Cardiorespiratory fitness assessed with cardiopulmonary exercise testing in patients with juvenile idiopathic arthritis: a systematic review and meta-analysis.

Abstract

Juvenile idiopathic arthritis (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 to healthy controls. 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 versus 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. From 480 literature records initially retrieved, 8 studies (538 participants) were included in final meta-analysis. VO2peak was significantly lower in patients with JIA compared to controls [weighted-mean-difference, WMD:-5.95 ml/kg/min, 95% CI (-9.26; -2.65)]; Exercise duration as well as VO2peak(%predicted) were found to be significantly impaired in patients with JIA compared to controls [standardized-mean-difference, SMD: -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. VO2peak and other CPET variables were lower in patients with JIA compared to 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. CRD42022380833.