Recommendations for the prescription of physical exercise for patients with spondyloarthritis

Objectives: To develop expert-based recommendations on physical activity and exercise for patients with spondyloarthritis (SpA). Methods: Two discussion groups, one of physical therapists, rehabilitation physicians, and professionals of physical activity and sports, and another of rheumatologists interested in SpA, were held to discuss the results of a survey of rheumatologists on exercise and two focus groups with patients on barriers to exercise. Preliminary recommendations were drafted. These were submitted to the opinion of the experts in both groups according to a two round Delphi methodology. Results: Twenty one recommendations covering general aspects of exercise, adaptation to patient, how to deliver messages, pain management, and type of exercise and monitoring were issued. The level of agreement varied slightly between expert groups but it was high overall. Items with poor agreement were removed from the consensus. Conclusions: We present recommendations on when and how to prescribe and monitor exercise inpatients with SpA based on the opinion of experts in exercise and in SpA. We must now test whether these recommendations are useful for clinical practice and have an effect on patients with SpA seen by rheumatologists. (C) 2017 Published by Elsevier Espana, S.L.U.