Impact of Yoga on Spinal Mobility and Psychological Outcomes in Patients with Axial Spondyloarthritis: A Prospective Non-randomized Controlled Study.

Exercise is a key non-pharmacological component of therapy in axial spondyloarthritis (axSpA). Evidence for yoga as a mind-body intervention remains limited. This study aimed to assess the effects of an 8-week yoga program on mobility, function, disease activity, activity-related competences, and psychological outcomes in axSpA compared with physiotherapy and healthy individuals. We conducted a prospective, non-randomized, study (University Hospital Erlangen, May 2021-January 2024). AxSpA patients participated either in weekly yoga sessions for 8 weeks (approximately 60 min; online format) or received standard individual physiotherapy (≥ 30 min/week). A healthy control group completed the same yoga program. Health related outcomes at baseline and follow-up were measured and changes were analysed using linear mixed-effects models. Seventy-six participants were included. In axSpA, spinal mobility improved in the yoga group (BASMI Δ - 0.31; p = 0.002), while the physiotherapy group worsened (Δ + 0.29; p = 0.003). Physical activity related health competency (control competence Δ + 1.10; p = 0.001; self-regulation Δ + 0.72; p = 0.021) and psychological outcomes improved in the yoga group with increased quality of life mental scores (Δ + 6.62; p < 0.001) and reduced kinesiophobia (TSK Δ - 3.25; p = 0.008); physiotherapy showed no meaningful changes. Disease activity showed a significant decrease in the yoga group (BASDAI Δ -0.44; p = 0.049). Healthy individuals showed similar directional changes with smaller effects. An 8-week yoga intervention was associated with improvements in mobility, psychological outcomes and activity-related competences. Findings support yoga as a complementary treatment addressing both physical and psychological dimensions of axSpA. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00025215).