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Silva CG, Santulhão M, Serrado A, Soares M, Morais N. Disability, Physical Activity, and Their Correlates in Patients With Inflammatory Bowel Disease: A Portuguese Cross-Sectional Survey. Gastroenterol Nurs 2024; 47:265-276. [PMID: 39087992 DOI: 10.1097/sga.0000000000000809] [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] [Received: 08/20/2022] [Accepted: 12/16/2023] [Indexed: 08/02/2024] Open
Abstract
Knowledge about disability and physical activity is critical for enhancing self- and clinical management of inflammatory bowel disease, but the interplay between the two is unknown. This study aimed to explore the correlates of disability and physical activity in patients with inflammatory bowel disease. A cross-sectional online survey was conducted in 2019 in Portuguese patients (n = 108) capturing disability, clinical factors including disease status and comorbidities, physical activity habits, and barriers. The magnitude of disability was moderate (mean [95% confidence interval] = 41.85 [38.39, 45.31]). Disease activity and comorbidities were the most important predictors of disability (Model 2, F(102) = 20.285, p < .001, R2 = 0.499, R2adj = 0.443). About 62% of the participants engaged in moderate (31.5%) to vigorous (30.6%) physical activities. Perceived effort to engage in physical activities was the sole predictor of total weekly physical activity (R2 = 0.070, R2adj = 0.044, p = .006). The amount of disability and physical activity were poorly associated (ρ = -0.144, p = .068). Findings encourage gastroenterology nurses and other healthcare providers involved in the comprehensive care of patients with gastrointestinal disorders to recommend regular physical activity to these patients as part of an overall health enhancement strategy. Disability and back pain should be given further attention.
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Affiliation(s)
- Cândida G Silva
- Cândida G. Silva, PhD, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Mariana Santulhão, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Condomínio Residencial Sénior-Montepio Rainha Dona Leonor, Caldas da Rainha, Portugal
- Alícia Serrado, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; ConMeFis-Consultório Médico de Fisiatria, Peniche, Portugal
- Mariana Soares, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Centro Hospitalar do Oeste, E.P.E.-Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
- Nuno Morais, MSc, PT, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; CDRSP-Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, Leiria, Portugal; Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
| | - Mariana Santulhão
- Cândida G. Silva, PhD, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Mariana Santulhão, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Condomínio Residencial Sénior-Montepio Rainha Dona Leonor, Caldas da Rainha, Portugal
- Alícia Serrado, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; ConMeFis-Consultório Médico de Fisiatria, Peniche, Portugal
- Mariana Soares, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Centro Hospitalar do Oeste, E.P.E.-Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
- Nuno Morais, MSc, PT, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; CDRSP-Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, Leiria, Portugal; Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
| | - Alícia Serrado
- Cândida G. Silva, PhD, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Mariana Santulhão, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Condomínio Residencial Sénior-Montepio Rainha Dona Leonor, Caldas da Rainha, Portugal
- Alícia Serrado, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; ConMeFis-Consultório Médico de Fisiatria, Peniche, Portugal
- Mariana Soares, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Centro Hospitalar do Oeste, E.P.E.-Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
- Nuno Morais, MSc, PT, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; CDRSP-Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, Leiria, Portugal; Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
| | - Mariana Soares
- Cândida G. Silva, PhD, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Mariana Santulhão, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Condomínio Residencial Sénior-Montepio Rainha Dona Leonor, Caldas da Rainha, Portugal
- Alícia Serrado, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; ConMeFis-Consultório Médico de Fisiatria, Peniche, Portugal
- Mariana Soares, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Centro Hospitalar do Oeste, E.P.E.-Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
- Nuno Morais, MSc, PT, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; CDRSP-Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, Leiria, Portugal; Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
| | - Nuno Morais
- Cândida G. Silva, PhD, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Mariana Santulhão, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Condomínio Residencial Sénior-Montepio Rainha Dona Leonor, Caldas da Rainha, Portugal
- Alícia Serrado, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; ConMeFis-Consultório Médico de Fisiatria, Peniche, Portugal
- Mariana Soares, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Centro Hospitalar do Oeste, E.P.E.-Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
- Nuno Morais, MSc, PT, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; CDRSP-Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, Leiria, Portugal; Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
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Vekara L, Kantanen S, Kolho KL, Räsänen K, Lakka T, Huhtala H, Piippo-Savolainen E, Arikoski P, Hiltunen P. Psychological well-being of children and adolescents with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2024; 78:1287-1296. [PMID: 38629478 DOI: 10.1002/jpn3.12220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/14/2024] [Accepted: 02/29/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVES Prior studies on the psychological well-being in pediatric inflammatory bowel disease (PIBD) have reported controversial results. Our aim was to compare the psychological well-being and lifestyle factors in patients with PIBD and their controls and to assess the role of contributing disease characteristics. METHODS This cross-sectional study included 60 PIBD patients aged 6-17 years (26 with Crohn's disease [CD], 34 with ulcerative colitis [UC] or unclassified colitis [IBD-U]) from two university hospitals in Finland, and their age- and sex-matched healthy controls. Psychological well-being was assessed with three measures: a questionnaire on overall psychological well-being (PSWB) and for adolescents also Beck Depression Inventory (BDI Ia) and Perceived Stress Scale (PSS). In addition to disease characteristics and pain, we assessed physical activity, sleep, screen time, and social well-being. RESULTS Controls were more likely of stressing more (odds ratio [OR] = 3.67, 95% confidence interval [95% CI] 95% CI = 1.02-13.14), but other measures of psychological well-being did not differ statistically significantly between patients and controls. In CD, a clinically more active disease associated with inferior psychological well-being in adolescents (BDI [ρ = 0.63, p = 0.021], PSS [ρ = 0.70, p = 0.008], PSWB [ρ = 0.56, p = 0.049]). Longer time from diagnosis correlated with better psychological well-being on BDI (ρ = -0.39, p = 0.024) and PSS (ρ = -0.38, p = 0.034). Lifestyle was more sedentary in PIBD (less physical activity in children OR = 0.82, 95% CI = 0.68-0.99 and more screen time in adolescents OR = 1.18, 95% CI = 1.00-1.40). CONCLUSION Although the clinical features of PIBD are potentially a burden for psychological well-being, many young patients cope well with their disease. Individual variation in well-being is remarkable, making supportive measures challenging.
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Affiliation(s)
- Laura Vekara
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Saija Kantanen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Kaija-Leena Kolho
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Faculty of Medicine, University of Helsinki and Department of Pediatric Gastroenterology, Helsinki University Hospital HUS, Helsinki, Finland
| | - Kati Räsänen
- Kuopio Pediatric Research Unit, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Timo Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Eija Piippo-Savolainen
- Kuopio Pediatric Research Unit, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Pekka Arikoski
- Kuopio Pediatric Research Unit, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Pauliina Hiltunen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
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Saidi O, Rochette E, Merlin E, Duché P. Pathways of sleep disturbances in juvenile idiopathic arthritis and recommendations for clinical management approaches: A critical review. Sleep Med Rev 2024; 73:101870. [PMID: 37897844 DOI: 10.1016/j.smrv.2023.101870] [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] [Received: 06/06/2023] [Revised: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease affecting young people. It has a profound impact on their physical, mental and social lives, leading to long-term disability. With the growing awareness of the importance of sleep in all areas of functioning in young people, an emerging literature has drawn attention to the role of sleep in the pathogenesis of JIA. Sleep disturbances in children and adolescents with JIA arise from a wide range of symptoms and pathways, leading to a vicious cycle that exacerbates subclinical inflammation, symptoms and disease progression. Putative factors contributing to sleep disturbances include chronic inflammation, JIA-associated sleep disorders, JIA symptoms (e.g. pain), psychological comorbidities and potential circadian disruption, which may be exacerbated by the transition to adolescence. Here, we review these pathways and advocate key strategies and alternatives for sleep management in young people with JIA in clinical settings. We identify gaps in knowledge and suggest future directions to improve our understanding of JIA sleep disorders, including clinical trials investigating potential strategies to improve sleep health in this young population.
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Affiliation(s)
- Oussama Saidi
- Laboratory "Impact of Physical Activity on Health" (IAPS), Toulon University, F-83041, Toulon, France.
| | - Emmanuelle Rochette
- Laboratory "Impact of Physical Activity on Health" (IAPS), Toulon University, F-83041, Toulon, France; Department of Pediatrics, Clermont-Ferrand University Hospital, F-63000, Clermont-Ferrand, France; INSERM, CIC 1405, CRECHE Unit, Clermont Auvergne University, F-63000, Clermont-Ferrand, France
| | - Etienne Merlin
- Department of Pediatrics, Clermont-Ferrand University Hospital, F-63000, Clermont-Ferrand, France; INSERM, CIC 1405, CRECHE Unit, Clermont Auvergne University, F-63000, Clermont-Ferrand, France
| | - Pascale Duché
- Laboratory "Impact of Physical Activity on Health" (IAPS), Toulon University, F-83041, Toulon, France.
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Hill L, Roofigari N, Faraz M, Popov J, Moshkovich M, Figueiredo M, Hartung E, Talbo M, Lalanne-Mistrih ML, Sherlock M, Zachos M, Timmons BW, Obeid J, Pai N. Physical Activity in Pediatric Inflammatory Bowel Disease: A Scoping Review. Pediatr Exerc Sci 2024; 36:44-56. [PMID: 37487582 DOI: 10.1123/pes.2022-0078] [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: 06/10/2022] [Revised: 04/10/2023] [Accepted: 04/18/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is a chronic, systemic condition affecting the gastrointestinal tract. IBD can be severe and are associated with impairment in growth, school absences, abdominal pain, and fatigue. Physical activity (PA) could have an anti-inflammatory effect in addition to other benefits. It is important to address the possible risks, physiological effects of PA, and potential barriers, and facilitators for PA participation in pediatric IBD. However, potential barriers and facilitators to PA have yet to be adequately described. METHODS We conducted a scoping review to map and describe the current literature on PA in pediatric IBD populations between 1980 and April 2022 using Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines for Scoping reviews. RESULTS Nineteen articles were identified including 10 descriptive, 6 interventional, and 3 physiological responses to PA studies. Patients and healthy controls demonstrated similar responses to exercise. Barriers to participation were low self-esteem, body image, and active IBD symptoms. Facilitators included personal interest, activity with friends, and support from family. CONCLUSION This review highlighted that PA participation may reduce in children with IBD-related symptoms. Short- and medium-term impacts of PA on immune modulation require further study; it is possible that regular PA does not negatively affect biomarkers of disease activity.
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Affiliation(s)
- Lee Hill
- Division of Gastroenterology & Nutrition, Department of Pediatrics, McMaster University, Hamilton, ON,Canada
- Department of Endocrinology, Research Institute of the McGill University Health Center, Montreal, QC,Canada
| | | | - Maria Faraz
- Department of Pathology, Albany Medical Center, Albany, NY,USA
| | - Jelena Popov
- Division of Gastroenterology & Nutrition, Department of Pediatrics, McMaster University, Hamilton, ON,Canada
| | - Michal Moshkovich
- Division of Gastroenterology & Nutrition, Department of Pediatrics, McMaster University, Hamilton, ON,Canada
- Faculty of Health Sciences, McMaster University, Hamilton, ON,Canada
| | - Melanie Figueiredo
- Division of Gastroenterology & Nutrition, Department of Pediatrics, McMaster University, Hamilton, ON,Canada
- Faculty of Health Sciences, McMaster University, Hamilton, ON,Canada
| | - Emily Hartung
- Division of Gastroenterology & Nutrition, Department of Pediatrics, McMaster University, Hamilton, ON,Canada
| | - Meryem Talbo
- School of Human Nutrition, McGill University, Montreal, QC,Canada
| | - Marie-Laure Lalanne-Mistrih
- Montreal Clinical Research Institute, Montreal, QC,Canada
- Department of Nutrition, University Hospital of Guadeloupe, Pointe-à-Pitre,France
- UFR of Medicine, University of French West Indies, Abymes, Guadeloupe,France
| | - Mary Sherlock
- Division of Gastroenterology & Nutrition, Department of Pediatrics, McMaster University, Hamilton, ON,Canada
- Department of Nutrition, University Hospital of Guadeloupe, Pointe-à-Pitre,France
| | - Mary Zachos
- Division of Gastroenterology & Nutrition, Department of Pediatrics, McMaster University, Hamilton, ON,Canada
- Department of Nutrition, University Hospital of Guadeloupe, Pointe-à-Pitre,France
| | - Brian W Timmons
- Child Health and Exercise Medicine Program, McMaster University, Hamilton, ON,Canada
| | - Joyce Obeid
- Child Health and Exercise Medicine Program, McMaster University, Hamilton, ON,Canada
| | - Nikhil Pai
- Division of Gastroenterology & Nutrition, Department of Pediatrics, McMaster University, Hamilton, ON,Canada
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON,Canada
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Mohapatra A, Patwari S, Pansari M, Padhan S. Navigating Pain in Rheumatology: A Physiotherapy-Centric Review on Non-pharmacological Pain Management Strategies. Cureus 2023; 15:e51416. [PMID: 38299133 PMCID: PMC10828527 DOI: 10.7759/cureus.51416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2023] [Indexed: 02/02/2024] Open
Abstract
Rheumatism is a broad term for the painful afflictions of the musculoskeletal system, which include a variety of symptoms ranging from vague pain or aching to profound disability. This article explores the imperative role of physiotherapy in navigating pain within the field of rheumatology, providing a comprehensive review of non-pharmacological pain management strategies. A literature search of PubMed, Web of Science, Scopus, and Cochrane databases was conducted, employing keywords like "Pain," "Rheumatic disease," and "Physiotherapy," with the review emphasizing recent English studies, particularly randomized trials, meta-analyses, and systematic reviews over the last 10 years, to consolidate evidence on the efficacy of physiotherapy interventions for individuals with rheumatic disease. Pain, a significant challenge for individuals with rheumatic diseases, is often intense and persistent, associated with subsequent physical disability, but employing a holistic approach encompassing drugs, physical therapy, and patient education can yield substantial benefits in managing these painful conditions. In addition to pharmacological interventions, management strategies incorporate a non-pharmacological approach, encompassing rehabilitation and physical therapy in alignment with the International Classification of Functioning, Disability, and Health (ICF) model. The patient and physiotherapist collaborate to develop a goal-oriented treatment plan, utilizing modalities like heat, cold, electrotherapy, and hydrotherapy for pain management, progressing to mobility enhancement, posture re-education, and activities focused on a range of motion and muscle strengthening.
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Affiliation(s)
- Avilash Mohapatra
- Department of Surgery and Physiotherapy, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Sneha Patwari
- Department of Physiotherapy, Regional College of Paramedical Health Science, Guwahati, IND
| | - Mukta Pansari
- Department of Physiotherapy, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Srikanta Padhan
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Raipur, IND
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Pella E, Sgouropoulou V, Theodorakopoulou M, Iatridi F, Boutou A, Karpetas A, Papagianni A, Sarafidis P, Dimitroulas T. Cardiorespiratory fitness assessed with cardiopulmonary exercise testing in patients with juvenile idiopathic arthritis: a systematic review and meta-analysis. Rheumatology (Oxford) 2023; 62:3526-3533. [PMID: 37280055 DOI: 10.1093/rheumatology/kead272] [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] [Received: 12/07/2022] [Revised: 04/22/2023] [Accepted: 05/19/2023] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVES JIA is the most common type of arthritis in children and adolescents, causing joint damage, chronic pain and disability. Deconditioning is also prevalent in patients with JIA due to both inactivity and the disease progression, resulting in reduced cardiorespiratory fitness (CRF). We aimed to evaluate CRF of patients with JIA compared with healthy controls. METHODS This is a systematic review and meta-analysis of studies using cardiopulmonary exercise testing (CPET) to examine differences in determinants of CRF between patients with JIA vs healthy controls. The primary outcome was peak oxygen uptake (VO2peak). Literature search involved PubMed, Web of Science and Scopus databases, manual search of article references and grey literature. Quality assessment was undertaken with Newcastle-Ottawa Scale. RESULTS From 480 literature records initially retrieved, eight studies (538 participants) were included in final meta-analysis. VO2peak was significantly lower in patients with JIA compared with controls [weighted mean difference (WMD): -5.95 ml/kg/min (95% CI -9.26, -2.65)]. Exercise duration and VO2peak (% predicted) were found to be significantly impaired in patients with JIA compared with controls [standardized mean difference: -0.67 (95% CI -1.04, -0.29) and WMD: -11.31% (95% CI -20.09, -2.53), respectively], while no significant differences were found in maximum heart rate. CONCLUSION VO2peak and other CPET variables were lower in patients with JIA compared with controls, indicating reduced CRF in the former. Overall, exercise programs for patients with JIA should be promoted as part of their treatment to improve physical fitness and reduce muscle atrophy. PROSPERO REGISTRATION CRD42022380833.
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Affiliation(s)
- Eva Pella
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki Sgouropoulou
- 1st Department of Paediatrics, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marieta Theodorakopoulou
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fotini Iatridi
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Afroditi Boutou
- Department of Respiratory Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Aikaterini Papagianni
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pantelis Sarafidis
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros Dimitroulas
- 4th Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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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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Wu CY, Liang LL, Ho HJ, Hsu CT, Hsu HT, Ao CK, Wu CY, Lin YH, Chuang YF, Hsu YC, Chen YJ, Ng SC. Physical Fitness and Inflammatory Bowel Disease Risk Among Children and Adolescents in Taiwan. JAMA Pediatr 2023; 177:608-616. [PMID: 37126317 PMCID: PMC10152374 DOI: 10.1001/jamapediatrics.2023.0929] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 03/01/2023] [Indexed: 05/02/2023]
Abstract
Importance The incidence of inflammatory bowel disease (IBD) is increasing in newly industrialized countries but disease etiologies remain unclear. Objective To investigate the association between physical fitness and subsequent IBD risk among children and adolescents in Taiwan. Design, Setting, and Participants This nationwide cohort study was conducted between January 1, 2010, and December 31, 2018. Data sources included the Taiwan National Health Insurance Research Database, the National Student Fitness Tests Database, and the Air Quality Monitoring System Database. This study included students who were aged 10 years, completed physical fitness tests between grades 4 and 13, and had at least 1 year of follow-up. Data analysis was last performed on January 15, 2023. Exposures Physical fitness tests included cardiorespiratory endurance (CE; number of minutes to complete an 800-m run), musculoskeletal endurance (ME; number of bent-leg curl-ups in 1 minute), musculoskeletal power (MP; standing broad jump distance), and flexibility fitness (FF; 2-leg sit-and-reach distance). Main Outcomes and Measures Subsequent risk of IBD was compared among students based on physical fitness test results. Six-year cumulative incidences and hazard ratios (HRs) were calculated after adjusting for competing mortality. Performance was reported in quantiles, ranging from 1 (best) to 4 (poorest). Results There were 4 552 866 students who completed physical fitness tests between grades 4 and 13; among these students, 1 393 641 were aged 10 years and were included in the analysis. Six-year cumulative incidence of IBD risk was lowest among students in the best-performing quantile of CE (quantile 1, 0.74% [95% CI, 0.63%-0.86%]; P < .001), ME (0.77% [0.65%-0.90%]; P < .001), and MP (0.81% [0.68%-0.93%]; P = .005) compared with students in quantiles 2 through 4, respectively; however, no association was observed for quantiles of FF. After adjusting for competing HRs for mortality and other confounders, better CE was inversely associated with IBD risk (adjusted HR, 0.36 [95% CI, 0.17-0.75]; P = .007). Other measures of physical fitness were not independently associated with IBD risk. Conclusions and Relevance The results of this study suggest that CE was inversely associated with IBD risk among children and adolescents, but ME, MP, and FF were not independently associated with IBD risk. Future studies that explore the mechanisms are needed.
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Affiliation(s)
- Chun-Ying Wu
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Health Innovation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Microbiota Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Translational Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Faculty of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Li-Lin Liang
- Health Innovation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsiu J. Ho
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Health Innovation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Microbiota Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chen-Te Hsu
- Department of Recreation and Sport Management, Shu-Te University, Kaohsiung, Taiwan
| | - Hsiu-Tao Hsu
- Center for Physical and Health Education, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Chon-Kit Ao
- Department of Economics, National Cheng Kung University, Tainan, Taiwan
| | - Chen-Yi Wu
- Health Innovation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Faculty of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Hsian Lin
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Health Innovation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Microbiota Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Fang Chuang
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yao-Chun Hsu
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yi-Ju Chen
- Health Innovation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Post Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Siew C. Ng
- Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
- Microbiota I-Center, Hong Kong, China
- State Key Laboratory of Digestive Disease, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, China
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Rochette E, Saidi O, Merlin É, Duché P. Physical activity as a promising alternative for young people with juvenile idiopathic arthritis: Towards an evidence-based prescription. Front Immunol 2023; 14:1119930. [PMID: 36860845 PMCID: PMC9969142 DOI: 10.3389/fimmu.2023.1119930] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in young people. Although biologics now enable most children and adolescents with JIA to enjoy clinical remission, patients present lower physical activity and spend more time in sedentary behavior than their healthy counterparts. This impairment probably results from a physical deconditioning spiral initiated by joint pain, sustained by apprehension on the part of both the child and the child's parents, and entrenched by lowered physical capacities. This in turn may exacerbate disease activity and lead to unfavorable health outcomes including increased risks of metabolic and mental comorbidities. Over the past few decades, there has been growing interest in the health benefits of increased overall physical activity as well as exercise interventions in young people with JIA. However, we are still far from evidence-based physical activity and / or exercise prescription for this population. In this review, we give an overview of the available data supporting physical activity and / or exercise as a behavioral, non-pharmacological alternative to attenuate inflammation while also improving metabolism, disease symptoms, poor sleep, synchronization of circadian rhythms, mental health, and quality of life in JIA. Finally, we discuss clinical implications, identify gaps in knowledge, and outline a future research agenda.
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Affiliation(s)
- Emmanuelle Rochette
- Department of Pediatrics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France,Clermont Auvergne University, INSERM, CIC 1405, CRECHE unit, Clermont-Ferrand, France,Toulon University, Laboratory “Impact of Physical Activity on Health” (IAPS), Toulon, France,*Correspondence: Emmanuelle Rochette,
| | - Oussama Saidi
- Toulon University, Laboratory “Impact of Physical Activity on Health” (IAPS), Toulon, France
| | - Étienne Merlin
- Department of Pediatrics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France,Clermont Auvergne University, INSERM, CIC 1405, CRECHE unit, Clermont-Ferrand, France
| | - Pascale Duché
- Toulon University, Laboratory “Impact of Physical Activity on Health” (IAPS), Toulon, France
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10
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Jonyk L, Sagawa Junior Y, Tordi N, Ballot Schmit C. Description of physical activity in children with juvenile idiopathic arthritis using accelerometry. Arch Pediatr 2023; 30:83-88. [PMID: 36513538 DOI: 10.1016/j.arcped.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/22/2022] [Accepted: 11/11/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Juvenile idiopathic arthritis (JIA) can lead to functional impotence and reduced physical activity (PA) in patients. The objective of this study was to monitor the daily PA of children aged 6-18 years with JIA using accelerometry based on disease activity and individual abilities, and to compare this with age recommendations. METHODS Patients volunteering for the study wore an accelerometer for 7 consecutive days; data were evaluated using a wGT3X ActiGraph™. The 2010 World Health Organization (WHO) recommendations were used for comparison. RESULTS We collected accelerometry data for 24 patients of the University Hospital Center (UHC) of Besançon. Only two patients did not reach the recommendations of moderate-to-vigorous PA (MVPA). Time spent in MVPA was negatively correlated with age, BMI, number of joints with active arthritis, JADAS score, and visual analogue pain assessment (VAPA). Patients with active disease, those with upper extremity pain, and female patients had significantly lower PA scores. CONCLUSIONS Almost all of the patients of the UHC of Besançon who accepted the study reached the WHO recommendations. Having an active disease, having painful upper limbs, or being a girl is associated with decreased PA.
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Affiliation(s)
- L Jonyk
- Department of Pediatrics, University Hospital Center Jean Minjoz, Besançon, France.
| | - Y Sagawa Junior
- Clinical Functional Exploration Laboratory of Movement, Department of Physical Medicine and Rehabilitation, University Hospital Center of Besançon, Besançon 25000, France
| | - N Tordi
- Exercise Performance Health Innovation Platform, University of Bourgogne Franche-Comté, Besançon, France
| | - C Ballot Schmit
- Department of Pediatrics, University Hospital Center Jean Minjoz, Besançon, France
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11
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Vanhelst J, Beghin L, Coopman S, Labreuche J, Djeddi D, Gottrand F, Turck D, Ley D. Physical fitness in children and adolescents with inflammatory bowel disease: protocol for a case-control study. BMJ Open 2022; 12:e063403. [PMID: 36220315 PMCID: PMC9557790 DOI: 10.1136/bmjopen-2022-063403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Inflammatory bowel disease (IBD) is a chronic disorder of the gastrointestinal tract, associated with adverse health consequences that may adversely influence physical activity and body composition in youth. These effects may lead to changes in physical fitness, which is positively associated with health-related outcomes. The aim is to assess health-related physical fitness levels in paediatric patients with IBD and to compare these levels with those in healthy matched controls. METHODS AND ANALYSIS This trial is a bicentric case-control study. Fifty paediatric patients with IBD and 50 matched healthy controls will be recruited (1:1), and physical fitness levels (cardiorespiratory fitness, muscular strength, speed/agility and flexibility) will be assessed. The primary outcome is cardiorespiratory fitness, which will be compared between children and adolescents with IBD and healthy controls matched for age, sex and body mass index class. We will assess whether the two groups differ with respect to other physical fitness components and cardiovascular risk in adulthood according to sex-specific cut-offs for a healthy cardiorespiratory fitness level in adolescents. We will identify relationships between physical fitness and characteristics of IBD, quality of life and daily physical activity. ETHICS AND DISSEMINATION This study was approved by the Research Ethics Committee (Comité de Protection des Personnes, Centre-Ouest I, Tours, France; No 2019-A02651-56) and was declared to the Commission Nationale de l'Informatique et des Libertés. All procedures will be performed according to the ethical standards of the 1975 Declaration of Helsinki, as revised in 2008, and the European Union's Guidelines for Good Clinical Practice. Written informed consent will be obtained from the youths and their parents. Research findings will be disseminated in peer-reviewed journals and scientific meetings, as well as in social media and IBD family support groups. TRIAL REGISTRATION NUMBER NCT04647578.
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Affiliation(s)
- Jérémy Vanhelst
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris Cité (CRESS), Bobigny, France
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Laurent Beghin
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000, Lille, France
| | - Julien Labreuche
- Univ. Lille, CHU Lille, EA 2694 - Public Health: epidemiology and quality of care, F-59000, Lille, France
| | - Djamal Djeddi
- Department of Paediatrics, Amiens University Hospital and University of Amiens, Amiens, France
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000, Lille, France
| | - Dominique Turck
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000, Lille, France
| | - Delphine Ley
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000, Lille, France
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12
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Penagini F, Calcaterra V, Dilillo D, Vandoni M, Gianolio L, Gatti A, Rendo G, Giuriato M, Cococcioni L, De Silvestri A, Zuccotti G. Self-Perceived Physical Level and Fitness Performance in Children and Adolescents with Inflammatory Bowel Disease. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9091399. [PMID: 36138708 PMCID: PMC9497882 DOI: 10.3390/children9091399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 01/18/2023]
Abstract
Background: Inflammatory bowel disease (IBD) patients show a higher risk of developing metabolic and cardiovascular diseases due to the presence of systemic low-grade chronic inflammation. Exercise can improve cardiovascular fitness and modulate the inflammatory processes. We evaluated the physical activity (PA) level and the fitness performance of children and adolescents with IBD. Patients and methods: We considered 54 pediatric patients with IBD (14.6 ± 2.2; 22 M), including CD (n = 27) UC (n = 24) and IBD unclassified (n = 3), and 70 healthy children. In all children, the Physical Activity Questionnaire (PAQ-C) and the International Fitness Enjoyment Scale were self-reported and recorded. Results: PAQ-C showed significant difference in PA levels in patients with IBD compared to controls (p < 0.001). A decrease in general fitness (p = 0.003), cardiorespiratory fitness (p = 0.002), strength (p = 0.01), speed agility (p = 0.003), and flexibility (p = 0.01) were also detected between patients and controls. Speed agility was related to age (p = 0.02) and BMI z-score (p = 0.01), and flexibility to BMI z-score (p = 0.05). We noted a correlation between PA levels and physician global assessment (p = 0.021) and activity disease severity (p = 0.025). Conclusions: A poorer PA level and poor physical competence were found in patients with IBD compared to healthy children and adolescents. Monitored exercise could provide multiple benefits at both physical and psychological levels.
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Affiliation(s)
- Francesca Penagini
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Dario Dilillo
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Laura Gianolio
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA), Department of Public health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Giulia Rendo
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Matteo Giuriato
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy
- Faculty of Physical Culture, Unit of Molecular Biology, Department of Health and Natural Sciences, Gdansk University of Physical Education and Sport, 80070 Gdansk, Poland
| | - Lucia Cococcioni
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Annalisa De Silvestri
- Biometry & Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
- Correspondence:
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Physical Examination Tool for Swollen and Tender Lower Limb Joints in Juvenile Idiopathic Arthritis: A Pilot Diagnostic Accuracy Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084517. [PMID: 35457387 PMCID: PMC9029970 DOI: 10.3390/ijerph19084517] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children, with lower limb involvement highly prevalent. Recent evidence has highlighted the lack of specific lower limb physical examination (PE) tools for clinicians assisting the paediatric rheumatology team in identifying lower extremity disease in patients with JIA. Early clinical detection may lead to more prompt and targeted interventions to reduce lower limb problems in children with JIA. The aim of this pilot study is to provide preliminary data on the diagnostic accuracy of a lower limb PE tool in JIA. METHODS Children with JIA requiring magnetic resonance imaging (MRI) on their lower limb joints per their usual care were eligible. Lower limb joint counts were conducted clinically by a podiatrist and paediatric rheumatologist using the proposed twenty joint per side, PE tool. The PE were compared to MRI assessments completed by two independent paediatric radiologists. Data were analysed using agreement (observed, positive and negative) and Cohen's kappa with 95% CIs. RESULTS Fifteen participants were recruited into the study in which 600 lower limb joints were clinically examined. Statistical analysis showed excellent inter-rater reliability between podiatrist and paediatric rheumatologist for both joint swelling and tenderness. Results of the intra-rater reliability of the podiatrist using the PE tool indicated excellent percentage agreements (98.5-100%) and substantial kappa coefficients (0.93-1). The inter-rater reliability between radiological assessments contrasted the PE results, showing low agreement and poor reliability. Comparisons between PE and MRI resulted in poor kappa coefficients and low agreement percentages. The most agreeable joint between MRI and PE was the ankle joint, while the worst performing joint was the sub-talar joint. CONCLUSION Results indicate potential clinical reliability; however, the validity and diagnostic accuracy of the proposed PE tool remains unclear due to low kappa coefficients and inconsistent agreements between PE and MRI results. Further research will be required before the tool may be used in a clinical setting.
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Min M, Hancock DG, Aromataris E, Crotti T, Boros C. Experiences of living with Juvenile Idiopathic Arthritis: a qualitative systematic review. JBI Evid Synth 2021; 20:60-120. [PMID: 34669687 DOI: 10.11124/jbies-21-00139] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review was to investigate the available qualitative evidence to enhance understanding of the experiences of children, young adults, and their carers living with Juvenile Idiopathic Arthritis in any setting. INTRODUCTION Juvenile Idiopathic Arthritis is the most common chronic rheumatic disease in childhood. Despite the availability of effective treatments, persistent pain, growth retardation, physical disability, and psychological problems can occur. This may reduce the quality of life for Juvenile Idiopathic Arthritis patients by negatively affecting their family, educational, and social well-being. Patient-centered management and care for Juvenile Idiopathic Arthritis patients requires increasing attention to their self-reported quality of life and experiences, in addition to clinically measured disease activity. Furthermore, taking care of children with Juvenile Idiopathic Arthritis may have negative impacts on the lives of their carers and families. The experiences of carers have been poorly understood and studied. This review describes experiences and perspectives from patients and carers in order to inform the needs of families throughout their Juvenile Idiopathic Arthritis journey. INCLUSION CRITERIA Studies describing the experiences of patients aged <21 years who have been diagnosed with Juvenile Idiopathic Arthritis according to the International League of Associations for Rheumatology criteria, as well as the experiences of their carers, have been considered. METHODS A comprehensive search using PubMed, CINAHL, Embase, PsycINFO, Web of Science, and Google Scholar, as well as relevant conference proceedings of the American College of Rheumatology (ACR; 2018-2019), the European Pediatric Rheumatology Congress (PReS) 2018, the European League Against Rheumatism (EULAR; 2018-2019), and the Asia Pacific League of Associations for Rheumatology (APLAR; 2018-2019), was undertaken in December 2020 to identify pertinent published and unpublished studies. Studies published in English from 2001 to 2020 were included. The JBI approach to study selection, critical appraisal, data extraction, and data synthesis was used. RESULTS Ten studies were included in this review. A total of 61 findings were extracted and aggregated to form 12 categories. From the 12 categories, five synthesized findings were developed: i) Self-management of Juvenile Idiopathic Arthritis requires pain management, medication management, and the acquisition of knowledge and professional support; ii) A promising relationship with health care professionals but unbalanced access to services; iii) Parental financial burden and their adjustment to maintain family happiness; iv) Patients and parents support the web-based approach to communicate and develop self-management skills and acknowledge the importance of clinical trials; v) Desire to live a normal life without prejudice from school, social settings, and the workplace. CONCLUSIONS This review has provided a comprehensive overview of experiences and perceptions of Juvenile Idiopathic Arthritis patients and their parents. It is important to understand what they need to know and understand about the disease. This review also highlights the importance of appropriate web-based programs, career counseling, infrastructures, and school facilities. Findings in this review can guide future policy and practice in order to improve care for families and children with Juvenile Idiopathic Arthritis. Further research is required to develop management strategies for medication intolerance and evaluate the longitudinal benefits of relevant Juvenile Idiopathic Arthritis programs. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42019133165).
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Affiliation(s)
- Ming Min
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia University of Adelaide Discipline of Paediatrics, Women's and Children's Hospital, Adelaide, SA, Australia Women's and Children's Hospital Department of Rheumatology, Adelaide, SA, Australia JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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Vanhelst J, Béghin L, Turck D, Labreuche J, Coopman S, Gottrand F, Ley D. Daily physical activity patterns in children and adolescents with inflammatory bowel disease. Pediatr Res 2021; 90:847-852. [PMID: 33469176 DOI: 10.1038/s41390-020-01313-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/14/2020] [Accepted: 11/19/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND The aim of this study was to assess PA patterns among children and adolescents with inflammatory bowel disease (IBD). METHODS Sixty participants with IBD (42 Crohn's disease [CD], 10 ulcerative colitis [UC], and 8 IBD-unclassified [IBD-U], 30 male patients) in remission (n = 45) or with mild disease (n = 15) were compared with 60 healthy age- and sex-matched controls. Each participant wore a triaxial accelerometer during 4 consecutive days for objective daily PA quantification. RESULTS Overall, there was no significant difference in daily PA patterns between patients with IBD and healthy controls, with 31.7% of patients with IBD and 38.3% of healthy controls fulfilling the recommendation of 60 min of moderate-to-vigorous physical activity (MVPA) daily (NS). Male patients with IBD spent significantly less time in MVPA compared with matched healthy controls (mean difference, 16.2 min day-1; p < 0.05). No difference was observed for female patients with IBD. No difference in sedentary pattern between male patients with IBD and controls was found. CONCLUSIONS Children and adolescents with inactive or mildly active IBD have similar PA patterns compared with healthy controls, except for male patients who have reduced moderate-to-vigorous PA. By far, most patients with IBD do not fulfill the MVPA recommendations for health benefits. IMPACT There is few data on PA patterns in pediatric patients with IBD. Methodological issues to assess PA limit the strengths of these studies. Pediatric IBD patients with inactive or mildly active IBD have similar physical activity patterns compared with healthy controls, except for male patients who have reduced moderate-to-vigorous PA. Most patients with IBD do not fulfill the MVPA recommendations for health benefits.
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Affiliation(s)
- Jérémy Vanhelst
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France. .,CIC 1403 - Clinical Investigation Center, CHU Lille, 59000, Lille, France.
| | - Laurent Béghin
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.,CIC 1403 - Clinical Investigation Center, CHU Lille, 59000, Lille, France
| | - Dominique Turck
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital, 59000, Lille, France
| | - Julien Labreuche
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Evaluation des technologies de santé et des pratiques médicales, 59000, Lille, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital, 59000, Lille, France
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital, 59000, Lille, France
| | - Delphine Ley
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital, 59000, Lille, France
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Saidi O, Rochette E, Bourdier P, Ratel S, Merlin E, Pereira B, Duché P. Sleep in children and adolescents with juvenile idiopathic arthritis: a systematic review and meta-analysis of case-control studies. Sleep 2021; 45:6370831. [PMID: 34525202 DOI: 10.1093/sleep/zsab233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 07/02/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Juvenile idiopathic arthritis (JIA) is one of the most common pediatric rheumatic disease. However, sleep alteration associated with this auto-immune disease remain unclear. We aimed in this systematic review and meta-analysis to compare sleep duration, quality, and architecture in JIA subjects with those in their healthy peers. METHODS Systematic search performed in PubMed, EMBase, Cochrane, and PsycINFO databases included 19 studies in the qualitative synthesis of which 10 met the inclusion criteria for the meta-analysis. RESULTS Pooled results from subjective methods indicated pronounced sleep disturbances and complaints in youth with JIA compared with their healthy counterparts. This was further confirmed by Increased difficulty maintaining sleep (wake after sleep onset; SMD: -0.69; CI: -1.29; -0.09, p =0.02) and a tendency to increased difficulty initiating sleep (sleep onset latency; SMD: -0.29; CI: -0.60; 0.03, p =0.07). There were no remarkable differences in sleep duration or sleep architecture between JIA patients and healthy controls. High heterogeneity was found for several outcomes. This could be explained by the different methods used as well as associated sleep disorders, medication and comorbidities. CONCLUSIONS Although included studies were methodologically diverse, the summarized results of our review and meta-analysis bring evidence that children with JIA present more fragmented sleep compared to healthy peers. Thereby, the implementation of strategies to manage and improve sleep in this population are needed and might have a beneficial effect on the symptoms and functions of JIA.
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Affiliation(s)
- Oussama Saidi
- Université Clermont Auvergne, AME2P, (EA 3533), Clermont-Ferrand, France.,CRNH-Auvergne, Clermont-Ferrand, France.,Université de Toulon, Laboratoire IAPS, Toulon, France
| | - Emmanuelle Rochette
- Université de Toulon, Laboratoire IAPS, Toulon, France.,CHU Clermont-Ferrand, Université Clermont Auvergne, INSERM, CIC 1405, Unité CRECHE, Clermont-Ferrand, France
| | - Pierre Bourdier
- Université Clermont Auvergne, AME2P, (EA 3533), Clermont-Ferrand, France.,CRNH-Auvergne, Clermont-Ferrand, France
| | - Sébastien Ratel
- Université Clermont Auvergne, AME2P, (EA 3533), Clermont-Ferrand, France.,CRNH-Auvergne, Clermont-Ferrand, France
| | - Etienne Merlin
- CHU Clermont-Ferrand, Université Clermont Auvergne, INSERM, CIC 1405, Unité CRECHE, Clermont-Ferrand, France.,Université Clermont Auvergne, INRA, UMR 1019 UNH, ECREIN, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Délégation de la Recherche Clinique et Innovations, Clermont-Ferrand, France
| | - Pascale Duché
- Université de Toulon, Laboratoire IAPS, Toulon, France
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17
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Bourdier P, Birat A, Rochette E, Doré É, Courteix D, Dutheil F, Pereira B, Ratel S, Merlin E, Duché P. Muscle function and architecture in children with juvenile idiopathic arthritis. Acta Paediatr 2021; 110:280-287. [PMID: 32420673 DOI: 10.1111/apa.15335] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 04/21/2020] [Accepted: 04/28/2020] [Indexed: 11/30/2022]
Abstract
AIM To assess muscle function and functional abilities in children with juvenile idiopathic arthritis (JIA). METHODS Fourteen children with JIA and 14 healthy controls matched for age and sex were included. Muscle characteristics, both structural (thickness, cross-sectional area (CSA) and fascicle angle) and qualitative (intermuscular adipose tissue; IMAT), were assessed in thigh muscles using ultrasound and peripheral quantitative computed tomography (pQCT). Muscle function and functional abilities were determined from the assessment of maximal voluntary isometric contraction (MVIC) knee extensors force and vertical jump performance. RESULTS No significant difference in MVIC force was observed between the two groups. However, squat jump height was significantly reduced in children with JIA (18.3 ± 5.4 vs 24.3 ± 7.9 cm, P < .05). No differences in structural parameters were observed, but IMAT/CSA (0.22 ± 0.02 vs 0.25 ± 0.03; P = .01) was significantly lower in children with JIA than in healthy children. CONCLUSION Knee extensor muscle architecture and force were comparable between children with and without JIA, but functional abilities (vertical jump performance) were poorer in JIA. The lower IMAT area in JIA could result from a lower physical activity level compared with healthy children.
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Affiliation(s)
- Pierre Bourdier
- Laboratoire AME2P Université Clermont Auvergne Clermont‐Ferrand France
| | - Anthony Birat
- Laboratoire AME2P Université Clermont Auvergne Clermont‐Ferrand France
| | - Emmanuelle Rochette
- INSERM, CIC 1405, Unité CRECHE, CHU Clermont‐Ferrand Université Clermont Auvergne Clermont‐Ferrand France
- CHU Clermont‐Ferrand Clermont‐Ferrand France
- Laboratoire IAPS Université de Toulon Toulon France
| | - Éric Doré
- Laboratoire AME2P Université Clermont Auvergne Clermont‐Ferrand France
| | - Daniel Courteix
- Laboratoire AME2P Université Clermont Auvergne Clermont‐Ferrand France
| | - Frédéric Dutheil
- CNRS Laboratoire de Psychologie Sociale et Cognitive (LaPSCo) UCA‐CNRS 6024, CHU Université Clermont Auvergne Clermont–Ferrand France
- Faculty of Health School of Exercise Science Australian Catholic University Melbourne Vic. Australia
| | | | - Sébastien Ratel
- Laboratoire AME2P Université Clermont Auvergne Clermont‐Ferrand France
| | - Etienne Merlin
- INSERM, CIC 1405, Unité CRECHE, CHU Clermont‐Ferrand Université Clermont Auvergne Clermont‐Ferrand France
- CHU Clermont‐Ferrand Clermont‐Ferrand France
- INRA, UMR 1019 UNH, ECREIN Université Clermont Auvergne Clermont‐Ferrand France
| | - Pascale Duché
- Laboratoire AME2P Université Clermont Auvergne Clermont‐Ferrand France
- Laboratoire IAPS Université de Toulon Toulon France
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18
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Mazzolani BC, Smaira FI, Astley C, Iraha AY, Pinto AJ, Marques IG, Cordeiro Amarante M, Rezende NS, Sieczkowska SM, Franco TC, Miranda LCDA, Lindoso L, Helito AC, Oba J, Queiroz LB, Pereira RMR, Roschel H, Silva CA, Gualano B. Changes in Eating Habits and Sedentary Behavior During the COVID-19 Pandemic in Adolescents With Chronic Conditions. Front Pediatr 2021; 9:714120. [PMID: 34966698 PMCID: PMC8711628 DOI: 10.3389/fped.2021.714120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Among healthy adolescents, school closures and home confinement were shown to increase unhealthier eating habits and sedentary behavior. It remains unknown to which extent the pandemic has impacted the lifestyle of adolescents with chronic conditions. Thus, the aim of this study is to report on the impact of the COVID-19 outbreak on eating habits and sedentary behavior among adolescents with multiple chronic conditions (n = 347) from a tertiary, referral hospital vs. healthy peers. Methods: This observational study was conducted in São Paulo (Brazil) between July and October 2020, period in which a set of social distancing measures to contain the pandemic. Results: The main findings of this study were that adolescents with chronic conditions and health peers showed important changes in eating habits (e.g., more often cooking and eating in front of television than before quarantine). Also, 86.8% of adolescents with chronic conditions and 91.6% of healthy adolescents reported increasing screen time during pandemic. No major differences were observed between patients and controls. Conclusions: Adolescents with chronic conditions and healthy peers exposed to pandemic showed substantial changes in lifestyle, stressing the need for specific care to mitigate poor eating habits and excessive sedentary behavior for patients and healthy adolescents.
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Affiliation(s)
- Bruna Caruso Mazzolani
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Fabiana Infante Smaira
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Camilla Astley
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Amanda Yuri Iraha
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Ana Jessica Pinto
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Isabela Gouveia Marques
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Milla Cordeiro Amarante
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Nathalia Saffioti Rezende
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Sofia Mendes Sieczkowska
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Tathiane Christine Franco
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Luana Cristina do Amaral Miranda
- Instituto da Criança e do Adolescente, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Lívia Lindoso
- Instituto da Criança e do Adolescente, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Alberto Carame Helito
- Instituto da Criança e do Adolescente, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Jane Oba
- Instituto da Criança e do Adolescente, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Ligia Bruni Queiroz
- Instituto da Criança e do Adolescente, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Rosa Maria R Pereira
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Clovis Artur Silva
- Instituto da Criança e do Adolescente, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil.,Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Food Research Center, University of São Paulo, São Paulo, Brazil
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19
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Pritchard L, Verschuren O, Roy M, Kaup C, Rumsey DG. Reproducibility of the Six‐Minute Walk Test in Children and Youth with Juvenile Idiopathic Arthritis. Arthritis Care Res (Hoboken) 2020; 74:686-690. [DOI: 10.1002/acr.24492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 09/25/2020] [Accepted: 10/20/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Lesley Pritchard
- Department of Physical Therapy Faculty of Rehabilitation Medicine University of Alberta Canada Edmonton Alberta
| | - Olaf Verschuren
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine Utrecht University Utrecht the Netherlands
| | - Michelle Roy
- Glenrose Rehabilitation Hospital Edmonton Alberta Canada
| | - Cara Kaup
- Glenrose Rehabilitation Hospital Edmonton Alberta Canada
| | - Dax G. Rumsey
- Glenrose Rehabilitation Hospital Edmonton Alberta Canada
- Department of Pediatrics Faculty of Medicine and Dentistry University of Alberta Canada Edmonton Alberta
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20
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Min M, Hancock DG, Aromataris E, Crotti T, Boros C. Experiences of living with juvenile idiopathic arthritis: a qualitative systematic review protocol. JBI Evid Synth 2020; 18:2058-2064. [PMID: 32925420 DOI: 10.11124/jbisrir-d-19-00301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The objective of this review is to identify, critically appraise and synthesize the available qualitative evidence to understand the experiences of children, young adults and their carers living with juvenile idiopathic arthritis in any setting. INTRODUCTION Juvenile idiopathic arthritis is the most common rheumatic disease in childhood. Despite the availability of effective treatments, the disease still has negative impacts on patients' and carers' lives. Patients' and carers' experiences of living with juvenile idiopathic arthritis have been recognized as important in the measurement of health status and treatment implementation. Addressing these needs will facilitate more effective management and treatment of the disease. This protocol describes a method for a systematic review regarding the perspectives from patients and carers in order to highlight the needs of families throughout their juvenile idiopathic arthritis journey. INCLUSION CRITERIA Studies on the experiences of patients aged <21 years who have been diagnosed with juvenile idiopathic arthritis according to the International League of Associations for Rheumatology criteria, as well as the experiences of their carers, will be considered. Papers included in this review will include, but not be limited to, designs such as phenomenology, grounded theory and ethnography. METHODS A comprehensive search using PubMed, CINAHL, Embase, PsycINFO and Web of Science was undertaken in August 2019. Available studies published in English from 2001 to 2019 will be included. The recommended JBI method for study selection, critical appraisal, data extraction and data synthesis will be used. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42019133165).
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Affiliation(s)
- Ming Min
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - David G Hancock
- University of Adelaide Discipline of Paediatrics, Women's and Children's Hospital, Adelaide, Australia
| | - Edoardo Aromataris
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Tania Crotti
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Christina Boros
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.,University of Adelaide Discipline of Paediatrics, Women's and Children's Hospital, Adelaide, Australia
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21
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Vanhelst J, Coopman S, Labreuche J, Dupont C, Bertrand V, Djeddi D, Turck D, Ley D. Protocol of a randomised controlled trial assessing the impact of physical activity on bone health in children with inflammatory bowel disease. BMJ Open 2020; 10:e036400. [PMID: 32430452 PMCID: PMC7239538 DOI: 10.1136/bmjopen-2019-036400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Low bone mineral density (BMD) is a frequent issue in children and adolescents with inflammatory bowel disease (IBD). Several studies in healthy populations have reported a positive impact of physical activity (PA) on bone health. Recently, an observational study in paediatric patients with IBD showed a significant positive relationship between daily PA and BMD. However, intervention studies investigating a causal relationship between PA and BMD are warranted to confirm these results. The aim of this randomised controlled trial will be to investigate the effect of a PA programme on BMD in paediatric patients with IBD. METHODS AND ANALYSIS This trial is a multicentre (four centres), randomised, controlled, blinded end-point study. Eighty children with IBD will be randomly assigned in a 1:1 ratio to receive a programme with adapted physical exercises (intervention group) or usual PA (control group) during a 9-month period. The primary outcome is the change from baseline at 9 months (the end of the study) in whole-body BMD assessed by dual-energy X-ray absorptiometry. Secondary efficacy outcomes include the changes from baseline at 9 months in: BMD assessed in the lumbar spine and trochanter; daily PA (time spent in moderate-to-vigorous PA); body composition (fat mass and fat-free mass); fatigue resistance; quality of life and activity of IBD. ETHICS AND DISSEMINATION The study was approved by the Research Ethics Committee in France (Comité de Protection des Personnes, Sud-Ouest and Outre-Mer III, Bordeaux, France, No 2018/27). All procedures will be performed according to the ethical standards of the Helsinki Declaration of 1975, as revised in 2008, and the European Union's Guidelines for Good Clinical Practice. Written informed consent will be obtained from the parents or legal guardian and from the children. Research findings will be disseminated in peer-reviewed journals and scientific meetings. TRIAL REGISTRATION NUMBER NCT03774329.
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Affiliation(s)
- Jérémy Vanhelst
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France, Lille, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University, Jeanne de Flandre Children's Hospital, Lille, France
| | - Julien Labreuche
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Evaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France, Lille, France
| | - Claire Dupont
- Department of Paediatrics, Caen University Hospital F 14000 Caen, France and Normandy University, Caen, France
| | | | - Djamal Djeddi
- Department of Paediatrics, Amiens University Hospital and University of Amiens, Amiens, France
| | - Dominique Turck
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France, Lille, France
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University, Jeanne de Flandre Children's Hospital, Lille, France
| | - Delphine Ley
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France, Lille, France
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University, Jeanne de Flandre Children's Hospital, Lille, France
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