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On the other hand, exercise remains an essential component of the treatment of axSpA at all stages, which is often discounted or underused. This is compounded by a gap in demand and supply between increasing number patients with axSpA and paucity of trained specialists and rehabilitation personnel in the Asia\u2010Pacific countries. The acceptability and uptake of therapeutic exercise is strikingly poor in this region because of multiple factors such as lack of awareness among health professionals and the general population, poor healthcare infrastructure, lack of resources and limited accessibility to rehabilitation services. Health authorities and professional bodies in these countries need to work in tandem to expand healthcare facilities, encourage training opportunities and promote safe and effective exercise interventions which is accessible to the general population and individuals with axSpA. Adequate patient education, optimum control of disease activity and strict adherence to therapeutic exercise is essential to predict the best clinical outcome. In this narrative review we have appraised the impact of therapeutic exercise in this era of biological therapies in axSpA and have explored the challenges of rehabilitation services in the Asia\u2010Pacific countries. Overall, the available quality of evidence is mixed, acknowledging the beneficial role of exercise and optimum usage and protocols pertaining to axSpA specific exercises and therefore further research is warranted.<\/jats:p>","DOI":"10.1111\/1756-185x.14035","type":"journal-article","created":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T09:22:49Z","timestamp":1606468969000},"page":"170-182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Therapeutic exercises and rehabilitation in axial spondyloarthropathy: Balancing benefits with unique challenges in the Asia\u2010Pacific countries"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1788-846X","authenticated-orcid":false,"given":"Parthajit","family":"Das","sequence":"first","affiliation":[{"name":"Apollo Gleneagles Hospital &amp; Vivekananda Institute of Medical Science Kolkata India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rathindranath","family":"Haldar","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Institute of Post Graduate Medical Education and Research Kolkata India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3672-9245","authenticated-orcid":false,"given":"Sham","family":"Santhanam","sequence":"additional","affiliation":[{"name":"Gleneagles Global Health City Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5842-1877","authenticated-orcid":false,"given":"Vinod","family":"Ravindran","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology at Calicut Kozhikode India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31591-4"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.108233"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.2298\/SARH180110009Z"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/injr.injr_108_17"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.12456"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-213585"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39298"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13510"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13752"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2016.01.024"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.4061\/2011\/681640"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61507-3"},{"key":"e_1_2_12_14_1","unstructured":"World Health Organization & World Bank.World report on disability 2011.World Health Organization.https:\/\/www.who.int\/disabilities\/world_report\/2011\/report.pdf?ua=1. 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