OBJECTIVE: To investigate the effect of high-intensity exercise on emotional distress, fatigue, and ability to do a full day's activities in patients with axial spondyloarthritis (axSpA). METHOD: A total of 28 physically inactive axSpA patients were randomized to either an exercise group (EG), which performed 12 weeks of cardiorespiratory and strength exercises, or a control group (CG), which received treatment as usual. The outcomes reported in this paper are secondary outcomes in the trial and included emotional distress (General Health Questionnaire-12, 0 to 36, 36 = worst), fatigue (numeric rating scale (NRS), 0 to 10, 10 = worst), and ability to do a full day's activities (NRS, 0 to 10, 10 = worst). Post-intervention differences were assessed by analysis of covariance with baseline values as covariates. RESULTS: Twenty-four patients were included in the analyses. All patients in the EG followed the exercise protocol. The EG had a statistically significant beneficial effect (mean group differences (95% confidence interval)) on emotional distress (-5.8 (-9.7 to -1.9), p < 0.01), fatigue (-2.4 (-4.3 to -0.4), p = 0.02), and ability to do a full day's work (-2.2 (-3.9 to -0.4), p = 0.02) compared to the CG. CONCLUSION: This pilot study showed promising effects of cardiorespiratory and strength exercises on emotional distress, fatigue, and ability to do a full day's activities in patients with axSpA. The findings need to be confirmed in a larger trial.

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