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Exercise interventions for ankylosing spondylitis: a protocol for a Bayesian network meta-analysis
  1. Shun-Li Kan1,
  2. Ling-Xiao Chen2,
  3. Zhi-Fang Yuan3,
  4. Wei Hu1,
  5. Ru-Sen Zhu1
  1. 1Department of Spine Surgery, Tianjin Union Medical Center, Tianjin, China
  2. 2Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
  3. 3Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China
  1. Correspondence to Dr Ru-Sen Zhu; rszhuspine{at}


Introduction Ankylosing spondylitis (AS) is a universal chronic inflammatory rheumatic disease which predominantly results in chronic back pain and stiffness. However, some patients suffering from AS do not react well to pharmacological interventions. Exercise intervention has been employed for the treatment of AS and works as a complementary part of the management of AS. However, the effect of different types of exercise interventions remains unclear. The purpose of this study is to determine the relative efficacy of different types of exercise interventions for individuals with AS using a Bayesian network meta-analysis.

Methods and analysis We will conduct a systematic literature review of randomised controlled trials that compare different types of exercise interventions for individuals with AS. PubMed, EMBASE and the Cochrane Library will be searched up to February 2019. The primary outcomes are functional capacity, pain and disease activity. The risk of bias for individual studies will be evaluated according to the Cochrane Handbook. A Bayesian network meta-analysis will be performed to compare the efficacy of different types of exercise interventions. The quality of evidence will be assessed by the Grading of Recommendations, Assessment, Development and Evaluation approach.

Ethics and dissemination Ethical approval and patient consent are not required as this study is a meta-analysis based on published studies. The results of this network meta-analysis will be submitted to a peer-reviewed journal for publication.

PROSPERO registration number CRD42019123099.

  • exercise
  • ankylosing spondylitis
  • network meta-analysis
  • bayesian

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  • Contributors S-LK, L-XC, Z-FY and R-SZ: participated in the conception and design of the study, including search strategy development. S-LK, L-XC, Z-FY and WH: tested the feasibility of the study. S-LK: wrote the manuscript. All the authors critically reviewed this manuscript and approved the final version.

  • Funding This work was supported by Tianjin Municipal Science and Technology Commission (16KG158), and Foundation of Tianjin Union Medical Center (2018YJ010). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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