Abstract / Summary
Background and Objectives: Exercise is central to axSpA management, but whether live remote delivery preserves effects of the same face-to-face program is uncertain. Methods: Five databases were searched until 9 September 2026; registry, reference, and citation searches ended on 11 September 2026. Reports from one trial were linked; contextual studies were illustrative. Results: Of 214 database records, 123 unique records were screened, and 11 reports representing eight studies were selected from the five databases. A ClinicalTrials.gov record and doctoral thesis linked to the Karaca trial were obtained separately and were not counted among those 11 database-selected reports. One assessor-blinded RCT compared the same individualized clinical Pilates program by videoconference or in clinic. Fifty participants were randomized, 46 assessed at eight weeks, and 40 at six months. Median BASFI improvement was 3.0 versus 2.5 points at eight weeks (p = 0.587) and 2.0 versus 2.0 points at six months (p = 0.838). Mann–Whitney U tests used α = 0.017; between-group effect estimates and 95% confidence intervals were unavailable. All-randomized attendance was 93.8% versus 94.0%. Five participants reported transient symptoms; three serious events were judged unrelated, and no intervention-related serious adverse event was reported. Conclusions: Remote delivery was implementable with high short-term attendance among digitally eligible participants. This trial does not establish equivalence, non-inferiority, preserved effect, broad accessibility, or a safety profile. Adequately powered non-inferiority trials are needed.