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In spite of recommendations, a relevant proportion of German axSpA patients does not adhere to recommended HbE practices. To enhance HbE care, we developed the novel digital therapeutic (DTx) \u201cAxia\u201d compliant with the European medical device regulation (MDR). Axia offers a modern app-based HbE solution with patient educative content and further integrated features. Objective: We aimed to assess Axia\u2019s efficacy, attractiveness, and functionality through a survey among axSpA-patients involved in the first user tests. Methods: A mixed-method online questionnaire with 38 items was administered to 37 axSpA volunteers after using Axia. Numeric rating scales (NRS) and likelihood scales were primarily used. Results: HbE frequency significantly increased from a median of 1\u00a0day\/week to 6 days\/week (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) by using Axia. Existing HbE practitioners also increased their frequency (median of 4 days\/week before, 6 days\/week with Axia, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Axia received a median rating of 5 out of 5 stars. On NRS scales, Axia scored a median of 9 for intuitiveness and design, and a median of 8 for entertainment. 64.9% reported improved range of motion, 43.2% reported reduced pain, and 93.6% enhanced disease-specific knowledge. All users recommended Axia to other patients. Conclusion: Axia increases axSpA patients HbE frequency, possibly due to its good intuitiveness and design, leading to reduction in pain and subjective improvement of range of motion. This warrants further investigation in large randomized controlled interventional trials to establish its efficacy conclusively and patients adherence to HbE.<\/jats:p>","DOI":"10.1007\/s00296-024-05600-w","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T10:01:51Z","timestamp":1714384911000},"page":"1143-1154","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["The exercise-app Axia for axial spondyloarthritis enhances the home-based exercise frequency in axial spondyloarthritis patients \u2013 A cross-sectional survey"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3168-7074","authenticated-orcid":false,"given":"Patrick-Pascal","family":"Strunz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1202-8447","authenticated-orcid":false,"given":"Maxime","family":"Le Maire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8883-3404","authenticated-orcid":false,"given":"Tobias","family":"Heusinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4941-2683","authenticated-orcid":false,"given":"Juliana","family":"Klein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5762-9182","authenticated-orcid":false,"given":"Hannah","family":"Labinsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8760-3931","authenticated-orcid":false,"given":"Anna","family":"Fleischer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7536-9409","authenticated-orcid":false,"given":"Karsten Sebastian","family":"Luetkens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1773-4763","authenticated-orcid":false,"given":"Patricia","family":"Possler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0074-4459","authenticated-orcid":false,"given":"Michael","family":"Gernert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-7743","authenticated-orcid":false,"given":"Robert","family":"Leppich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6421-9699","authenticated-orcid":false,"given":"Astrid","family":"Schmieder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8403-0652","authenticated-orcid":false,"given":"Ludwig","family":"Hammel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8116-4308","authenticated-orcid":false,"given":"Evelin","family":"Schulz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4686-8561","authenticated-orcid":false,"given":"Billy","family":"Sperlich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7745-3903","authenticated-orcid":false,"given":"Matthias","family":"Froehlich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3289-2299","authenticated-orcid":false,"given":"Marc","family":"Schmalzing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"key":"5600_CR1","unstructured":"Fittkau & Maa\u00df consulting (2015) W3B-Studie - Fitness-Apps von jedem 3. 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Maxime Le Maire reported to be Chief Executive Officer of Applimeda, Co-Founder and shareholder of Applimeda GmbH. Tobias Heusinger reported to be Chief Regulatory & Medical Officer of Applimeda, Co-Founder and shareholder of Applimeda GmbH. Juliana Klein stated to be PRRC of Applimeda. Hannah Labinsky received travel grants from UCB, Boehringer Ingelheim, Pfizer, and Abbvie as well as compensations for consulting activity from Pfizer and for lecturing activities from Janssen. Anna Fleischer declared no conflict of interest. Karsten Sebastian Luetkens declared no conflict of interest. Patricia Possler declared no conflict of interest. Michael Gernertreceived travel grants, compensation for advisory boards or speaker\u2019s fees from AbbVie, Chugai, Eli Lilly, Hexal, Janssen, Novartis, Pfizer, Takeda. Robert Leppich declared to be Chief Technology Officer of Applimeda, Co-Founder and shareholder of Applimeda GmbH. Astrid Schmieder declared no conflict of interest. Ludwig Hammel declared to be Former Chief Executive Officer of DVMB. Evelin Schulz declared to be Chief Executive Officer of DVMB. Billy Sperlich declared no conflict of interest. Matthias Froehlich received speaker\u2019s fees, travel grants or compensation for board memberships from AbbVie, Novartis, Janssen, and Eli Lilly. Marc Schmalzing received speaker\u2019s fees, travel grants, research funding, or compensation for consultancies or board memberships from AbbVie, Actelion, AstraZeneca, BMS, Boehringer\/Ingelheim, Celgene, Chugai\/Roche, Eli Lilly, Genzyme, Gilead, Hexal\/Sandoz, Janssen-Cilag, MSD, Novartis, Pfizer, Sanofi Pasteur, Takeda (Shire), UCB (less than $ 10,000 each).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. The study was submitted to the ethics committee of the Medical Faculty of the University of Wuerzburg (DE\/EKBY13) (Date December 4th, 2023, No 2023112302). The ethics committee considered the study to be part of the quality management process. Therefore, the study required no further ethical approval according to the national regularities.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All participants provided informed consent to take part in the user tests and the survey. Furthermore, the participants gave informed consent for publication of the data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}