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Polat MC, Çelikel E, Tekin ZE, Güngörer V, Kurt T, Tekgöz N, Sezer M, Karagöl C, Coşkun S, Kaplan MM, Öner N, Acar BÇ. Assessment of quality of life and physical activity in patients with oligoarticular juvenile idiopathic arthritis in remission. Eur J Pediatr 2024; 183:955-964. [PMID: 38071637 DOI: 10.1007/s00431-023-05367-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/22/2023] [Accepted: 12/03/2023] [Indexed: 03/05/2024]
Abstract
The purpose of this study was to evaluate physical activity (PA) and health-related quality of life (HRQOL) in children with oligoarticular juvenile idiopathic arthritis (JIA) in remission in comparison with healthy peers and to determine the disease-related factors affecting PA levels. This study was conducted with 50 oligoarticular JIA patients in remission and 50 healthy peers between 9 and 14 years. Demographic and clinical characteristics, laboratory parameters, and treatments were noted from electronic medical records. HRQOL was assessed with the Pediatric Quality of Life Inventory (PedsQL). PA was evaluated with the Physical Activity Questionnaire for Children (PAQ-C). Oligoarticular JIA patients had significantly lower self-reported median PedsQL scores in the domains of school functioning and social functioning compared to the control group (67.5 (10) vs. 75 (25), p = 0.001 and 70 (15) vs. 85 (26.3), p < 0.001, respectively). The median PAQ-C score was 2.6 (1.1) in patients with JIA and 3 (0.9) in their healthy peers (p = 0.02). The PAQ-C score was 2.8 (1.2) in patients < 8 years at the disease onset and 2.3 (1) in those aged ≥ 8 years (p = 0.022). There was no significant difference in the number of affected joints, type of affected joint, MTX and biologic agent treatment, and remission with or without drugs with the total score of the PedsQL and PAQ-C. All PedsQL domains were positively correlated with the PAQ-C. Conclusion: Oligoarticular JIA patients demonstrated lower PA and HRQOL scores compared to healthy controls despite favorable disease control. What is Known: • Oligoarticular JIA has fewer functional limitations and disabilities compared to other JIA subtypes. • As JIA can affect all aspects of a child's life, there is a need to improve the quality of life related to the disease. What is New: • It should be considered that patients with oligoarticular JIA may show lower PA and HRQOL scores compared to healthy controls despite favorable disease control. • Since there may be a relationship between PA and HRQOL, factors that may affect PA should be investigated to provide a holistic approach to JIA treatment.
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Affiliation(s)
- Merve Cansu Polat
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
| | - Elif Çelikel
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Zahide Ekici Tekin
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Vildan Güngörer
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Tuba Kurt
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Nilüfer Tekgöz
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Müge Sezer
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Cüneyt Karagöl
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Serkan Coşkun
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Melike Mehveş Kaplan
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Nimet Öner
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Banu Çelikel Acar
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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Gudjonsdottir B, Oskarsdottir SA, Kristjansdottir A, Gudmundsdottir JA, Kamban SW, Licina ZA, Gudmundsdottir DB. Impact of Musculoskeletal Pain on Functioning and Disability in Children with Juvenile Idiopathic Arthritis in Iceland. Phys Occup Ther Pediatr 2024; 44:554-571. [PMID: 38178574 DOI: 10.1080/01942638.2023.2299028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
AIMS 1) to map questions of pain from a survey to the International Classification of Functioning, Disability and Health (ICF) 2) to compare the impact of musculoskeletal pain on functioning based on the different components of the ICF in children with juvenile idiopathic arthritis (JIA) and age-matched peers. METHOD A cross-sectional case-control survey. A total of 28 children with JIA and 36 age-matched children participated. The survey included questions on the child's sex and age, about pain experienced, number of painful body areas, pain frequency and three short forms of Patient-Reported Outcome Measurement Information System (PROMIS) pain questionnaires. Sixteen children with JIA (57%) and 10 peers (28%) reported pain during past seven days. Their responses were used in the description of impact of pain. RESULTS After the mapping of the questions to ICF, a comparison between the two groups indicated that a higher number of children with JIA described effects of pain on mental function, mobility, general tasks and demands, than their peers. More children with JIA expressed to others that they had pain, non-verbally and verbally. CONCLUSION The findings provide important information about the impacts of pain on daily life in children with JIA and about their intervention needs.
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Affiliation(s)
- Bjorg Gudjonsdottir
- Department of Physical Therapy, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Audur Kristjansdottir
- Department of Physical Therapy, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Solrun W Kamban
- Landspitali - The National University Hospital of Iceland, Children's Medical Center, Reykjavik, Iceland
| | - Zinajda Alomerovic Licina
- Landspitali - The National University Hospital of Iceland, Children's Medical Center, Reykjavik, Iceland
| | - Drifa Bjork Gudmundsdottir
- Landspitali - The National University Hospital of Iceland, Children's Medical Center, Reykjavik, Iceland
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de Koning L, Warnink-Kavelaars J, van Rossum M, Limmen S, Van der Looven R, Muiño-Mosquera L, van der Hulst A, Oosterlaan J, Rombaut L, Engelbert R. Physical activity and physical fitness in children with heritable connective tissue disorders. Front Pediatr 2023; 11:1057070. [PMID: 37009265 PMCID: PMC10065825 DOI: 10.3389/fped.2023.1057070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/21/2023] [Indexed: 04/04/2023] Open
Abstract
Objectives Health problems in patients with heritable connective tissue disorders (HCTD) are diverse and complex and might lead to lower physical activity (PA) and physical fitness (PF). This study aimed to investigate the PA and PF of children with heritable connective tissue disorders (HCTD). Methods PA was assessed using an accelerometer-based activity monitor (ActivPAL) and the mobility subscale of the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT). PF was measured in terms of cardiovascular endurance using the Fitkids Treadmill Test (FTT); maximal hand grip strength, using hand grip dynamometry (HGD) as an indicator of muscle strength; and motor proficiency, using the Bruininks-Oseretsky Test of Motor Proficiency-2 (BOTMP-2). Results A total of 56 children, with a median age of 11.6 (interquartile range [IQR], 8.8-15.8) years, diagnosed with Marfan syndrome (MFS), n = 37, Loeys-Dietz syndrome (LDS), n = 6, and genetically confirmed Ehlers-Danlos (EDS) syndromes, n = 13 (including classical EDS n = 10, vascular EDS n = 1, dermatosparaxis EDS n = 1, arthrochalasia EDS n = 1), participated. Regarding PA, children with HCTD were active for 4.5 (IQR 3.5-5.2) hours/day, spent 9.2 (IQR 7.6-10.4) hours/day sedentary, slept 11.2 (IQR 9.5-11.5) hours/day, and performed 8,351.7 (IQR 6,456.9-1,0484.6) steps/day. They scored below average (mean (standard deviation [SD]) z-score -1.4 (1.6)) on the PEDI-CAT mobility subscale. Regarding PF, children with HCTD scored well below average on the FFT (mean (SD) z-score -3.3 (3.2)) and below average on the HGD (mean (SD) z-score -1.1 (1.2)) compared to normative data. Contradictory, the BOTMP-2 score was classified as average (mean (SD) z-score.02 (.98)). Moderate positive correlations were found between PA and PF (r(39) = .378, p < .001). Moderately sized negative correlations were found between pain intensity and fatigue and time spent actively (r(35) = .408, p < .001 and r(24) = .395 p < .001, respectively). Conclusion This study is the first to demonstrate reduced PA and PF in children with HCTD. PF was moderately positively correlated with PA and negatively correlated with pain intensity and fatigue. Reduced cardiovascular endurance, muscle strength, and deconditioning, combined with disorder-specific cardiovascular and musculoskeletal features, are hypothesized to be causal. Identifying the limitations in PA and PF provides a starting point for tailor-made interventions.
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Affiliation(s)
- Lisanne de Koning
- Center of Expertise Urban Vitality, Faculty of Health, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Correspondence: Lisanne de Koning
| | - Jessica Warnink-Kavelaars
- Department of Rehabilitation Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, Netherlands
| | - Marion van Rossum
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands
- Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, Netherlands
| | - Selina Limmen
- Center of Expertise Urban Vitality, Faculty of Health, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
| | - Ruth Van der Looven
- Department of Physical and Rehabilitation Medicine, Child Rehabilitation, Ghent University Hospital, Ghent, Belgium
| | - Laura Muiño-Mosquera
- Department of Pediatrics, Division of Pediatric Cardiology, Ghent University Hospital, Ghent, Belgium
- Center for Medical Genetics, Ghent University Hospital/Ghent University, Ghent, Belgium
| | - Annelies van der Hulst
- Department of Pediatric Cardiology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, Netherlands
| | - Jaap Oosterlaan
- Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me Program & Emma Neuroscience Group, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, Netherlands
| | - Lies Rombaut
- Center for Medical Genetics, Ghent University Hospital/Ghent University, Ghent, Belgium
| | - Raoul Engelbert
- Center of Expertise Urban Vitality, Faculty of Health, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, Netherlands
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Vincent HK, Sharififar S, Abdelmalik B, Lentini L, Chen C, Woolnough LU. Gait parameters, functional performance and physical activity in active and inactive Juvenile Idiopathic Arthritis. Gait Posture 2022; 98:226-232. [PMID: 36191581 DOI: 10.1016/j.gaitpost.2022.09.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/04/2022] [Accepted: 09/19/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Children with Juvenile Idiopathic Arthritis (JIA) may adopt different movement patterns and participate in physical activity during different states of disease. RESEARCH QUESTION Which specific features of gait and physical function performance differ among children with active or inactive JIA compared to healthy children? METHODS Forty-three children participated (14.5 ± 4.2 yrs; 60 % female). 3D-motion analysis methods were coupled with force measures from an instrumented treadmill captured gait mechanical measures. The 30-second Chair Rise Test (repetitions) and stair ascent-descent tests were performed, and the 11-point Wong-Baker face scale assessed pain after each test. RESULTS Compared to healthy controls children with active and inactive JIA had worse outcomes (12-21 % slower self-selected and fast walking speeds, 28-34 % slower stair navigation times, 28 % fewer chair rise repetitions in 30 s; all p < .05). Children with active JIA had 8-13 % slower gait speeds, 4 % fewer chair rise repetitions and 14-16 % slower stair navigation times. At faster walking speed, children with active JIA had less hip joint flexion/extension excursion in the sagittal plane during the gait cycle, produced higher leg stiffness, and demonstrated greater interlimb asymmetry in GRF vertical impulse during loading than healthy children (all p < .05). The Pedi-FABS subscore of "Duration: performing athletic activity for as long as you would like without stopping" was rated lower in children with active JIA compared to controls (p < .05). CONCLUSION Gait speed, specific load-bearing functional tasks and leg stiffness features of gait may be informative 'functional biomarkers' for assessing JIA burden and tracking treatment efficacy. Additional prospective studies are needed to determine how these features change over time with pain change, and understand impact on quality of life and physical activity participation.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida, PO Box 112730, Gainesville, FL 32607, United States.
| | - Sharareh Sharififar
- Department of Physical Medicine and Rehabilitation, University of Florida, PO Box 112730, Gainesville, FL 32607, United States.
| | - Bishoy Abdelmalik
- Department of Physical Medicine and Rehabilitation, University of Florida, PO Box 112730, Gainesville, FL 32607, United States.
| | - Logan Lentini
- Department of Pediatrics, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, United States.
| | - Cong Chen
- Department of Orthopaedics, University of Florida, PO Box112727, Gainesville, FL 32611, United States.
| | - Leandra U Woolnough
- Department of Pediatrics, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, United States
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5
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Woolnough LU, Lentini L, Sharififar S, Chen C, Vincent HK. The relationships of kinesiophobia and physical function and physical activity level in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2022; 20:73. [PMID: 36050703 PMCID: PMC9438303 DOI: 10.1186/s12969-022-00734-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Kinesiophobia may hinder physical performance measures and functional quality of life in children with juvenile idiopathic arthritis (JIA). This study aims to quantify differences in physical function in patients with JIA compared to healthy controls, and determine the effects of kinesiophobia on physical function and physical activity. METHODS This was a comparative study of participants with JIA and healthy controls (JIA n = 26, control n = 17). All children with JIA had lower extremity joint involvement. Performance-based measures included gait speed, chair and stair navigation performance. Self-reported measures included Patient Reported Outcome Measurement Information System (PROMIS®) Physical Function Mobility, and Pain Interference and the Pediatric Functional Activity Brief Scale (Pedi-FABS). The Tampa Scale of Kinesiophobia (TSK-11) assessed patient fear of movement due to pain. Linear regression models were used to determine the contribution of TSK-11 scores on performance test and Pedi-FABS scores. RESULTS Gait speeds were 11-15% slower, chair rise repetitions were 28% fewer, and stair ascent and descent times were 26-31% slower in JIA than controls (p < .05). PROMIS® Physical Function Mobility scores were 10% lower and Pain Interference scores were 2.6 times higher in JIA than healthy controls (p = .003). TSK-11 scores were higher in JIA than controls (p < .0001). After controlling for covariates, TSK-11 scores explained 11.7-26.5% of the variance of regression models for stair climb time, chair rise performance and Pedi-FABS scores (p < .05). CONCLUSIONS Children with JIA experience difficulty with tasks related to body transfers. Kinesiophobia is a significant contributor to the functional task performance and may impact clinical outcomes.
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Affiliation(s)
- Leandra U. Woolnough
- grid.15276.370000 0004 1936 8091Department of Pediatrics and Physical Medicine and Rehabilitation, University of Florida, 1600 SW Archer Rd HD-409, PO Box 100296, Gainesville, FL 32610 USA
| | - Logan Lentini
- grid.15276.370000 0004 1936 8091Department of Pediatrics and Physical Medicine and Rehabilitation, University of Florida, 1600 SW Archer Rd HD-409, PO Box 100296, Gainesville, FL 32610 USA
| | - Sharareh Sharififar
- grid.15276.370000 0004 1936 8091Department of Pediatrics and Physical Medicine and Rehabilitation, University of Florida, 1600 SW Archer Rd HD-409, PO Box 100296, Gainesville, FL 32610 USA
| | - Cong Chen
- grid.15276.370000 0004 1936 8091Department of Pediatrics and Physical Medicine and Rehabilitation, University of Florida, 1600 SW Archer Rd HD-409, PO Box 100296, Gainesville, FL 32610 USA
| | - Heather K. Vincent
- grid.15276.370000 0004 1936 8091Department of Pediatrics and Physical Medicine and Rehabilitation, University of Florida, 1600 SW Archer Rd HD-409, PO Box 100296, Gainesville, FL 32610 USA
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6
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Gizik J, Meister S, Hartmann M, Sahm D, Georgi M, Baumeister N, Kühne M, Haas JP, Schwirtz A. Physiotherapie und Sport bei Kinderrheuma – Shake your
bones. AKTUEL RHEUMATOL 2022. [DOI: 10.1055/a-1757-2862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungIm Rahmen kindlicher rheumatischer Erkrankungen haben die zumeist schmerzhaften
Entzündungsvorgänge am muskulo-skelettalen System
(z. B.: Gelenke, Muskeln, Sehnen, Gefäße) Auswirkungen
auf die tägliche Mobilität der Betroffenen. Immobilität,
körperliche und sportliche Inaktivität sind oft die Folge. Die
geltenden Richtlinien der Nationalen Empfehlungen für Bewegung und
Bewegungsförderung werden daher oftmals nicht erreicht.
Bewegungsreduzierte oder -inaktive Patienten können jedoch durch
verschiedene Maßnahmen in ihrem Bewegungsverhalten gefördert
werden. Die Physiotherapie bietet eine erste Möglichkeit in
geschütztem Rahmen und unter fachlicher Aufsicht körperlich und
sportlich aktiv zu sein. Neben der Wiederherstellung und Verbesserung des
physiologischen Bewegungsausmaßes liegen die Erhaltung der
Selbstständigkeit und Lebensqualität im Vordergrund der
physiotherapeutischen Behandlung. Dazu zählen Aktivierung, Anbahnung von
physiologischen Bewegungsabläufen, Korrektur von Gelenkachsen und das
Vermitteln von Körperwahrnehmung bei körperlicher
Aktivität. Medizinisches Fachwissen und Verständnis sowie Wissen
über die Anforderungen verschiedener Sportartenprofile
ermöglicht gezielte Hilfestellungen. Durch kontinuierliche, engmaschige
Begleitung und langsame Steigerung von Intensität und Umfang in der
Physiotherapie können Ängste und Bedenken bezüglich dem
Wiedereinstieg bzw. Einstieg in sportliche Betätigung abgebaut werden.
Der jeweilige Gesundheitszustand und die Situation der
Entzündungsaktivität sind maßgebend für die
Therapieinterventionen. Sport gilt heute in der Physiotherapie als
Therapieelement und hilft Beschwerden zu lindern, verbessert körperliche
Defizite und vermittelt dabei Freude an der Bewegung. Für
Alltagsaktivitäten und den Freizeitsport kann eine individuelle
Sportberatung basierend auf dem bestehenden Erkrankungsstatus, dem funktionellen
und sportmotorischen Leistungsniveau sowie den eigenen Interessen wirkungsvoll
zu einem aktiven Lebensstil beitragen. Eine weitere Möglichkeit der
angeleiteten Bewegungsförderung stellt der Schulsport dar. Individuelle,
differenzierte Schulsportteilnahmebescheinigungen verbessern die Inklusion. Ein
auf den Erkrankungsstatus angepasstes und vorgegebenes Trainingsprogramm kann
mithilfe konkreter Vorgaben bei der Umsetzung der sportlichen Ziele
unterstützen. In Zukunft soll ein digital gestütztes
professionelles Monitoring die Bewegungsempfehlungen für zuhause noch
weiter verbessern und helfen den Mangel an flächendeckenden
Beratungsstellen für Erkrankte mit kindlichem Rheuma zu verringern.
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Affiliation(s)
- Josephine Gizik
- Technische Universität München, Fakultät
für Sport- und Gesundheitswissenschaften, Professur für
Biomechanik im Sport, München, Germany
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Sophia Meister
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Matthias Hartmann
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Daniel Sahm
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Mathias Georgi
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Nadja Baumeister
- Technische Universität München, Fakultät
für Sport- und Gesundheitswissenschaften, Professur für
Biomechanik im Sport, München, Germany
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Mareike Kühne
- Technische Universität München, Fakultät
für Sport- und Gesundheitswissenschaften, Professur für
Biomechanik im Sport, München, Germany
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Johannes-Peter Haas
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Ansgar Schwirtz
- Technische Universität München, Fakultät
für Sport- und Gesundheitswissenschaften, Professur für
Biomechanik im Sport, München, Germany
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7
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Heale LD, Houghton KM, Rezaei E, Baxter-Jones ADG, Tupper SM, Muhajarine N, Benseler SM, Boire G, Cabral DA, Campillo S, Chédeville G, Chetaille AL, Dancey P, Duffy C, Duffy KW, Ellsworth J, Guzman J, Huber AM, Jurencak R, Lang B, Laxer RM, Morishita K, Oen KG, Petty RE, Ramsey SE, Roth J, Schneider R, Scuccimarri R, Spiegel L, Stringer E, Tse SML, Tucker LB, Turvey SE, Yeung RSM, Rosenberg AM. Clinical and psychosocial stress factors are associated with decline in physical activity over time in children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2021; 19:97. [PMID: 34187498 PMCID: PMC8243495 DOI: 10.1186/s12969-021-00584-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/19/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Physical activity (PA) patterns in children with juvenile idiopathic arthritis (JIA) over time are not well described. The aim of this study was to describe associations of physical activity (PA) with disease activity, function, pain, and psychosocial stress in the 2 years following diagnosis in an inception cohort of children with juvenile idiopathic arthritis (JIA). METHODS In 82 children with newly diagnosed JIA, PA levels, prospectively determined at enrollment, 12 and 24 months using the Physical Activity Questionnaire for Children (PAQ-C) and Adolescents (PAQ-A) raw scores, were evaluated in relation to disease activity as reflected by arthritis activity (Juvenile Arthritis Disease Activity Score (JADAS-71)), function, pain, and psychosocial stresses using a linear mixed model approach. Results in the JIA cohort were compared to normative Pediatric Bone Mineral Accrual Study data derived from healthy children using z-scores. RESULTS At enrollment, PA z-score levels of study participants were lower than those in the normative population (median z-score - 0.356; p = 0.005). At enrollment, PA raw scores were negatively associated with the psychosocial domain of the Juvenile Arthritis Quality of Life Questionnaire (r = - 0.251; p = 0.023). There was a significant decline in PAQ-C/A raw scores from baseline (median and IQR: 2.6, 1.4-3.1) to 24 months (median and IQR: 2.1, 1.4-2.7; p = 0.003). The linear mixed-effect model showed that PAQ-C/A raw scores in children with JIA decreased as age, disease duration, and ESR increased. The PAQ-C/A raw scores of the participants was also negatively influenced by an increase in disease activity as measured by the JADAS-71 (p < 0.001). CONCLUSION Canadian children with newly diagnosed JIA have lower PA levels than healthy children. The decline in PA levels over time was associated with disease activity and higher disease-specific psychosocial stress.
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Affiliation(s)
- Liane D. Heale
- grid.422356.40000 0004 0634 5667McMaster Children’s Hospital and McMaster University, Hamilton, Canada
| | - Kristin M. Houghton
- grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital and University of British Columbia, 4480 Oak Street, Room K4-120, Vancouver, BC V6H 3V4 Canada
| | - Elham Rezaei
- grid.25152.310000 0001 2154 235XJim Pattison Children’s Hospital and University of Saskatchewan, Saskatoon, Canada
| | | | - Susan M. Tupper
- grid.25152.310000 0001 2154 235XJim Pattison Children’s Hospital and University of Saskatchewan, Saskatoon, Canada
| | - Nazeem Muhajarine
- grid.25152.310000 0001 2154 235XJim Pattison Children’s Hospital and University of Saskatchewan, Saskatoon, Canada
| | - Susanne M. Benseler
- grid.413571.50000 0001 0684 7358Alberta Children’s Hospital and University of Calgary, Calgary, Canada
| | - Gilles Boire
- grid.86715.3d0000 0000 9064 6198Centre Intégré Universitaire de Santé et de Services Sociaux de l’Estrie– Centre Hospitalier Universitaire de Santé (CIUSSS de l’Estrie-CHUS) and University of Sherbrooke, Sherbrooke, Canada
| | - David A. Cabral
- grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital and University of British Columbia, 4480 Oak Street, Room K4-120, Vancouver, BC V6H 3V4 Canada
| | - Sarah Campillo
- grid.416084.f0000 0001 0350 814XMontreal Children’s Hospital and McGill University, Montreal, Canada
| | - Gaëlle Chédeville
- grid.416084.f0000 0001 0350 814XMontreal Children’s Hospital and McGill University, Montreal, Canada
| | - Anne-Laure Chetaille
- grid.411081.d0000 0000 9471 1794le Centre Hospitalier Universitaire de Quebec, Quebec, Canada
| | - Paul Dancey
- grid.477424.60000 0004 0640 6407Janeway Children’s Health and Rehabilitation Centre and Memorial University, St. John’s, Canada
| | - Ciaran Duffy
- grid.414148.c0000 0000 9402 6172Children’s Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada
| | - Karen Watanabe Duffy
- grid.414148.c0000 0000 9402 6172Children’s Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada
| | - Janet Ellsworth
- grid.416656.60000 0004 0633 3703Stollery Children’s Hospital and University of Alberta, Edmonton, Canada
| | - Jaime Guzman
- grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital and University of British Columbia, 4480 Oak Street, Room K4-120, Vancouver, BC V6H 3V4 Canada
| | - Adam M. Huber
- grid.414870.e0000 0001 0351 6983IWK Health Centre and Dalhousie University, Halifax, Canada
| | - Roman Jurencak
- grid.414148.c0000 0000 9402 6172Children’s Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada
| | - Bianca Lang
- grid.414870.e0000 0001 0351 6983IWK Health Centre and Dalhousie University, Halifax, Canada
| | - Ronald M. Laxer
- grid.42327.300000 0004 0473 9646The Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Kimberly Morishita
- grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital and University of British Columbia, 4480 Oak Street, Room K4-120, Vancouver, BC V6H 3V4 Canada
| | - Kiem G. Oen
- grid.413983.4The Children’s Hospital of Winnipeg and University of Manitoba, Winnipeg, Canada
| | - Ross E. Petty
- grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital and University of British Columbia, 4480 Oak Street, Room K4-120, Vancouver, BC V6H 3V4 Canada
| | - Suzanne E. Ramsey
- grid.414870.e0000 0001 0351 6983IWK Health Centre and Dalhousie University, Halifax, Canada
| | - Johannes Roth
- grid.414148.c0000 0000 9402 6172Children’s Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada
| | - Rayfel Schneider
- grid.42327.300000 0004 0473 9646The Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Rosie Scuccimarri
- grid.416084.f0000 0001 0350 814XMontreal Children’s Hospital and McGill University, Montreal, Canada
| | - Lynn Spiegel
- grid.42327.300000 0004 0473 9646The Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Elizabeth Stringer
- grid.414870.e0000 0001 0351 6983IWK Health Centre and Dalhousie University, Halifax, Canada
| | - Shirley M. L. Tse
- grid.42327.300000 0004 0473 9646The Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Lori B. Tucker
- grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital and University of British Columbia, 4480 Oak Street, Room K4-120, Vancouver, BC V6H 3V4 Canada
| | - Stuart E. Turvey
- grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital and University of British Columbia, 4480 Oak Street, Room K4-120, Vancouver, BC V6H 3V4 Canada
| | - Rae S. M. Yeung
- grid.42327.300000 0004 0473 9646The Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Alan M. Rosenberg
- grid.25152.310000 0001 2154 235XJim Pattison Children’s Hospital and University of Saskatchewan, Saskatoon, Canada
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8
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Abdelaleem EA, Ezzat DA, Mostafa GR. Functional disability and health-related quality of life in juvenile idiopathic arthritis children from Beni-Suef. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-021-00060-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Juvenile idiopathic arthritis (JIA) is a common childhood disease which causes significant impairment in quality of life. The aim of the study is to assess the health-related quality of life and its relation to functional disability in JIA patients.
Child health assessment questionnaire (CHAQ) and pediatrics quality of life 4 generic core questionnaire (PedsQL) were used to evaluate functional disability and health-related quality of life.
Results
CHAQ (VAS) of JIA patients ranged from 0 to 9 with a mean of 3.64 ± 2.9 (SD), and of controls ranged from 0 to 4 with a mean of 1.32 ± 1.3 (SD) with a statistically significant difference and a p value of 0.001. CHAQ-disability index (DI) of the cases ranged from 0 to 3 with a mean of 1.06 ± 0.9 (SD) and of controls was consistent = 0. Pediatric quality of life (PedsQL) among cases ranged from 26.08 to 91.3 with a mean of 67.95 ± 19.2 (SD) and among controls ranged from 78.27 to 100 with a mean of 90.73 ± 7.7 (SD) showing statistically significant difference with a p value < 0.001.
Childhood health assessment questionnaire (CHAQ) scores were significantly higher among studied females with JIA as compared with males. The mean CHAQ-DI scores were 4.56 ± 2.7 vs. 1.29 ± 2.6 in females and males respectively with a significant p value of 0.002. The mean CHAQ-(VAS) scores were 1.38 ± 0.8 vs. 0.23 ± 0.3 in females and males respectively with a significant p value of 0.016. Pediatric quality of life (PedsQL) scores were significantly higher among studied males with JIA as compared with studied females. The childhood health assessment questionnaire (CHAQ) was negatively correlated with all (physical, emotional, social, and school) items of the pediatric quality of life (PedsQL) (p < 0.001).
Conclusion
We found a significant impairment in the functional ability and health-related quality of life in patients with JIA compared to healthy children, with more impairment in females than males. CHAQ was negatively correlated with all items of PedsQL.
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9
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Physical activity assessment in children and adolescents with juvenile idiopathic arthritis compared with controls. Arch Pediatr 2020; 28:47-52. [PMID: 33250332 DOI: 10.1016/j.arcped.2020.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/13/2020] [Accepted: 10/02/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE We aimed to assess physical activity (PA) in children with juvenile idiopathic arthritis (JIA) compared with healthy peers and to determine factors influencing PA level. METHODS This was a cross-sectional study of the measured level of PA in children with JIA, compared with age- and gender-matched healthy schoolchildren. PA was estimated using a physical activity questionnaire for children and for adolescents (cPAQ/aPAQ). Disease activity was evaluated with the Juvenile Arthritis Disease Activity Score (JADAS). Functional ability was assessed with the Childhood Health Assessment Questionnaire (CHAQ). RESULTS A total of 55 children with JIA and 55 healthy control schoolchildren were included. Children with JIA had significantly lower levels of PA compared with their healthy peers as assessed with the cPAQ/aPAQ (P=0.0121). In total, 76% of the JIA group spent the day sleeping and sitting, which was significantly higher compared with the reference group (P=0.001 and P=0.055, respectively). Low PA level was associated with systemic JIA (P=0.002, OR=2.123), polyarticular JIA with positive rheumatoid factor (P=0.001, OR=2.014), JADAS-27≥6 (P=0.001, OR=2.524), patients undergoing treatment (P=0.001, OR=1.271), and higher CHAQ (P=0.002, OR=2.461). CONCLUSION Children with JIA were less physically active than their healthy peers and less active than recommended for general health.
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10
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Taha R, Papadopoulou M, Zetterberg M, Oskarsdottir S, Grönlund MA. Visual Function And Quality Of Life In A Cohort Of Swedish Children With Juvenile Idiopathic Arthritis. Clin Ophthalmol 2019; 13:2081-2091. [PMID: 31749605 PMCID: PMC6818101 DOI: 10.2147/opth.s202486] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate quality of life (QoL) in children with juvenile idiopathic arthritis (JIA). Methods Forty children with a mean age of 7.9 years were included. The children underwent an ophthalmological examination and completed questionnaires on physical function (CHAQ) and vision-related (VR) QoL (EYE-Q). Results No differences regarding visual acuity (VA), refraction, intraocular pressure or physical or VRQoL were found between those with JIA without (n=33) and those with JIA-associated uveitis (n=7). When comparing physical function measured by CHAQ disability index and JIA subtype, a difference was found; children with polyarthritis scored the worst (p=0.0098). Children with subnormal VA scored worse on EYE-Q compared with those with normal VA (p=0.013). We found correlations between duration of JIA and CHAQ disability index (r=-0.42, p=0.0007) and CHAQ well-being (r=-0.34, p=0.022). Conclusion This study indicates the importance of measuring not only physical function but also VRQoL in children with JIA and JIA-associated uveitis.
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Affiliation(s)
- Rezhna Taha
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Maria Papadopoulou
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Madeleine Zetterberg
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Solveig Oskarsdottir
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Marita Andersson Grönlund
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden
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11
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Bourdier P, Saidi O, Rochette E, Ratel S, Merlin E, Pereira B, Duché P. Physical activity and sedentary levels in children with juvenile idiopathic arthritis and inflammatory bowel disease. A systematic review and meta-analysis. Pediatr Res 2019; 86:149-156. [PMID: 31029060 DOI: 10.1038/s41390-019-0409-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/28/2019] [Accepted: 04/16/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Physical activity (PA) is essential for children throughout their growth and maturation. It improves physiological and psychological health and limits the risk of developing metabolic disorders. However, some chronic physiological and metabolic diseases may lead to decreased PA. The diversity of outcomes in the literature offers no consensus for physical activity and sedentary levels in children with juvenile idiopathic arthritis (JIA) or inflammatory bowel disease (IBD). METHODS A literature review and a meta-analysis were carried out with original studies from a Medline database search. Only high-quality studies (STROBE checklist) written in English comparing PA level or sedentary behavior (SB) between children with the disorders and their healthy peers were considered. The aim was to examine PA and SB in children with JIA or IBD compared to their healthy peers. RESULTS The literature review and meta-analysis identified decreased PA and increased time spent in SB in these populations, which may exacerbate both their lower physical fitness and the symptoms of their health disorders. CONCLUSION Results nevertheless show discrepancies due to the different materials and methods used and the variables measured. Further studies are needed to establish a gold standard method for assessing PA level in these populations.
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Affiliation(s)
- Pierre Bourdier
- Laboratoire des Adaptations Métaboliques en conditions Physiologiques et Physiopathologiques (AME2P), Université Clermont Auvergne, 3533, Clermont-Ferrand, France.,CRNH-Auvergne, 63000, Clermont-Ferrand, France
| | - Oussama Saidi
- Laboratoire des Adaptations Métaboliques en conditions Physiologiques et Physiopathologiques (AME2P), Université Clermont Auvergne, 3533, Clermont-Ferrand, France.,CRNH-Auvergne, 63000, Clermont-Ferrand, France
| | - Emmanuelle Rochette
- CRNH-Auvergne, 63000, Clermont-Ferrand, France.,CHU Clermont-Ferrand, Pédiatrie, Hôpital Estaing, 63000, Clermont-Ferrand, France.,Université Clermont Auvergne, INSERM, CIC 1405, Unité CRECHE, 63000, Clermont-Ferrand, France.,Université de Toulon, Laboratoire IAPS, 83041, Toulon, France
| | - Sébastien Ratel
- Laboratoire des Adaptations Métaboliques en conditions Physiologiques et Physiopathologiques (AME2P), Université Clermont Auvergne, 3533, Clermont-Ferrand, France.,CRNH-Auvergne, 63000, Clermont-Ferrand, France
| | - Etienne Merlin
- CHU Clermont-Ferrand, Pédiatrie, Hôpital Estaing, 63000, Clermont-Ferrand, France.,Université Clermont Auvergne, INSERM, CIC 1405, Unité CRECHE, 63000, Clermont-Ferrand, France.,Université Clermont Auvergne, INRA, UMR 1019 UNH, ECREIN, 63000, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Délégation de la Recherche Clinique et Innovations, 63000, Clermont-Ferrand, France
| | - Pascale Duché
- Université de Toulon, Laboratoire IAPS, 83041, Toulon, France.
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12
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Flodén A, Broström EW, von Heideken J, Rostlund S, Nilsson R, Löwing K, Iversen MD. A qualitative study examining the validity and comprehensibility of physical activity items: developed and tested in children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2019; 17:16. [PMID: 31023371 PMCID: PMC6482510 DOI: 10.1186/s12969-019-0317-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 03/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Not all physical activity (PA) questionnaires (PAQ) gather information regarding PA intensity, duration, and modes and only a few were developed specifically for children. We assessed children's comprehensibility of items derived from two published PAQs used in children along with three items designed to ascertain PA intensity in order to assess comprehensibility of items and identify response errors. We modified items to create a new PAQ for children (ASCeND). We hypothesized that children would have comprehension difficulties with some original PAQ items and that ASCeND would be easier to comprehend, and would improve recall and reporting of PA. METHODS For this qualitative study, we recruited 30 Swedish children [ages 10-16 years; mean age = 13.0 (SD = 1.8)]; median disease activity score = 4.5 (IQR 2.2-9.0); median disease duration = 5.0 (IQR 2.6-10.8) with juvenile idiopathic arthritis (JIA) from a children's hospital-based rheumatology clinic. We conducted cognitive interviews to identify children's comprehension of PAQ items. Interviews were audiotaped, transcribed, and independently analyzed. In phase one, 10 children were interviewed and items modified based on feedback. In phase two, an additional 20 children were interviewed to gather more feedback and further refine the modified items, to create the ASCeND. RESULTS The median interview time was 41 min (IQR 36-56). In phase one, 219 comments were generated regarding directions for recording PA duration, and transportation use, walking, dancing, weight-bearing exercise and cardio fitness. Based on feedback we modified the survey layout, clarified directions and collapsed or defined items to reduce redundancy. In phase two, 95 comments were generated. Most comments related to aerobic fitness and strenuous PA. Children had difficulty recalling total walking and other activities per day. Children used the weather on a particular day, sports practice, or gym schedules to recall time performing activities. The most comments regarding comprehension were generated about the 3-item PA intensity survey, suggesting children had problems responding to intensity items. CONCLUSIONS The newer layout facilitated recall of directions or efficiency in answering items. The 3-item intensity survey was difficult to answer. Sports-specific items helped children more accurately recall the amount of daily PA. The ASCeND appeared to be easy to answer and to comprehend.
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Affiliation(s)
- August Flodén
- Department of Physical Therapy, Stockholm South General Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Eva W. Broström
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Johan von Heideken
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Sara Rostlund
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Rikard Nilsson
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Kristina Löwing
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Maura D. Iversen
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Section of Clinical Sciences, Department of Medicine, Brigham & Women’s Hospital, Boston, MA USA
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, 360 Huntington Avenue 120 E Beharkis Health Sciences Building, Boston, MA 02115 USA
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13
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Ebraheem MF, Sallam RAER, Mohsen MA, El-Kady BA, El-Hawary GE, Baiomy AA. Vascular cell adhesion molecule-1 (VCAM-1), flow mediated dilatation (FMD) and carotid intima media thickness (IMT) in children with juvenile idiopathic arthritis: Relation to disease activity, functional status and fatigue. THE EGYPTIAN RHEUMATOLOGIST 2019. [DOI: 10.1016/j.ejr.2018.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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14
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Heale LD, Dover S, Goh YI, Maksymiuk VA, Wells GD, Feldman BM. A wearable activity tracker intervention for promoting physical activity in adolescents with juvenile idiopathic arthritis: a pilot study. Pediatr Rheumatol Online J 2018; 16:66. [PMID: 30348203 PMCID: PMC6198499 DOI: 10.1186/s12969-018-0282-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 10/03/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Children and adolescents with juvenile idiopathic arthritis (JIA) are less physically active than their healthy peers and are at high risk of missing out on the general health benefits of physical activity. Wearable activity trackers are a promising option for intervening in this population with potential advantages over traditional exercise prescriptions. The objectives of this study were to: (1) determine the feasibility of a wearable activity tracker intervention in adolescents with JIA; and (2) estimate the variability in response to a wearable activity tracker intervention on the physical activity levels of adolescents with JIA. METHODS Participants aged 12-18 years with JIA were recruited during their routine rheumatology clinic visits at a tertiary care hospital. Participants completed the 3-Day Physical Activity Recall self-reported questionnaire at baseline, 1 week and 5 week follow-up. At the 1 week follow up, participants were instructed to start wearing an activity tracker for 28 consecutive days. Participants completed a feasibility questionnaire at their end of study visit. Participant demographics, adherence rates and feasibility outcomes were summarized using descriptive statistics. The effect of wearing a tracker on moderate-to-vigorous physical activity (MVPA) and total metabolic equivalents (METs) per day were analyzed using a paired t-test. RESULTS Twenty-eight participants (74% female; median age 15.1, range 12.8-18.6) were included in the analysis. All of the participants were able to synchronize the activity tracker to a supported device, use the activity tracker correctly and complete the study measurements. On average, participants had activity logged on their smartphone application for 72% of the intervention period. The standard deviation of the change in mean METs/day was 12.148 and for mean MVPA blocks/day was 3.143 over the study period. CONCLUSION Wrist worn activity tracking is a feasible intervention for adolescent patients with JIA. More research is needed to examine the effect of activity tracking on physical activity levels. TRIAL REGISTRATION Not an applicable clinical device trial as per the criteria listed on ClinicalTrials.gov as the primary objective is feasibility.
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Affiliation(s)
- Liane D. Heale
- 0000 0004 0473 9646grid.42327.30Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8 Canada
| | - Saunya Dover
- 0000 0004 0473 9646grid.42327.30Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, 686 Bay St, Toronto, ON M5G 0A4 Canada
| | - Y. Ingrid Goh
- 0000 0004 0473 9646grid.42327.30Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8 Canada ,0000 0004 0473 9646grid.42327.30Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, 686 Bay St, Toronto, ON M5G 0A4 Canada
| | - Victoria A. Maksymiuk
- 0000 0004 0473 9646grid.42327.30Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8 Canada
| | - Greg D. Wells
- 0000 0004 0473 9646grid.42327.30Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8 Canada
| | - Brian M. Feldman
- 0000 0004 0473 9646grid.42327.30Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8 Canada ,0000 0001 2157 2938grid.17063.33Department of Pediatrics and the Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7 Canada
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15
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Riquelme I, do Rosário RS, Vehmaskoski K, Natunen P, Montoya P. Influence of chronic pain in physical activity of children with cerebral palsy. NeuroRehabilitation 2018; 43:113-123. [DOI: 10.3233/nre-172409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Inmaculada Riquelme
- University Institute of Health Sciences Research (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | | | - Kari Vehmaskoski
- JAMK University of Applied Sciences, School of Health and Social Studies, Jyväskylä, Finland
| | - Pekka Natunen
- JAMK University of Applied Sciences, School of Health and Social Studies, Jyväskylä, Finland
| | - Pedro Montoya
- University Institute of Health Sciences Research (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
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16
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Sontichai W, Vilaiyuk S. The correlation between the Childhood Health Assessment Questionnaire and disease activity in juvenile idiopathic arthritis. Musculoskeletal Care 2018; 16:339-344. [PMID: 29573557 DOI: 10.1002/msc.1239] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 01/22/2018] [Accepted: 01/22/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND The Childhood Health Assessment Questionnaire (CHAQ) has been adapted from the Stanford Health Assessment Questionnaire for assessing functional ability in children. The present study aimed to determine the correlation between CHAQ and disease activity in juvenile idiopathic arthritis (JIA) during active and inactive disease. METHODS JIA patients in the Pediatric Department, Ramathibodi Hospital, between January 2011 and December 2013, were included in the study. The CHAQ disability index (DI) and disease activity variables, including active and limited joint count, erythrocyte sedimentation rate, patient's global assessment (PtGA), physician's global assessment (PGA) and 27-joint Juvenile Arthritis Disease Activity Score (JADAS27), were collected from medical records for each patient over six visits. At each visit, each patient was classified as having either active or inactive disease. The correlations between CHAQ-DI and disease activity variables were analysed using Spearman's correlation. RESULTS The classification of 139 JIA patients consisted of enthesitis-related arthritis (30.9%), systemic JIA (28.1%), oligoarthritis (16.5%), rheumatoid factor (RF)-negative polyarthritis (15.1%), RF-positive polyarthritis (6.5%) and undifferentiated arthritis (2.9%). Out of 812 patient visits, 606 were in active disease and 206 were in inactive disease. RF-negative polyarthritis had the highest CHAQ-DI (0.39 ± 0.66), while oligoarthritis had the lowest (0.20 ± 0.32). There was a good correlation between CHAQ-DI and JADAS27, PGA and PtGA in all JIA subtypes (p < 0.05) during active disease, but a poor correlation between CHAQ-DI and disease activity variables during inactive disease. CONCLUSIONS CHAQ-DI had a good correlation with disease activity during active disease but a poor correlation during inactive disease. Therefore, CHAQ is only useful for assessing functional ability during active disease.
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Affiliation(s)
- Watchareewan Sontichai
- Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Division of Allergy, Immunology, and Rheumatology, Faculty of Medicine Chiang Mai University, Chiang Mai, Thailand
| | - Soamarat Vilaiyuk
- Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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17
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Patti A, Maggio MC, Corsello G, Messina G, Iovane A, Palma A. Evaluation of Fitness and the Balance Levels of Children with a Diagnosis of Juvenile Idiopathic Arthritis: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070806. [PMID: 28753965 PMCID: PMC5551244 DOI: 10.3390/ijerph14070806] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/14/2017] [Accepted: 07/16/2017] [Indexed: 12/18/2022]
Abstract
Background: Juvenile idiopathic arthritis is a main cause of physical disability and has high economic costs for society. The purpose of this study was to assess the fitness levels and the postural and balance deficits with a specific test battery. Methods: Fifty-six subjects were enrolled in this study. Thirty-nine healthy subjects were included in the control group and seventeen in the juvenile idiopathic arthritis group. All subjects were evaluated using a posturography system. The fitness level was evaluated with a battery of tests (Abalakov test, sit-up test, hand grip test, backsaver sit and reach, the toe touch test). An unpaired t-test was used to determine differences. Pearson’s correlation coefficient was used to evaluate the correlation between the tests. Results: The battery of tests demonstrated that subjects in the juvenile idiopathic arthritis group have lower fitness levels compared to the control group. The juvenile idiopathic arthritis group showed low postural control with respect to the control group. Pearson analysis of the juvenile idiopathic arthritis group data showed significant correlations between variables. Pearson’s results from the control group data showed a similar trend. Conclusions: The results suggest that the battery of tests used could be an appropriate tool. However, we highlight that these conclusions need to be supported by other studies with a larger population scale.
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Affiliation(s)
- Antonino Patti
- Department of Psychology and Educational Science, University of Palermo, 90133 Palermo, Italy.
| | - Maria Cristina Maggio
- Department of Science for the Promotion of Health and Infant Maternal "G. D'Alessandro", University of Palermo, 90133 Palermo, Italy.
| | - Giovanni Corsello
- Department of Science for the Promotion of Health and Infant Maternal "G. D'Alessandro", University of Palermo, 90133 Palermo, Italy.
| | - Giuseppe Messina
- Department of Psychology and Educational Science, University of Palermo, 90133 Palermo, Italy.
- Posturalab Italy, 90131 Palermo, Italy.
| | - Angelo Iovane
- Department of Psychology and Educational Science, University of Palermo, 90133 Palermo, Italy.
| | - Antonio Palma
- Department of Psychology and Educational Science, University of Palermo, 90133 Palermo, Italy.
- Regional Sport School of Sicily CONI (Olympic National Italian Committee), 90141 Palermo, Italy.
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18
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Bos GJFJ, Lelieveld OTHM, Armbrust W, Sauer PJJ, Geertzen JHB, Dijkstra PU. Physical activity in children with Juvenile Idiopathic Arthritis compared to controls. Pediatr Rheumatol Online J 2016; 14:42. [PMID: 27387754 PMCID: PMC4936199 DOI: 10.1186/s12969-016-0102-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 06/30/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To compare physical activity (PA) in children with juvenile idiopathic arthritis (JIA) with controls and to analyse the effect of disease specific factors on PA in children with JIA treated according to current treatment regimes. METHODS PA was measured with a 7-day activity diary and expressed as physical activity level (PAL). Moderate to vigorous physical activity (MVPA) (hours/day) and sedentary time (hours/day) was determined. In children with JIA, medication, the number of swollen and/or painful joints, disease activity, functional ability, pain and well-being was determined. Multivariate regression analysis was performed to analyze differences in PA between JIA and controls, adjusted for influences of age, gender, season, Body Mass Index (BMI) and to analyze predictors of PA in JIA patients. RESULTS Seventy-six children with JIA (26 boys and 50 girls, mean ± SD age 10.0 ± 1.4 years) and 131 controls (49 boys and 82 girls, mean ± SD age 10.4 ± 1.2 years) participated in this study. Children with JIA had a significantly lower PAL (0.10, p = 0.01) corrected for age, BMI, gender and season. They spent less time in MVPA (0.41 h/day, p = 0.06) and had a significantly higher mean time spent in sedentary activities (0.59 h/day, p 0.02) compared to controls. The activity level of children with JIA was related to age, gender, season, feeling of well-being and pain. CONCLUSION Children with JIA have a lower PAL, spent less time in MVPA and spent more time on sedentary activities compared to controls despite current medical treatment and PA encouragement. TRIAL REGISTRATION Data of the children with JIA are from the Rheumates@work study ISRCTN92733069 .
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Affiliation(s)
- G. J. F. Joyce Bos
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands
| | - Otto T. H. M. Lelieveld
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands
| | - Wineke Armbrust
- Department of Pediatric Rheumatology, University of Groningen, University Medical Center Groningen, Beatrix Children’s Hospital, PO Box 30001, 9700 RB Groningen, The Netherlands
| | - Pieter J. J. Sauer
- University of Groningen, University Medical Center Groningen, Beatrix Children’s Hospital, PO Box 30001, 9700 RB Groningen, The Netherlands
| | - Jan H. B. Geertzen
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands
| | - Pieter U. Dijkstra
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands ,Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands
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Duché P, Rochette E, Merlin E. Reply to the Letter to the Editor: "The need for differentiating between exercise, physical activity, and training." Budde et al. Autoimmun Rev (2015). Autoimmun Rev 2015; 15:289-90. [PMID: 26640158 DOI: 10.1016/j.autrev.2015.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 11/25/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Pascale Duché
- Clermont Université, Université Blaise Pascal, Laboratoire des Adaptations Métaboliques en conditions Physiologiques et Physiopathologiques (AME2P), EA 3533, 63001 Clermont-Ferrand, France
| | - Emmanuelle Rochette
- Clermont Université, Université Blaise Pascal, Laboratoire des Adaptations Métaboliques en conditions Physiologiques et Physiopathologiques (AME2P), EA 3533, 63001 Clermont-Ferrand, France; CHU Clermont-Ferrand, Pédiatrie, Hôpital Estaing, 63003 Clermont-Ferrand, France; INSERM, CIC 1405, Unité CRECHE, 63001 Clermont-Ferrand, France.
| | - Etienne Merlin
- CHU Clermont-Ferrand, Pédiatrie, Hôpital Estaing, 63003 Clermont-Ferrand, France; INSERM, CIC 1405, Unité CRECHE, 63001 Clermont-Ferrand, France
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Juvenile idiopathic arthritis and physical activity: possible inflammatory and immune modulation and tracks for interventions in young populations. Autoimmun Rev 2015; 14:726-34. [PMID: 25936296 DOI: 10.1016/j.autrev.2015.04.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 04/12/2015] [Indexed: 12/26/2022]
Abstract
Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease characterized by persistent joint inflammation that manifests as joint pain and swelling and limited range of joint motion. In healthy subjects, the literature reports that physical activity has an anti-inflammatory effect. In JIA patients, exercise could be used as a therapeutic tool to counteract disease-related inflammation and thereby improve clinical symptoms, although transient flare of pain could be the price to pay. Indeed, in patients with a chronic inflammatory disease, physical activity is prone to exacerbate underlying inflammatory stress. Physical activity improves quality of life and symptoms in JIA patients, but the mechanisms of action remain unclear. This review focuses on the mechanisms underlying exercise-induced immune and hormonal changes. Data on the impact of acute and chronic physical activities on the secretion of hormones and other molecules such as miRNA or peptides involved in the inflammatory process in JIA was compiled and summarized, and the key role of the biological effect of muscle-derived interleukin 6 in the exercise-induced modulation of pro/anti-inflammatory balance is addressed. We also go on to review the effect of training and type of exercise on cytokine response. This review highlights the beneficial effect of physical exercise in children with JIA and potential effect of exercise on the balance between pro- and anti-inflammatory response.
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