{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:16:11Z","timestamp":1790972171989,"version":"4.1.0"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Ankylosing spondylitis(AS) is a chronic inflammatory rheumatic disease that leads to a reduced quality of life. Exercise appears to be one of the promising modes of intervention. The aim of this study was to review the available evidence and compare the effectiveness of different exercises in relieving symptoms of AS.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We searched the Pubmed, WOS, EMbase, CNKI, Cochrane Library, and Scopus databases. The search has spanned from the creation of the database until September 15, 2023. We extracted the first author, year of article publication, sample information, intervention, duration of intervention, and outcome indicators from the literature that met the inclusion criteria. The Cochrane Risk Assessment Tool was used to assess the risk of bias for included studies. I\u00b2 was used to judge the consistency of the included studies. Egger\u2019s test and Begg\u2019s test were used to judge whether there was significant publication bias. Forest plots were used to compare intervention effects and SUCRA was provided to rank the effects of the interventions. This study has been registered in PROSPERO(No. CRD42024518522).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>After screening, 10 papers matched the inclusion criteria for this study, and the total sample size of the 10 papers was 623. Upon analysis, the papers included in this study did not have significant publication bias (Begg\u2019s Test P = 0.210) and had good consistency (P&gt;0.05). The direct comparisons showed that Running, Pilates, Stretching, Yoga, and Tai Chi were more effective interventions than traditional therapies. The effect sizes, confidence intervals, and number of studies for each intervention are shown below: Running [MD -1.90 (95% CI -3.14,-0.66) n = 1], Pilates [MD -1.70 (95% CI -2.90,-0.51) n = 1], Stretching [MD -1.54 (95% CI -2.21,-0.88) n = 4], Yoga [MD -1.24 (95% CI -2.18,-0.30) n = 1], Tai Chi [MD -0.78 (95% CI -1.44,-0.12) n = 2], Exergame[MD -0.80 (95% CI -1.99,0.39) n = 1], Swiss balls[MD -1.07 (95% CI -2.58,0.44) n = 1]. The indirect comparisons showed that the range of effect sizes for each sport intervention intersected the null line. Based on cumulative probability, the order of effectiveness of different exercises in relieving AS symptoms is Running, Pilates, Stretching, Yoga, Tai Chi, Exergame, and Swiss ball.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Running, Pilates, Stretching, Yoga, and Tai Chi provided significant relief from AS symptoms. Exergame and Swiss ball were not statistically significant in relieving AS symptoms. There were no significant differences in the effectiveness of different exercise interventions in relieving AS symptoms. Running may have the most beneficial effect on alleviating AS symptoms.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302965","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T17:29:18Z","timestamp":1718386158000},"page":"e0302965","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Effectiveness of exercise intervention in relieving symptoms of ankylosing spondylitis: A network meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3516-8412","authenticated-orcid":true,"given":"Yekui","family":"Luo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangning","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Shang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2024-8049","authenticated-orcid":true,"given":"Jae Chul","family":"Seo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"issue":"4","key":"pone.0302965.ref001","doi-asserted-by":"crossref","first-page":"220","DOI":"10.4078\/jrd.2023.0041","article-title":"Updates on ankylosing spondylitis: pathogenesis and therapeutic agents","volume":"30","author":"S. H. Kim","year":"2023","journal-title":"Journal of rheumatic diseases"},{"issue":"6","key":"pone.0302965.ref002","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1016\/j.semarthrit.2016.09.002","article-title":"Systematic review of clinical, humanistic, and economic outcome comparisons between radiographic and non-radiographic axial spondyloarthritis","volume":"46","author":"J. Sieper","year":"2017","journal-title":"Seminars in arthritis and rheumatism"},{"key":"pone.0302965.ref003","doi-asserted-by":"crossref","first-page":"S191","DOI":"10.1007\/s12306-013-0285-9","article-title":"Rehabilitation and surgical management of ankylosing spondylitis","volume":"97 Suppl 2","author":"E. Lubrano","year":"2013","journal-title":"Musculoskeletal surgery"},{"issue":"6","key":"pone.0302965.ref004","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1111\/os.13747","article-title":"A Novel Classification of Cervical Spine Trauma in Ankylosing Spondylitis and Corresponding Surgical Outcomes","volume":"15","author":"B. Liu","year":"2023","journal-title":"Orthopaedic surgery"},{"issue":"15","key":"pone.0302965.ref005","doi-asserted-by":"crossref","first-page":"e25179","DOI":"10.1097\/MD.0000000000025179","article-title":"The efficacy of moxibustion and acupuncture therapy for ankylosing spondylitis: A protocol for an overview of systematic reviews and meta-analysis","volume":"100","author":"Q. Zhu","year":"2021","journal-title":"Medicine"},{"issue":"7","key":"pone.0302965.ref006","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1080\/09638288.2019.1645218","article-title":"Effects of water therapy on disease activity, functional capacity, spinal mobility and severity of pain in patients with ankylosing spondylitis: a systematic review and meta-analysis","volume":"43","author":"Z. Liang","year":"2021","journal-title":"Disability and rehabilitation"},{"issue":"4","key":"pone.0302965.ref007","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.semarthrit.2015.08.003","article-title":"Exercise for ankylosing spondylitis: An evidence-based consensus statement","volume":"45","author":"J. R. Millner","year":"2016","journal-title":"Seminars in arthritis and rheumatism"},{"issue":"6","key":"pone.0302965.ref008","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1136\/ard.2011.151027","article-title":"2010 update of the ASAS\/EULAR recommendations for the management of ankylosing spondylitis","volume":"70","author":"J. Braun","year":"2011","journal-title":"Annals of the rheumatic diseases"},{"key":"pone.0302965.ref009","first-page":"98","article-title":"2023). Research on Exercise Adherence among Patients with Ankylosing Spondylitis:A Literature Review","volume":"03","author":"L. Zhou","journal-title":"Military Nursing"},{"issue":"1","key":"pone.0302965.ref010","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1136\/ard-2022-223297","article-title":"Efficacy and safety of non-pharmacological and non-biological interventions: a systematic literature review informing the 2022 update of the ASAS\/EULAR recommendations for the management of axial spondyloarthritis","volume":"82","author":"A. Ortolan","year":"2023","journal-title":"Annals of the rheumatic diseases"},{"issue":"16\u201318","key":"pone.0302965.ref011","doi-asserted-by":"crossref","first-page":"52","DOI":"10.7748\/ns2013.12.28.16.52.e7807","article-title":"Ankylosing spondylitis: diagnosis and management","volume":"28","author":"D. 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Byrnes","year":"2018","journal-title":"Journal of bodywork and movement therapies"},{"issue":"2","key":"pone.0302965.ref014","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1080\/14397595.2020.1745409","article-title":"Investigation of the effectiveness of aerobic exercise training in individuals with ankylosing spondylitis: Randomized controlled study","volume":"31","author":"B Calik","year":"2021","journal-title":"Mod Rheumatol"},{"issue":"10","key":"pone.0302965.ref015","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1007\/s00296-022-05145-w","article-title":"Effectiveness of aquatic exercise in the treatment of inflammatory arthritis: systematic review","volume":"42","author":"LN Medrado","year":"2022","journal-title":"Rheumatol Int"},{"issue":"9","key":"pone.0302965.ref016","doi-asserted-by":"crossref","first-page":"1680","DOI":"10.3899\/jrheum.151244","article-title":"The Minimum Clinically Important Improvement and Patient-acceptable Symptom State in the BASDAI and BASFI for Patients with Ankylosing Spondylitis","volume":"43","author":"M. J. Kviatkovsky","year":"2016","journal-title":"The Journal of rheumatology"},{"issue":"9","key":"pone.0302965.ref017","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.medcli.2014.10.015","article-title":"Efectos de un programa de ejercicio f\u00edsico y relajaci\u00f3n en el medio acu\u00e1tico en pacientes con espondiloartritis: ensayo cl\u00ednico aleatorizado","volume":"145","author":"R. F. Garc\u00eda","year":"2015","journal-title":"Medicina Cl\u00ednica"},{"issue":"5","key":"pone.0302965.ref018","doi-asserted-by":"crossref","first-page":"931","DOI":"10.17219\/acem\/32590","article-title":"The Effectiveness of Exergames in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial","volume":"25","author":"A. Y. Karahan","year":"2016","journal-title":"Advances in clinical and experimental medicine: official organ Wroclaw Medical University"},{"issue":"1","key":"pone.0302965.ref019","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1186\/s13102-022-00577-0","article-title":"The effect of Aqua Stretching exercises and Pilates on pain, function and spine posture in patients with ankylosing spondylitis: a randomized controlled trial","volume":"14","author":"F. Gandomi","year":"2022","journal-title":"BMC sports science, medicine & rehabilitation"},{"issue":"3","key":"pone.0302965.ref020","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1097\/RHU.0000000000000499","article-title":"The Effectiveness of Structured Group Education on Ankylosing Spondylitis Patients","volume":"23","author":"M. 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Hol\u00f8yen","year":"2018","journal-title":"Musculoskeletal care"},{"issue":"1","key":"pone.0302965.ref029","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.aimed.2021.11.001","article-title":"A study protocol for a randomised controlled trial on the efficacy of yoga as an adjuvant therapy for patients with Ankylosing spondylitis amidst COVID-19 pandemic","volume":"9","author":"J. Singh","year":"2022","journal-title":"Advances in integrative medicine"},{"issue":"1","key":"pone.0302965.ref030","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1080\/09593985.2021.2005199","article-title":"Comparison of the effects of aerobic training alone versus aerobic training combined with clinical Pilates exercises on the functional and psychosocial status of patients with ankylosing spondylitis: A randomized controlled trial","volume":"39","author":"S. Oks\u00fcz","year":"2023","journal-title":"Physiotherapy theory and practice"},{"issue":"4","key":"pone.0302965.ref031","doi-asserted-by":"crossref","first-page":"e003468","DOI":"10.1136\/rmdopen-2023-003468","article-title":"Work productivity in patients with axial spondyloarthritis initiating biological or targeted synthetic disease-modifying antirheumatic drugs: a systematic literature review and meta-analysis","volume":"9","author":"M. Rudwaleit","year":"2023","journal-title":"RMD open"},{"key":"pone.0302965.ref032","author":"M. Guan","year":"2014","journal-title":"The Clinical Study on Current Status of Diagnosis and Treatment in Patients with Ankylosing Spondylitis (Doctoral dissertation, Southern Medical University)"},{"issue":"2","key":"pone.0302965.ref033","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1093\/rheumatology\/35.2.167","article-title":"The effect of 30 min cycle ergometry on ankylosing spondylitis","volume":"35","author":"R. J. 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