Rheumatology International

, Volume 38, Issue 7, pp 1277–1284 | Cite as

The EJES-3D tool for personalized prescription of exercise in axial spondyloarthritis through multimedia animations: pilot study

  • Mariano Tomás FlórezEmail author
  • Raquel Almodóvar
  • Fernando García Pérez
  • Ana Belén Rodríguez Cambrón
  • Loreto Carmona
  • María Ángeles Pérez Manzanero
  • Juan Aboitiz Cantalapiedra
  • Ana Urruticoechea-Arana
  • Carlos J. Rodríguez Lozano
  • Carmen Castro
  • Cristina Fernández-Carballido
  • Eugenio de Miguel
  • Eva Galíndez
  • José Luis Álvarez Vega
  • Juan Carlos Torre Alonso
  • Luis F. Linares
  • Mireia Moreno
  • Victoria Navarro-Compán
  • Xavier Juanola
  • Pedro Zarco
Physical Medicine and Rehabilitation


To develop and evaluate a web application based on multimedia animations, combined with a training program, to improve the prescription of exercises in spondyloarthritis (SpA). After a review of exercises included in the main clinical trials and recommendations of international societies, a multidisciplinary team—rehabilitators, rheumatologists, physiotherapists, computer scientists and graphic designers—developed a web application for the prescription of exercises (EJES-3D). Once completed, this was presented to 12 pairs of rehabilitators–rheumatologists from the same hospital in a workshop. Knowledge about exercise was tested in rheumatologists before and 6 months after the workshop, when they also evaluated the application. The EJES-3D application includes 38 multimedia videos and allows prescribing predesigned programs or customizing them. A patient can consult the prescribed exercises at any time from a device with internet connection (mobile, tablet, or computer). The vast majority of the evaluators (89%) were satisfied or very satisfied and considered that their expectations regarding the usefulness of the web application had been met. They highlighted the ability to tailor exercises adapted to the different stages of the disease and the quality and variety of the videos. They also indicated some limitations of the application and operational problems. The EJES-3D tool was positively evaluated by experts in SpA, potentially the most demanding group of users with the most critical capacity. This allows a preliminary validation of the contents, usefulness, and ease of use. Analyzing and correcting the errors and limitations detected is allowing us to improve the EJES-3D tool.


Exercise therapy Spondylarthritis Patient education Patient compliance 


Author contributions

MTF, RA, FGP, MAPM, JAC, and PZ designed the tool and contributed to the validation study. ABRC and LC conducted the validation study, including analysis; AU, CJRL, CC, CFC, EDM, EG, JLAV, JCTA, LFL, VNC, and XJ performed the validations by recruiting patients and answering the surveys. All authors contributed to the manuscript and accepted the last version.


Merck Sharp and Dohme Spain funded the training meeting and the methodological support for the surveys.

Compliance with ethical standards

Conflict of interest

This document does not recommend drugs or specific instruments from which the participants or the financer could economically benefit from their exploitation.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Unidad de Rehabilitación, Hospital Universitario Fundación AlcorcónAlcorcónSpain
  2. 2.Unidad de Reumatología, Hospital Universitario Fundación AlcorcónAlcorcónSpain
  3. 3.Servicio de ReumatologíaHospital Universitario Severo OchoaLeganésSpain
  4. 4.Instituto de Salud Musculoesquelética (InMusc)MadridSpain
  5. 5.ReumatologíaHospital Can MissesIbizaSpain
  6. 6.Servicio de ReumatologíaHospital Universitario de Gran Canaria Doctor NegrínLas PalmasSpain
  7. 7.Servicio de ReumatologíaHospital Universitario Reina SofíaCórdobaSpain
  8. 8.Sección de ReumatologíaHospital General Universitario de EldaAlicanteSpain
  9. 9.Servicio de ReumatologíaHospital Universitario La PazMadridSpain
  10. 10.Servicio de ReumatologíaHospital Universitario de BasurtoBilbaoSpain
  11. 11.Servicio de ReumatologíaHospital Regional Universitario Infanta CristinaBadajozSpain
  12. 12.Servicio de ReumatologíaHospital Monte Naranco, Universidad de OviedoOviedoSpain
  13. 13.Servicio de ReumatologíaHospital Clínico Universitario Virgen de la ArrixacaMurciaSpain
  14. 14.Servicio de ReumatologíaCorporació Sanitària Parc TaulíBarcelonaSpain
  15. 15.Servicio de ReumatologíaHospital Universitari de BellvitgeBarcelonaSpain

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