Abstract
Exercise adherence is essential in the management of Ankylosing Spondylitis (AS), yet its association with perceived exercise benefits/barriers and spinal mobility is not fully understood. This study aimed to assess exercise adherence and investigate its relationships with perceived exercise benefits and barriers, spinal mobility, and clinical characteristics in patients with AS. Seventy-one patients with AS were included in this cross-sectional study. Exercise adherence was assessed using the Exercise Adherence Rating Scale (EARS). Perceived benefits and barriers were evaluated with the Exercise Benefits/Barriers Scale (EBBS). Spinal mobility was assessed using the Bath Ankylosing Spondylitis Metrology Index (BASMI). Correlation analyses and multivariable linear regression were performed to identify independent predictors of exercise adherence. The EARS total score was 33.48 ± 10.81 (median 34, range 13–59). EARS total score showed a strong positive correlation with EBBS benefits (r = 0.608, p < 0.001), while the correlation with EBBS barriers was not significant (r = 0.198, p = 0.098). In multivariable regression analysis, BASMI (β = − 1.73, p = 0.001), EBBS benefits (β = 0.463, p < 0.001), and disease duration (β = 0.423, p = 0.019) were independently associated with exercise adherence. In patients with AS, higher exercise adherence is independently associated with greater perceived benefits of exercise, longer disease duration, and lower spinal mobility impairment. Interventions targeting motivational factors and mobility limitations may improve adherence to prescribed exercise programs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00296-026-06118-z.