285), pain (n = 930), PGA (n = 928), PCS (n = 165), BASDAI (n = 163), and BASFI (n = 84). Overall, PA_AP engagement was associated with minor worsening in HAQ (β = 0.36, 95% CI 0.19-0.52), while no statistically significant associations were observed for PCS, PGA, BASDAI, or BASFI. Exploratory analyses identified modest statistically significant benefits for two structured modules: Exercise training, with reductions in pain (β = - 5.99, 95% CI - 9.12 to - 2.87) and PGA (β = - 5.83, 95% CI - 9.04 to - 2.62), and Yoga for rheumatism, which improved PGA (β = - 5.65, 95% CI - 10.21 to - 1.09) and showed a favourable trend for pain.
CONCLUSION: In this real-world IA cohort, structured, disease-activity-tailored exercise and adapted yoga content delivered statistically significant benefits. However, overall PA_AP engagement showed no gains in functional or disease-activity outcomes, suggesting that more personalised, progressive, clinically guided digital physical-activity modules could offer greater therapeutic value. Key Points • Non-personalised physical-activity action plans produced only minor short-term changes in function and disease activity, with no consistent clinically meaningful improvement. • Two structured and partially individualised modules (tailored exercise training and adapted yoga) showed modest but statistically significant symptomatic benefits, particularly for pain and PGA. • Digital exercise tools may be most effective when they provide symptom-responsive adaptation, personalised progression, and physiotherapy-informed calibration rather than generic, non-progressive programmes.