Design and participants
heart, kidney and respiratory disease, word of mouth, necrosis
RECRUITMENT, NECROSIS
This prospective study was conducted as a randomized trial with parallel groups in a single-center. The setting of this quantitative study was the outpatient clinic of the physical medicine and rehabilitation department of a university hospital (University of Usak (Turkey)) between September 2020 and February 2022.After the trial was approved by the Ethical Committee of Usak University (ID:38824465-020), prospectively registered on Prior to a participant’s recruitment, all subjects completed informed consent forms. Also, as a part of the consent process all volunteers were told that they could quit the study at any time as part of the consent process.Participants were recruited through the announcements on social media and newsletter from the local AS patient associations and by word of mouth among the outpatient clinic staff of the rheumatology department. Individuals were recruited and enrolled based on the following inclusion criteria: confirmed diagnosis of AS by a rheumatologist according to the modified New York diagnostic criteria, diagnosed as AS at least for two years, age 18 to 50 years, regular use of disease-modifying anti-rheumatic drugs (anti-tumor necrosis factor (TNF) agents, sulfasalazine) at a stable dosage for at least twelve weeks. Patients were excluded if they had a regular exercise habit (totaling a minimum of 150 min of moderate exercise each week) during the previous six months, or in case of the presence of comorbid conditions including severe heart, kidney and respiratory disease, also, any problems that may prevent exercising (mental health, orthopedic, and neurological). The dropout criteria for this study were serious dosage changes in regular medication or a new treatment strategy during the study period, and continuity to exercise sessions of less than 85% (see Study flow diagram.