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IRD AS – Enhances mood

Evidence summary (Updated 2022)

Low mood and depression are common in patients across inflammatory rheumatic diseases. Furthermore, from the compelling body of evidence for the general population, being physically active has been shown to improved self-esteem and quality of life (1)
Exercise interventions in ankylosing spondylitis have b een shown to significantly improve depression score and function (2). A recent randomised controlled trial of 100 patients in Norway supported this and showed that high intensity exercise 3 times per week in patients with axial spondyloarthritis can significantly improve mood at 3 months, although this was not sustained at 12 months in their study (3).

Quality of evidence:
Grade C – Low quality in AS, evidence limited to one moderate quality RCT.

Strength of recommendation
Grade 2 – Weak Recommendation in AS.

Low mood and depression are common in axial spondyloarthritis. There is low to moderate evidence to suggest physical activity can help improve mood and depression scores across inflammatory rheumatic diseases. Despite this, evidence from the general population suggests that physical activity should still be recommended to improve mood and self-esteem .


  1. Department of Health & Social Care. UK Chief Medical Officers’ Physical Activity Guidelines
  2. Lim HJ, Moon YI, Lee MS. Effects of home-based daily exercise therapy on joint mobility, daily activity, pain, and depression in patients with ankylosing spondylitis. Rheumatol Int. 2005;25(3):225-229.
  3. Sveaas SH, Dagfinrud H, Berg IJ, Provan SA, Johansen MW, Pedersen E, et al. High-Intensity Exercise Improves Fatigue, Sleep, and Mood in Patients With Axial Spondyloarthritis: Secondary Analysis of a Randomized Controlled Trial. Phys Ther [Internet]. 2020;100(8):1323–32. Available from: