Übungen bei Morbus Bechterew (AS) — Bewegung IST die Behandlung, Extension über Flexion, Pool ausgezeichnet

ASAS criteria + 2022 EULAR/ASAS axial spondyloarthritis management framework. Ankylosing spondylitis is the prototypical axSpA — inflammatory back pain, sacroiliitis, and axial fusion if untreated (radiographic 'bamboo spine'). Exercise is THE foundational treatment — Bath protocols (BASMI mobility score, BASFI functional index tracked over time) are the international standard. Anti-TNF biologics revolutionised AS management but exercise remains essential for posture and spinal mobility preservation; the two are complementary, not substitutes. Sveaas 2020 meta-analysis confirmed that exercise reduces disease activity, improves function, and protects posture vs control. Pool exercise is excellent (warmth + reduced axial load + spinal mobility in gentle resistance). The exercise priority is extension bias — AVOID prolonged flexion (sitting hunched, looking-down at phone) because the kyphotic fusion is what makes untreated AS visually devastating. Cardiovascular risk is elevated (especially aortic root + valve issues). Uveitis affects ~30% of AS patients over a lifetime. IBD overlap is common (HLA-B27 shared). The osteoporosis paradox is critical: axial fusion + low BMD = fragility-fracture risk THROUGH the fused spine (Geusens 2015 vertebral fracture rates elevated despite 'bone' on imaging).

Volya's catalogue carries the foundation moves: scapular-retraction for posture (the AS hill to die on), wall-push-up for upper-body strength + scaled progression, cat-cow for spinal mobility (axial mobility is what AS steals), supported-glute-bridge for posterior chain + hip extension, prone-y-raise for thoracic extension + scapular control, supine-knee-to-chest for low-back release between extension work, diaphragmatic-breathing for chest-wall mobility (chest expansion measured on BASMI), chin-tuck for cervical posture (AS forward-head is devastating long-term), standing-march for managed cardio. The AI coach also knows the nutrition side — anti-inflammatory Mediterranean (Macfarlane 2018 + Vadell 2020 reduce AS disease activity vs Western), osteoporosis paradox calcium 1000-1200 + vitamin D 1000-2000 IU/day + weight-bearing exercise + DEXA every 2 years, omega-3 1-3 g/day EPA+DHA, vitamin D often low target 40-60 ng/mL, IBD overlap ~10% low-FODMAP trial + GI referral, cardiovascular risk Mediterranean + omega-3 + BP control + lipid panel annually, protein 1.2-1.4 g/kg/day for muscle mass preservation (critical for spinal-extension capacity), uveitis 30% lifetime anti-inflammatory + omega-3 + vitamin A + zinc, AVOID prolonged immobility long flights/sedentary (stiffness + DVT through fused spine), AVOID starch-elimination London/Ebringer diet popular online weak evidence + nutrient gap risk. CRITICAL: Spondylitis Association of America (SAA) + ASAS + rheumatology + ophthalmology if uveitis + GI if IBD overlap + cardiology if aortic involvement + endocrinology + dietitian familiar with axSpA. This is NEVER a replacement for rheumatology care.