AQUATIC PHYSICAL TRAINING PROGRAM FOR CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS (JIA)

Abstract

The aim of this interim analysis was to evaluate whether JIA patients participating in a 26-week aquatic aerobic physical training program encountered detrimental effects of the physical training. Since only one report on aquatics in children has been published, there is too little evidence on this subject. Negative effects would make it unethical to proceed with the current training program. Forteen Dutch children with JIA (9 females, 5 males, age range 4 to 14 years, mean 8.9 years) were recruited from our pediatric rheumatology outpatient clinic. All children received medical treatment for their active joint disease for at least 6 months prior to inclusion. The children were randomized into an experimental (Exp; N = 7) and an assessment only (Con; N = 7) group. All children received the common medical treatment during the study. The children in the Exp-group received a 26-week aquatic group (2–4 children/group) exercise program, 1 hr a week. The program consisted predominantly of aerobic exercises in a heated pool (30–33° C). The following instruments were used: Childhood Health Assessment Questionnaire (CHAQ; functional ability), Juvenile Arthritis Quality of Life Questionnaire (JAQQ; health-related quality of life), Child Health Questionnaire (CHQ; health-related quality of life), Juvenile Arthritis Functional Assessment Scale (JAFAS; functional ability), a range of motion score, and a Wingate anaerobic test. Parents provided their informed consent, the local ethical committe approved all procedures. Manova for repeated measurements was used to explore the effects of the intervention. The mean outcomes on the instruments showed positive trends of the training program on physical aspects of health status, range of motion, health-related quality of life, and anaerobic power, however these improvements were not significant. There were no detrimental effects of this aquatic aerobic training program, so the program could be continued in its current form. The positive effects were too small to reach statistical significance. Final analysis with a larger sample size might be able to reveal statistical significant improvements.