Physical Activity Through Health Technology in Axial Spondyloarthritis

June 9, 2026 updated by: Rachael Stovall, University of Washington

Expanding Access to Early Exercise Prescriptions for Underserved Patients With Axial Spondyloarthritis: A Digital Health Approach

The purpose of this study is to find out whether a mobile app called the ExerciseRx app is a practical and helpful way for people with axial spondyloarthritis (axSpA) to receive exercise recommendations as part of their regular rheumatology care.

Researchers want to learn:

Whether people with axSpA find the ExerciseRx app easy to use and helpful for supporting regular exercise.

Whether using the ExerciseRx app leads to improvements in symptoms, physical function, and disease activity compared with usual care.

Participants assigned to the ExerciseRx group will use the app to complete guided exercises for 20-30 minutes, four times per week. They will also receive personalized weekly step-count goals to help increase their physical activity. Researchers will compare outcomes between participants using the app and those receiving usual care.

Study Overview

Study Type

Interventional

Enrollment (Estimated)

40

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Washington
      • Seattle, Washington, United States, 98195
        • Recruiting
        • University of Washington
        • Contact:
      • Seattle, Washington, United States, 98104
        • Recruiting
        • Harborview Medical Center
        • Contact:
        • Principal Investigator:
          • Rachael Stovall, MD, MAS

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Diagnosis of axial spondyloarthritis by a rheumatologist
  • English speaking
  • Insufficiently active (less than 150 minutes of moderate intensity aerobic activity per week)
  • Willing to wear a Fitbit for the study duration
  • Willing to have or create a Google account and download the Google Health app (previously known as the Fitbit app)

Exclusion Criteria:

  • Currently pregnant
  • International travel or any circumstance causing lack of access to wi-fi/Internet at any point during the study period
  • Recent or planned surgery that may affect ability to engage in physical activity
  • Unable to exercise for health reasons, or a provider has recommended against exercising for safety/health reasons
  • Unable to walk safely without difficulty, or is a fall risk (i.e., 3+ falls in past 6 months)
  • History of a fall resulting in a fracture or head injury in the past 6 months
  • Cardiovascular contraindicators for physical activity, or history of cardiovascular problems that may be exacerbated by physical activity, as defined by their rheumatologist
  • Diabetes causing hypoglycemia following physical activity

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: ExerciseRx app
the ExerciseRx app with personalized exercise recommendations, an educational handout, Fitbit-guided step goals, and physical therapy referral
Patients complete home exercise sessions given via the ExerciseRx app over 20-30 minutes 4 times per week for 12 weeks and receive daily step count goals. Patients also receive a FitBit to wear continuously throughout the study, and are given access to view their step counts via the ExerciseRx app, and receive an educational handout with exercises for axial spondyloarthritis.
Active Comparator: Usual care
An educational handout, Fitbit monitoring without step goals, and physical therapy referral
Patients receive recommendations from their physicians to continue their usual physical activity as tolerated, receive a FitBit to wear continuously throughout the study, with the ExerciseRx app locked to the baseline home screen, and receive an educational handout with exercises for axial spondyloarthritis.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Average minutes of physical activity/exercise during the week and % of participants with adherence to 60% or higher of the recommended exercises
Time Frame: Week 0 (baseline), 6 and 12
We will measure feasibility by adherence to the recommended exercises in the intervention arm, including any additional reported physical activity throughout each week. In the usual care arm, participants will report any physical therapy exercises completed from the handout, as well as other physical activity/exercise. Adherence will be measured using the modified Short QUestionnaire to ASsess Health-enhancing physical activity (mSQUASH), a validated tool for capturing physical activity in axSpA. For those in the intervention arm, adherence will also be captured via the built-in tracking features of the ExerciseRx app, providing an additional measure of feasibility. Adherence or engagement with the ExerciseRx app will be measured in three domains: frequency of app use, adherence to recommended exercises, and interaction with behavioral features.
Week 0 (baseline), 6 and 12
Acceptability of the ExeriseRx app as a platform to complete recommended exercises for axial spondyloarthritis including % of participants with average score above 5 on MAUQ indicating usability
Time Frame: Weeks 6 and 12
We will measure acceptability using the mHealth App Usability Questionnaire (MAUQ). Scores range from 1 to 7 with scores above 5 on a 7-point Likert scale considered to show usability.
Weeks 6 and 12

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in disease activity over 12 weeks
Time Frame: Weeks 0 (baseline), 6, and 12
We will measure changes in disease activity over the course of the study with Bath Axial Spondyloarthritis Disease Activity Index (BASDAI), a validated measure in axSpA. BASDAI ranges from 0-10 with 0 indicating remission and 10 indicated very high disease activity.
Weeks 0 (baseline), 6, and 12
Change in functional status
Time Frame: Weeks 0 (baseline), 6, and 12
We will measure changes in functional status over the course of the study via the Bath Axial Spondyloarthritis Functional Index (BASFI), a validated measure in axSpA. BASFI ranges from 0-10 with 0 indicating full function and 10 indicating severe functional impairment.
Weeks 0 (baseline), 6, and 12

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Barriers and facilitators to physical activity/exercise
Time Frame: Weekly throughout the 12 week study
Participants will receive weekly surveys from the ExerciseRx app regarding any barriers and facilitator to physical activity/exercise during the week.
Weekly throughout the 12 week study

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Collaborators

Investigators

  • Principal Investigator: Rachael Stovall, MD, University of Washington

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 1, 2026

Primary Completion (Estimated)

April 1, 2027

Study Completion (Estimated)

June 1, 2027

Study Registration Dates

First Submitted

June 3, 2026

First Submitted That Met QC Criteria

June 9, 2026

First Posted (Actual)

June 11, 2026

Study Record Updates

Last Update Posted (Actual)

June 11, 2026

Last Update Submitted That Met QC Criteria

June 9, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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