Moderate evidence supports exercise interventions in improving physical function , disease activity and chest expansion compared to controls ; there is low-level evidence of improved pain , stiffness , spinal mobility and cardiorespiratory function .
Supervised group exercise yields better outcomes than unsupervised home exercise .
The addition of aerobic components to flexibility programmes  improves cardiorespiratory outcomes , but not cardiovascular risk factors .
The most effective exercise protocol remains unclear .
Current evidence suggests that therapeutic exercises are beneficial for adults with ankylosing spondylitis ; effects on other SpA subtypes are unknown
To evaluate the effects of therapeutic exercise on pain , stiffness , quality of life , physical function , disease activity , health-related fitness and cardiovascular risk factors in adults with spondyloarthritis ( SpA ) .
GRADE guidelines: 3. Rating the quality of evidence.
This article introduces the approach of GRADE to rating  quality of evidence .  GRADE specifies four categories-high , moderate , low , and very low-that are applied to a body of evidence , not to individual studies . In the context of a systematic review , quality reflects our confidence that the estimates of the effect are correct . In the context of recommendations , quality reflects our confidence that the effect estimates are adequate to support a particular recommendation . R and omized trials begin as high- quality evidence , observational studies as low quality . " Quality " as used in GRADE means more than risk of bias and so may also be compromised by imprecision , inconsistency , indirectness of study results , and publication bias . In addition , several factors can increase our confidence in an estimate of effect . GRADE provides a systematic approach for considering and reporting each of these factors . GRADE separates the process of assessing quality of evidence from the process of making recommendations . Judgments about the strength of a recommendation depend on more than just the quality of evidence
Moderate evidence supports exercise interventions in improving physical function , disease activity and chest expansion compared to controls ; there is low-level evidence of improved pain , stiffness , spinal mobility and cardiorespiratory function .
Supervised group exercise yields better outcomes than unsupervised home exercise .
The addition of aerobic components to flexibility programmes  improves cardiorespiratory outcomes , but not cardiovascular risk factors .
The most effective exercise protocol remains unclear .
Current evidence suggests that therapeutic exercises are beneficial for adults with ankylosing spondylitis ; effects on other SpA subtypes are unknown
To evaluate the effects of therapeutic exercise on pain , stiffness , quality of life , physical function , disease activity , health-related fitness and cardiovascular risk factors in adults with spondyloarthritis ( SpA ) .