Abstract
ObjectiveTo describe the level of motor performance and functional skills in young children with JIA.MethodsIn a cross-sectional study in 56 preschool-aged (PSA) and early school- aged children (ESA) with JIA according to ILAR classification, motor performance was measured with the Bayley Scales of Infant Development II (BSID2) and the Movement Assessment Battery for Children (M-ABC). Functional skills were measured with the Pediatric Evaluation of Disability Inventory (PEDI). Disease outcome was measured with a joint count on swelling/range of joint motion, functional ability and joint pain.ResultsTwenty two PSA children (mean age 2.1 years) with a mean Developmental Index of the BSID2 of 77.9 indicating a delayed motor performance; 45% of PSA children showed a severe delayed motor performance. Mean PEDI scores were normal, 38% of PSA scored below -2 SD in one or more domains of the PEDI. Thirty four ESA children (mean age 5.2 years) with a mean M-ABC 42.7, indicating a normal motor performance, 12% of ESA children had an abnormal score. Mean PEDI scores showed impaired mobility skills, 70% of ESA children scored below -2 SD in one or more domains of the PEDI. Disease outcome in both age groups demonstrated low to moderate scores. Significant correlations were found between age at disease onset, disease duration and BSID2 or M-ABC and between disease outcome and PEDI in both age cohorts.ConclusionMore PSA children have more impaired motor performance than impaired functional skills, while ESA children have more impairment in functional skills. Disease onset and disease duration are correlated with motor performance in both groups. Impaired motor performance and delayed functional skills is primarily found in children with a polyarticular disease course. Clinical follow up and rehabilitation programs should also focus on motor performance and functional skills development in young children with JIA.
Highlights
Juvenile Idiopathic Arthritis (JIA) is the most common chronic joint disease in childhood [1]
Miller et al reported in a retrospective study of 88 school age children with Juvenile Rheumatoid Arthritis (JRA; referred to as JIA) that children with JRA have significantly impaired physical function compared to healthy children, including those with pauci-articular JRA [7]
This study describes the level of motor performance and the level of acquired functional ability in relation to clinical manifestation and disease outcome in PSA children with JIA and early school- aged children (ESA) children with JIA
Summary
Juvenile Idiopathic Arthritis (JIA) is the most common chronic joint disease in childhood [1]. Miller et al reported in a retrospective study of 88 school age children with Juvenile Rheumatoid Arthritis (JRA; referred to as JIA) that children with JRA have significantly impaired physical function compared to healthy children, including those with pauci-articular JRA ( referred to as oligo-articular JIA) [7] This seems relevant as school-age children are expected to have mastered a set of motor- and functional skills that allow them to fully participate in school activities, play and physical education. From this perspective it is of interest whether young children with JIA have a delayed motor performance and/or a delay in acquiring functional skills development and whether this is related to age at disease onset, disease course and disease severity. Currently there are no studies that describe the development of motor performance and functional skills and its relationship with age at disease onset, disease course and disease severity in young children with JIA
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