axSpA Track
FORGE
Functional Optimization & Rehabilitation through Graduated Exercise
Duration
24 weeks · Foundation, HIIT + Bands, Optimization
Structure
Progressive, 3 phases over 6 months
Delivery
Virtual
About this protocol
FORGE is built for radiographic and non-radiographic axial spondyloarthritis on three integrated pillars: spinal mobility and chest-expansion exercises targeting all BASMI domains; graduated walking-based HIIT addressing elevated cardiovascular risk; and progressive postural strengthening focused on anti-kyphosis extensor chains. Phase 3 introduces an adapted Norwegian 4×4. The programme is aligned with the 2022 ASAS-EULAR positioning of exercise as first-line therapy in axSpA.
Clinical authors
- Angelo Papachristos, PT, ACPAC
- Dr. Dharini Mahendira, MD
Evidence base
FORGE is derived from systematic review and randomized controlled trial evidence in Axial Spondyloarthritis (axSpA). Protocol parameters — phase structure, load progression, and outcome measures — align with EULAR, ACR, and ASAS exercise-therapy recommendations. Outcome tracking favours open-access PROMIS instruments where validated equivalents exist.
View the evidence library →Outcome measures
- BASMI (Bath AS Metrology Index, 5 domains)
- Chest Expansion at 4th intercostal space (cm)
- BASDAI (Bath AS Disease Activity Index)
- ASDAS-CRP (AS Disease Activity Score)
- BASFI (Bath AS Functional Index)
- 1.6-km Walk Test (VO₂ estimation)
- Peak HR + RPE (every session)
- Daily step count (weekly average)
PROMIS short forms are free, NIH-developed measures used in place of paid legacy instruments.
What's included
- Virtual assessment with a certified exercise therapist
- Personalised programme plan
- Live-virtual group or individual sessions
- Asynchronous guided home programme
- Regular ePRO check-ins with adaptive progression
- Care coordinator support
- Programme completion report
Interested in this protocol?
Speak to us about adding FORGE to your PSP or benefits plan.
Request a pilotFor patients