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Milatz F, Hansmann S, Klotsche J, Niewerth M, Kallinich T, Dressler F, Haas JP, Berendes R, Horneff G, Hufnagel M, Weller-Heinemann F, Windschall D, Trauzeddel R, Klaas M, Girschick H, Oommen PT, Foeldvari I, Cantez SM, Jansson AF, Hartmann M, Peitz-Kornbrust J, Minden K. Level and correlates of physical activity among children and adolescents with juvenile idiopathic arthritis compared to controls: results from a German nationwide prospective observational cohort study. Pediatr Rheumatol Online J 2024; 22:39. [PMID: 38509613 PMCID: PMC10953124 DOI: 10.1186/s12969-024-00976-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/13/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Physical active lifestyles are essential throughout growth and maturation and may offer potential preventive and therapeutic benefit in patients with juvenile idiopathic arthritis (JIA). Insufficient physical activity (PA), in contrast, can lead to aggravation of disease-related symptoms. This study aimed to i) examine PA levels in children and adolescents with JIA compared to general population controls and ii) investigate correlates of pronounced physical inactivity in order to identify risk groups for sedentary behaviour. METHODS Data from children and adolescents with JIA and population controls aged 3 to 17 years documented in the National Pediatric Rheumatologic Database (NPRD) and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) were used. Self-reported PA was collected from parents/guardians of children up to 11 years of age or adolescents 12 years of age and older. To compare PA-related data, age- and sex-specific pairwise analyses were conducted considering NPRD/KiGGS participants' data from 2017. Correlates of physical inactivity among patients were identified using a linear regression model. RESULTS Data of 6,297 matched-pairs (mean age 11.2 ± 4.2 years, female 67%, patients' disease duration 4.5 ± 3.7 years, persistent oligoarthritis 43%) were available for evaluation. Almost 36% of patients aged 3-17 years (vs. 20% of controls) achieved the WHO recommended amount of PA, while PA steadily decreased with age (18% of patients aged ≥ 12 years) and varied between JIA categories. Female adolescents and patients with enthesitis-related arthritis were least likely to achieve the minimum recommended level of PA. Physical inactivity was associated with female sex, higher age at disease onset, longer disease duration, more functional disability (C-HAQ) and higher disease activity (cJADAS-10). CONCLUSIONS Depending on JIA category, children and adolescents with JIA were similarly or even more likely to achieve the WHO recommended minimum level of PA compared to general population controls. However, since a large proportion of young JIA patients appear to be insufficiently physically active, engagement in targeted efforts to promote PA is urgently needed.
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Affiliation(s)
- Florian Milatz
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany.
| | - Sandra Hansmann
- Department of Neuropediatrics, Developmental Neurology and Social Paediatrics, University of Tuebingen, Tuebingen, Germany
| | - Jens Klotsche
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany
| | - Martina Niewerth
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany
| | - Tilmann Kallinich
- Department of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Programme area Systems Rheumatology, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany
| | - Frank Dressler
- Department of Paediatric Pneumology, Allergology and Neonatology, Children's Hospital, Hannover Medical School, Hannover, Germany
| | - Johannes-Peter Haas
- German Centre for Paediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | - Rainer Berendes
- Pediatric Rheumatology, Children's Hospital St. Marien, Landshut, Germany
| | - Gerd Horneff
- Department of Pediatric Rheumatology, Asklepios Kinderklinik Sankt Augustin, Sankt Augustin, Germany
- Department of Paediatric and Adolescent Medicine, University Hospital of Cologne, Cologne, Germany
| | - Markus Hufnagel
- Division of Pediatric Infectious Diseases and Rheumatology, Department of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
| | - Frank Weller-Heinemann
- Department of Pediatrics and Adolescent Medicine, Pediatric Rheumatology, Eltern-Kind-Zentrum Prof. Hess, Klinikum Bremen-Mitte, Bremen, Germany
| | - Daniel Windschall
- Clinic of Paediatric and Adolescent Rheumatology, Northwest German Centre for Rheumatology, St. Josef-Stift Sendenhorst, Sendenhorst, Germany
- Medizinische Fakultät, Universität Halle-Wittenberg, Halle, Germany
| | - Ralf Trauzeddel
- Department of Paediatrics, Helios Klinik Berlin-Buch, Berlin, Germany
| | - Moritz Klaas
- Children's Hospital, Vivantes Klinikum Friedrichshain, Berlin, Germany
| | - Hermann Girschick
- Children's Hospital, Vivantes Klinikum Friedrichshain, Berlin, Germany
| | - Prasad T Oommen
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Division of Pediatric Rheumatology, University Hospital, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Ivan Foeldvari
- Hamburg Centre for Paediatric and Adolescent Rheumatology, Schön Klinik Hamburg Eilbek, Hamburg, Germany
| | - Serdar Mustafa Cantez
- Department of Pediatrics and Neonatology, Division of Pediatric Rheumatology, University Hospital of Marburg and Gießen, Gießen, Germany
| | - Annette F Jansson
- Department of Rheumatology & Immunology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Matthias Hartmann
- German Centre for Paediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | - Joachim Peitz-Kornbrust
- Department of Pediatric Rheumatology, Asklepios Kinderklinik Sankt Augustin, Sankt Augustin, Germany
| | - Kirsten Minden
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany
- Department of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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