AIM: Evaluate whether group training in water in ankylosing spondylitis is better than group training on land. DESIGN: A randomized controlled pilot trial to compare the effect of group training in water (pool group) and on land (ball group), after six weeks of supervised Pilates training and four weeks follow-up. MATERIAL AND METHODS: Twelve persons with ankylosing spondylitis were randomized into two groups, six in each. Both groups exercised under supervision 45 minutes twice a week for six weeks. The primary outcome measures were Bath Ankylosing Spondylitis Metrology Index (BASMI), assessing range of motion in spine and hips, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), assessing subjective symptoms. RESULTS: There was a trend of improvement on BASMI after training and follow-up in both groups, but the change did not exceed measurement error. On BASDAI the mean improvement was 2,4 and 2,7 in the ball group consequently after training and follow-up, and 1.4 and 1.5 in the pool group. Five persons achieved a clinical important change (> 1 on BASDAI) after six weeks of training in the ball group and four persons in the pool group. CONCLUSION: Persons with ankylosing spondylitis may benefit at least as good from group training on land as in water, but the results must be interpreted with care since the number of participants was low.

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