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Yildiz-Kabak V, Buran S, Karaca NB, Tufekci O, Aliyev E, Bayindir Y, Atasavun Uysal S, Bilginer Y, Unal E, Ozen S. Examination of Physical Functions, Activity and Participation in Children with Juvenile Idiopathic Arthritis. Phys Occup Ther Pediatr 2024:1-14. [PMID: 38992979 DOI: 10.1080/01942638.2024.2376058] [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: 12/27/2023] [Accepted: 06/26/2024] [Indexed: 07/13/2024]
Abstract
AIMS To examine physical functions, activity, and participation level, and associated factors with participation in children with juvenile idiopathic arthritis (JIA) across the International Classification of Functioning Disability and Health-Children and Youth. METHODS 49 children (Girl/Boy:28/21) aged between 7 and 18 years (Mean: 13.4 ± 3.3) were included. To evaluate body structure/functioning; pain, fatigue, disease activity, and motor functions were assessed. Childhood Health Assessment Questionnaire and Juvenile Arthritis Biopsychosocial and Clinical Questionnaire were used to determine activity level. Child and Adolescent Scale of Participation was used to assess participation. RESULTS Mild level of pain (2.0 ± 2.3), disease activity (2.0 ± 2.3), and fatigue (4.1 ± 4.0) were recorded. Decrease in motor functions was determined in 75% of children, while 61% of whom had activity-related disability. There was mild to moderate participation restrictions, and participation was significantly associated with age (r = -0.29), pain severity (r = -0.31), disease activity (r = -0.39), motor functions (r = 0.33), and activity level (r = -0.43), (p ˂ 0.05). CONCLUSIONS Majority of children with JIA have deteriorations in physical functions, activity, and participation. Age, pain, disease activity, motor functions and activity level were associated with participation level. Children with JIA should be regularly evaluated multi-directional and they should be referred to rehabilitation programs to increase functionality and participation.
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Affiliation(s)
- Vesile Yildiz-Kabak
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Sinan Buran
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Nur Banu Karaca
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Orkun Tufekci
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Emil Aliyev
- Faculty of Medicine, Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey
| | - Yagmur Bayindir
- Faculty of Medicine, Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey
| | - Songul Atasavun Uysal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Yelda Bilginer
- Faculty of Medicine, Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey
| | - Edibe Unal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Seza Ozen
- Faculty of Medicine, Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey
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Huang HYR, Wireko AA, Miteu GD, Khan A, Roy S, Ferreira T, Garg T, Aji N, Haroon F, Zakariya F, Alshareefy Y, Pujari AG, Madani D, Papadakis M. Advancements and progress in juvenile idiopathic arthritis: A Review of pathophysiology and treatment. Medicine (Baltimore) 2024; 103:e37567. [PMID: 38552102 PMCID: PMC10977530 DOI: 10.1097/md.0000000000037567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/20/2024] [Indexed: 04/02/2024] Open
Abstract
Juvenile idiopathic arthritis (JIA) is a chronic clinical condition characterized by arthritic features in children under the age of 16, with at least 6 weeks of active symptoms. The etiology of JIA remains unknown, and it is associated with prolonged synovial inflammation and structural joint damage influenced by environmental and genetic factors. This review aims to enhance the understanding of JIA by comprehensively analyzing relevant literature. The focus lies on current diagnostic and therapeutic approaches and investigations into the pathoaetiologies using diverse research modalities, including in vivo animal models and large-scale genome-wide studies. We aim to elucidate the multifactorial nature of JIA with a strong focus towards genetic predilection, while proposing potential strategies to improve therapeutic outcomes and enhance diagnostic risk stratification in light of recent advancements. This review underscores the need for further research due to the idiopathic nature of JIA, its heterogeneous phenotype, and the challenges associated with biomarkers and diagnostic criteria. Ultimately, this contribution seeks to advance the knowledge and promote effective management strategies in JIA.
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Affiliation(s)
- Helen Ye Rim Huang
- Faculty of Medicine and Health Science, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Goshen David Miteu
- School of Biosciences, Biotechnology, University of Nottingham, Nottingham, UK
- Department of Biochemistry, Caleb University Lagos, Lagos, Nigeria
| | - Adan Khan
- Kent and Medway Medical School, Canterbury, Kent, UK
| | - Sakshi Roy
- School of Medicine, Queen’s University Belfast, Belfast, Northern Ireland, UK
| | - Tomas Ferreira
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Tulika Garg
- Government Medical College and Hospital Chandigarh, Chandigarh, India
| | - Narjiss Aji
- Faculty of Medicine and Pharmacy of Rabat, Rabat, Morocco
| | - Faaraea Haroon
- Faculty of Public Health, Health Services Academy, Islamabad, Pakistan
| | - Farida Zakariya
- Faculty of Pharmaceutical Sciences, Ahmadu Bello University Zaria, Zaria, Nigeria
| | - Yasir Alshareefy
- School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Anushka Gurunath Pujari
- Faculty of Medicine and Health Science, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Djabir Madani
- UCD Lochlann Quinn School of Business and Sutherland School of Law, University College Dublin, Dublin, Ireland
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, University of Witten-Herdecke, Wuppertal, Germany
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Ozdemir BC, Savci S, Tanriverdi A, Ozcan Kahraman B, Isguder R, Makay B, Unsal E. Determinants of physical activity level in children and adolescents with juvenile idiopathic arthritis. Z Rheumatol 2024; 83:71-77. [PMID: 37010629 DOI: 10.1007/s00393-023-01340-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2023] [Indexed: 04/04/2023]
Abstract
OBJECTIVE One of the most frequently discussed physical parameters in juvenile idiopathic arthritis (JIA) is physical activity level. There is limited evidence about determinants of physical activity level in JIA. In this study, we aimed to investigate the determinants of physical activity level in children and adolescents with JIA. MATERIALS AND METHODS Thirty-two JIA patients and 18 age- and sex-matched healthy individuals were included in the study. The age range was 8-18 years. Sociodemographic and clinical data of the participants were recorded. In both groups, anthropometry, fatigue, pain, knee extension muscle strength, gait variables, functional exercise capacity assessed by six-minute walk test (6MWT), and arterial stiffness were evaluated. Physical activity level was assessed by an accelerometer. RESULTS The disease activity level of the patients was low. Pain and fatigue scores were significantly higher in the JIA group compared to healthy controls (p < 0.05). Walking speed, physical activity level, time spent in low-intensity physical activity, time spent in moderate-to-vigorous-intensity physical activity, and 6MWT distance were significantly lower than in healthy controls (p < 0.05). Quadriceps muscle strength and arterial stiffness assessment results were similar in both groups (p > 0.05). In the JIA group, there was a positive correlation between physical activity and age, height, fat-free body mass, quadriceps muscle strength, and 6MWT distance (p < 0.05). Also, there was a negative correlation between physical activity and pain, fatigue, and cadence. Physical activity level was independently associated with 6MWT distance (42.9% of the variability). CONCLUSION In mildly affected JIA patients, gait speed, functional exercise capacity, and physical activity level are affected. Functional exercise capacity is a determinant of physical activity level in JIA.
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Affiliation(s)
- Berk Can Ozdemir
- Health Science Institute, Dokuz Eylul University, Izmir, Turkey.
| | - Sema Savci
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Aylin Tanriverdi
- Health Science Institute, Dokuz Eylul University, Izmir, Turkey
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Buse Ozcan Kahraman
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Rana Isguder
- Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Balahan Makay
- Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Erbil Unsal
- Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Woolnough LU, Lentini L, Bhavsar PH, Thomas MF, Casella ZM, Vincent HK. Child and Caregiver Beliefs of Importance of Physical Function and Quality of Life in Juvenile Idiopathic Arthritis: A Survey Study. Pediatr Phys Ther 2024; 36:88-93. [PMID: 37820355 DOI: 10.1097/pep.0000000000001060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
PURPOSE To evaluate patient-caregiver beliefs of relative importance across 4 domains while living with juvenile idiopathic arthritis (JIA). METHODS This was a cross-sectional, anonymous survey study conducted in an academic medical center. Participants with JIA and caregivers (N = 151) completed a Likert-style survey to rate items by importance of knowledge about 4 domains: medications, physical activity, routine measures, and quality of life. RESULTS Knowledge of medication issues ranked higher than the remaining 3 domains (4.2 ± 0.7 points vs 4.0 ± 0.7, 4.1 ± 0.8, and 4.0 ± 0.9 points, respectively; P = .026; P = .026). Compared with caregivers, participants rated importance lower for all 4 domains. CONCLUSIONS Gait and physical activity and well-being are not uniformly measured as part of routine clinical care and disease tracking in JIA. Both participants and caregivers ranked knowledge of physical activity similarly to routine office measures and quality of life. Inclusion of these measures in routine care could improve people centeredness and inform treatment plans.
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Affiliation(s)
- Leandra U Woolnough
- Departments of Pediatrics (Dr Woolnough and Mr Lentini) and Physical Medicine and Rehabilitation (Dr Vincent), College of Medicine, University of Florida, Gainesville, Florida; Applied Physiology and Kinesiology Program (Mss Bhavsar and Thomas and Mr Casella), University of Florida, Gainesville, Florida
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Palumbo BT, Shen V, Andrews R, Scott R. Case Report of Successful Bilateral Total Knee Arthroplasty: 46 Years and Still Going. JBJS Case Connect 2023; 13:01709767-202309000-00002. [PMID: 37418566 DOI: 10.2106/jbjs.cc.23.00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
CASE A 63-year-old woman with 46-year-old bilateral cemented total knee arthroplasty (TKA) presented to our clinic for routine evaluation. She was diagnosed with idiopathic juvenile arthritis at the age of 17. Radiographically she had well-fixed implants bilaterally without bone-cement lucency. She is ambulating without a limp, pain, or an assistance aid. CONCLUSION We report TKA implants that lasted for 46 years. Literature suggests that most TKAs can last up to 20 to 25 years, but there are few reports that document implant survivorship longer than that. Our report demonstrates the possibility of long survivorship in TKA implants.
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Affiliation(s)
- Brian T Palumbo
- Florida Orthopaedic Institute, Temple Terrace, Florida
- University of Southern Florida Health Morsani College of Medicine, Tampa, Florida
| | - Victor Shen
- Florida Orthopaedic Institute, Temple Terrace, Florida
- University of Southern Florida Health Morsani College of Medicine, Tampa, Florida
| | - Reed Andrews
- Florida Orthopaedic Institute, Temple Terrace, Florida
- University of Southern Florida Health Morsani College of Medicine, Tampa, Florida
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Kraft M, Hansmann S. [Analysis of movement disorders in paediatric and adolescent rheumatology]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023:10.1007/s00132-023-04406-1. [PMID: 37391675 DOI: 10.1007/s00132-023-04406-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/02/2023]
Abstract
Rheumatic diseases in childhood and adolescence like juvenile idiopathic arthritis can cause movement disorders due to pain, swelling and limited range of motion. This article describes different possibilities and results of movement analysis for rheumatic diseases. The influence of JIA on specific movements in individual joints and complex movements such as gait is examined. The results of gait analyses show a great influence of the disease on spatiotemporal parameters such as gait speed, cadence and stride length, on joint angles during walking and on torques and forces. Furthermore, the importance of gait analysis for estimating the efficacy of interventions like intra-articular steroids is described. This article provides a summary of current studies on the effects of rheumatic diseases on movement disorders in children and adolescents, as well as an outlook on the increasing importance of movement analysis for therapy monitoring and optimisation.
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Affiliation(s)
- Mareen Kraft
- Abteilung I - Allgemeine Pädiatrie, Hämatologie und Onkologie, Universitätsklinik für Kinder- und Jugendmedizin Tübingen, Tübingen, Deutschland
| | - Sandra Hansmann
- Abteilung III - Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, Universitätsklinik für Kinder- und Jugendmedizin Tübingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Deutschland.
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Vega-Fernandez P, De Ranieri D, Oberle E, Clark M, Bukulmez H, Lin C, Shenoi S, Thatayatikom A, Woolnough L, Benham H, Brunner E, Henrickson M, Pratt LR, Proulx-Gauthier JP, Janow G, Cassedy A, Ting TV, Roth J. Comprehensive and reliable sonographic assessment and scoring system for inflammatory lesions of the paediatric ankle. Rheumatology (Oxford) 2023; 62:2239-2246. [PMID: 36308429 PMCID: PMC10234197 DOI: 10.1093/rheumatology/keac622] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/30/2022] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE The clinical decision-making process in paediatric arthritis lacks an objective, reliable bedside imaging tool. The aim of this study was to develop a US scanning protocol and assess the reliability of B-mode and Doppler scoring systems for inflammatory lesions of the paediatric ankle. METHODS As part of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) US group, 19 paediatric rheumatologists through a comprehensive literature review developed a set of standardized views and scoring systems to assess inflammatory lesions of the synovial recesses as well as tendons of the paediatric ankle. Three rounds of scoring of still images were followed by one practical exercise. Agreement among raters was assessed using two-way single score intraclass correlation coefficients (ICC). RESULTS Of the 37 initially identified views to assess the presence of ankle synovitis and tenosynovitis, nine views were chosen for each B-mode and Doppler mode semi-quantitative evaluation. Several scoring exercises and iterative modifications resulted in a final highly reliable scoring system: anterior tibiotalar joint ICC: 0.93 (95% CI 0.92, 0.94), talonavicular joint ICC: 0.86 (95% CI 0.81, 0.90), subtalar joint ICC: 0.91 (95% CI 0.88, 0.93) and tendons ICC: 0.96 (95% CI 0.95, 0.97). CONCLUSION A comprehensive and reliable paediatric ankle US scanning protocol and scoring system for the assessment of synovitis and tenosynovitis were successfully developed. Further validation of this scoring system may allow its use as an outcome measure for both clinical and research applications.
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Affiliation(s)
- Patricia Vega-Fernandez
- Division of Rheumatology, Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Deirdre De Ranieri
- Division of Rheumatology, Department of Pediatrics, Northwestern Feinberg School of Medicine, Ann and Robert H. Lurie Children’s Hospital, Chicago, IL, USA
| | - Edward Oberle
- Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Matthew Clark
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hulya Bukulmez
- Division of Pediatric Rheumatology, Department of Pediatrics, Metro Health Medical System, Case Western Reserve University, Cleveland, OH, USA
| | - Clara Lin
- Department of Pediatrics, Children’s Hospital Colorado, Aurora, CO, USA
| | - Susan Shenoi
- Seattle Children’s Hospital and Research Center University of Washington, Seattle, WA, USA
| | - Akaluck Thatayatikom
- AdventHealth Medical Group Pediatric Rheumatology and Immunology, Orlando, FL, USA
| | | | - Heather Benham
- Department of Pediatrics, Scottish Rite for Children, Frisco, TX, USA
| | - Emily Brunner
- Department of Pediatrics, Geisinger Medical Center, Danville, PA, USA
| | - Michael Henrickson
- Division of Rheumatology, Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Laura R Pratt
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Ginger Janow
- Joseph M. Sanzari Children’s Hospital, Hackensack, NJ, USA
| | - Amy Cassedy
- Division of Biostatistics and Epidemiology, Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Tracy V Ting
- Division of Rheumatology, Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Räsänen K, Markula-Patjas K, Kantanen S, Sipilä K, Lakka TA, Arikoski P, Piippo-Savolainen E. Impaired cardiorespiratory and neuromuscular fitness in children and adolescents with juvenile idiopathic arthritis: a cross-sectional case-control study in the era of biologic drug therapies. Pediatr Rheumatol Online J 2023; 21:26. [PMID: 36932386 PMCID: PMC10022213 DOI: 10.1186/s12969-023-00808-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/11/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND In recent years, biologic drug therapies have altered the course of juvenile idiopathic arthritis (JIA) possibly also improving the patients' physical fitness. However, studies measuring both cardiorespiratory and muscular fitness in children with JIA are sparse and have failed to show consistent results. Our aim was to assess both cardiorespiratory and neuromuscular fitness and contributing factors in children and adolescents with JIA in the era of biologic drug therapies. METHODS This cross-sectional study consisted of 73 JIA patients (25 boys, 48 girls) aged 6.8- 17.5 years and 73 healthy age- and sex-matched controls, investigated in 2017-2019. Cardiorespiratory fitness was assessed by maximal ergospirometry and neuromuscular fitness by speed, agility, balance, and muscle strength tests. RESULTS Means (± SD) of maximal workload (Wmax/kg) and peak oxygen uptake (VO2peak/kg,) were lower in JIA patients than in controls (Wmax/kg: 2.80 ± 0.54 vs. 3.14 ± 0.50 Watts, p < 0.01; VO2peak/kg: 38.7 ± 7.53 vs. 45.8 ± 6.59 ml/min/kg, p < 0.01). Shuttle-run, sit-up and standing long jump test results were lower in JIA patients than in controls (p < 0.01). Mean (± SD) daily activity was lower (89.0 ± 44.7 vs. 112.7 ± 62.1 min/day, p < 0.05), and sedentary time was higher (427 ± 213 vs. 343 ± 211 min/day, p < 0.05) in JIA patients compared to controls. Physical activity and cardiorespiratory or neuromuscular fitness were not associated with disease activity. CONCLUSIONS JIA patients were physically less active and had lower cardiorespiratory and neuromuscular fitness than their same aged controls with no JIA. Therefore, JIA patients should be encouraged to engage in physical activities as a part of their multidisciplinary treatment protocols to prevent adverse health risks of low physical activity and fitness.
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Affiliation(s)
- Kati Räsänen
- Pediatric Research Unit, University of Eastern Finland and Kuopio University Hospital, Kuopio, PL100, 70029 KYS, Finland.
| | - Kati Markula-Patjas
- Center for Child Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Saija Kantanen
- Center for Child Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Kalle Sipilä
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Pekka Arikoski
- Pediatric Research Unit, University of Eastern Finland and Kuopio University Hospital, Kuopio, PL100, 70029 KYS, Finland
| | - Eija Piippo-Savolainen
- Pediatric Research Unit, University of Eastern Finland and Kuopio University Hospital, Kuopio, PL100, 70029 KYS, Finland
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Song Y, Shao E, Bíró I, Baker JS, Gu Y. Finite element modelling for footwear design and evaluation: A systematic scoping review. Heliyon 2022; 8:e10940. [PMID: 36247144 PMCID: PMC9563159 DOI: 10.1016/j.heliyon.2022.e10940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/04/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022] Open
Abstract
Finite element modelling has become an efficient tool for an in-depth understanding of the foot, footwear biomechanics and footwear optimization. The aim of this paper was to provide an updated overview in relation to the footwear finite element (FE) analysis published since 2000. The paper will attempt to outline the main challenges and research gaps that need confronting in the further development of realistic and accurate models for clinical and industrial applications. English databases of the Web of Science and PubMed were used to search (‘finite element’ OR ‘FEA’ OR ‘computational model’) AND (‘shoe’ OR ‘footwear’) until 16 December 2021. Articles that conducted FE analyses on the whole foot and footwear structures were included in this review. Twelve articles met the eligibility criteria, and were grouped into three categories for further analysis, (1) finite element modelling of the foot and high-heeled shoes; (2) finite element modelling of the foot and boot; (3) finite element modelling of the foot and sports shoe. Even though most of the existing foot-shoe FE analyses were performed under certain simplifications and assumptions, they have provided essential contributions in identifying the mechanical response of the foot in casual or athletic footwear. Further to this, the results have provided information in relation to optimizing footwear design to enhance functional performance. Nevertheless, further simulations still present several challenges, including reliable data information for geometry reconstruction, the balance between accurate details and computational cost, accurate representations of material properties, realistic boundary and loading conditions, and thorough model validation. In addition, some research gaps in terms of the coverage of footwear design, the consideration of insole/orthosis and socks, and the internal and external validity of the FE design should be fully covered.
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Affiliation(s)
- Yang Song
- Faculty of Sports Science, Ningbo University, Ningbo, China,Doctoral School on Safety and Security Sciences, Óbuda University, Budapest, Hungary,Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Enze Shao
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - István Bíró
- Doctoral School on Safety and Security Sciences, Óbuda University, Budapest, Hungary,Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Julien Steven Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China,Corresponding author.
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10
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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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11
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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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Proof-of-Concept Study of the Use of Accelerometry to Quantify Knee Joint Movement and Assist with the Diagnosis of Juvenile Idiopathic Arthritis. TECHNOLOGIES 2022. [DOI: 10.3390/technologies10040076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. Seven children and young people (CYP) with a diagnosis of JIA and suspected active arthritis of a single knee joint were recruited for this proof-of-concept study. The presence of active arthritis was confirmed by clinical examination. Four tri-axial accelerometers were integrated individually in elastic bands and placed above and below each knee. Participants performed ten periodic flexion-extensions of each knee joint while lying down, followed by walking ten meters in a straight path. The contralateral (non-inflamed) knee joint acted as a control. Accelerometry data were concordant with the results of clinical examination in six out of the seven patients recruited. There was a significant difference between the accelerometry measured range of movement (ROM, p-value = 0.032) of the knees with active arthritis and the healthy contralateral knees during flexion-extension. No statistically significant difference was identified between the ROM of the knee joints with active arthritis and healthy knee joints during the walking test. The study demonstrated that accelerometry may help in differentiating between healthy knee joints and those with active arthritis; however, further research is required to confirm these findings.
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Fellas A, Singh-Grewal D, Chaitow J, Santos D, Clapham M, Coda A. Effect of customised preformed foot orthoses on gait parameters in children with juvenile idiopathic arthritis: A multicentre randomised clinical trial. Gait Posture 2022; 95:93-99. [PMID: 35468489 DOI: 10.1016/j.gaitpost.2022.04.017] [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: 07/06/2021] [Revised: 04/09/2022] [Accepted: 04/18/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Children with juvenile idiopathic arthritis (JIA) can experience significant physical impairment of the lower extremity. Prolonged joint disease and symptoms may cause gait alterations such as reduced walking speed and increased plantar pressures in diseased areas of their feet. There is limited robust clinical trials investigating the effect of non-invasive mechanical therapies such as foot orthoses (FOs) on improving gait parameters in children with JIA. RESEARCH QUESTION Are customised preformed FOs effective in improving gait parameters in children with JIA? METHODS A multicentre, parallel design, single-blinded randomised clinical trial was used to assess the gait impacts of customised preformed FOs on children with JIA. Children with a diagnosis of JIA, exhibiting lower limb symptoms and aged 5-18 were eligible. The trial group received a low-density full length, Slimflex Simple device which was customised chair side and the control group received a sham device. Peak pressure and pressure time integrals were used as the main gait outcomes and were measured using portable Tekscan gait analysis technology at baseline, 3 and 6 months. Differences at each follow-up were assessed using the Wilcoxon rank sum test. RESULTS 66 participants were recruited. Customised preformed FOs were effective in altering plantar pressures in children with JIA versus a control device. Reductions of peak pressures and pressure time integrals in the heel, forefoot and 5th metatarsophalangeal joint were statistically significant in favour of the trial group. This was associated with statistically significant increased midfoot contact with the trial device at baseline, 3 and 6-month data collections. The trial intervention was safe and well accepted by participants, which is reflected in the high retention rate (92%). SIGNIFICANCE Clinicians may prescribe customised preformed FOs in children with JIA to deflect pressure from painful joints and redistribute from high pressure areas such as the rearfoot and forefoot.
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Affiliation(s)
- Antoni Fellas
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Australia.
| | - Davinder Singh-Grewal
- The Sydney Children's Hospital Network Randwick, and Westmead, Australia; University of Sydney Discipline of Paediatrics and Child Health, Sydney, Australia; University of New South Wales, School of Women's and Children's Health, Australia
| | - Jeffrey Chaitow
- The Sydney Children's Hospital Network Randwick, and Westmead, Australia
| | - Derek Santos
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK
| | | | - Andrea Coda
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Australia
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14
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Xiang L, Mei Q, Wang A, Fernandez J, Gu Y. Gait biomechanics evaluation of the treatment effects for hallux valgus patients: A systematic review and meta-analysis. Gait Posture 2022; 94:67-78. [PMID: 35247827 DOI: 10.1016/j.gaitpost.2022.02.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 02/19/2022] [Accepted: 02/24/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hallux valgus (HV) is a foot deformity characterized by lateral deviation of the big toe and medial deviation of the first metatarsal. RESEARCH QUESTION This study aimed to shed light on the treatment effects of different interventions and surgical procedures for HV deformity to determine the effectiveness of gait biomechanics correction. METHODS English-language searches of the electronic databases were conducted in the Cochrane Library, Web of Science, PubMed, Scopus, and Embase. Gait biomechanics evaluation before and after conservative or operative treatments was essential for inclusion in this review. Methodological quality was assessed by the Institute of Health Economics (IHE) quality appraisal tool. All pooled analysis was based on the random-effects model. RESULTS Twenty-five articles (1003 participants) were identified in this review. Three studies chose conservative therapies for HV deformity, incorporating foot orthotics and minimalist running intervention, and surgeries were performed in twenty-two studies. For the pressure parameter alteration under the hallux, the effect size (ES) in the conservative treatment subgroup was - 0.95 with 95%CI [- 1.69, - 0.21]. It demonstrated a moderate ES of - 0.44% and 95%CI [- 0.81, - 0.07] in the surgery subgroup. The five operations' peak pressure alteration under the hallux demonstrated a moderate ES of - 0.45% and 95%CI [- 0.54, - 0.36]. SIGNIFICANCE Both non-operative and operative treatments could achieve the forefoot pressure redistribution, decreasing loading beneath the hallux and first metatarsal regions,However, the treatment effects of surgeries were not very robust. The percutaneous DSTR-Akin technique is recommended as an adequate operative treatment, with a large ES and moderate heterogeneity. The negative gait return effect should be noticed while using Scarf osteotomy, despite positive clinical and radiographic outcomes.
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Affiliation(s)
- Liangliang Xiang
- Faculty of Sports Science, Ningbo University, Ningbo, China; Research Academy of Grand Health, Ningbo University, Ningbo, China; Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo, China; Research Academy of Grand Health, Ningbo University, Ningbo, China; Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Alan Wang
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand; Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Justin Fernandez
- Research Academy of Grand Health, Ningbo University, Ningbo, China; Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand; Department of Engineering Science, The University of Auckland, Auckland, New Zealand
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China; Research Academy of Grand Health, Ningbo University, Ningbo, China; Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.
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15
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Mian Q, Rumsey DG, Verschuren O, Moez EK, Roy M, Kaup C, Pritchard L. Reference Values for the Six Minute Walk Test in Children with Juvenile Idiopathic Arthritis. Phys Occup Ther Pediatr 2022; 42:187-197. [PMID: 34167453 DOI: 10.1080/01942638.2021.1934239] [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] [Indexed: 10/21/2022]
Abstract
AIMS To (1) describe six-minute walk test (6MWT) reference values for children with Juvenile Idiopathic Arthritis (JIA) and (2) explore predictors of 6MWT distance. A secondary objective was to determine how 6MWT distances of children with JIA compare to those of children without JIA reported in the literature. METHODS Demographic, clinical, height, weight and 6MWT data were extracted from clinical records of 120 children with JIA (70.8% female, mean age=12.4 ± 3.2 years) who attended a follow-up rheumatology clinic. A total of 272 6MWTs were included in the analyses. Linear mixed effects modeling was used to determine the relationship between predictive variables and 6MWT distance. 6MWT distances were compared to predicted values using published equations for estimating 6MWT distances in children without JIA. RESULTS Height, weight, and age were predictive of 6MWT distance (R2 = 0.62). Mean 6MWT distances for children with JIA were lower than those reported for children without JIA (p < 0.001). Mean 6MWT distance was 84% and 78% of predicted values for children without JIA. CONCLUSION The reference values and associated predictive model have application for assessing exercise capacity in children with JIA.
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Affiliation(s)
- Qaasim Mian
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Dax G Rumsey
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Olaf Verschuren
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine, Utrecht University, Utrecht, The Netherlands
| | - Elham K Moez
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Roy
- Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Cara Kaup
- Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Lesley Pritchard
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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