Abstract
BackgroundChronic non-bacterial osteomyelitis (CNO) is an autoinflammatory disorder of the skeletal system of yet unknown etiology. Patients present with local bone pain and inflammation and - to our experience - often suffer from functional impairment with significant disabilities of daily life. The objective of this study was to assess physical activity, fitness and health-related quality of life (HRQOL) in adolescents with established diagnosis of CNO versus healthy controls (HC).Methods15 patients with CNO and 15 age and gender matched HC aged 13–18 years, completed questionnaires, performed an incremental exercise test with gas exchange measures up to voluntary fatigue and wore an accelerometer over 7 days at home to assess physical activity behavior.ResultsAt the time of assessment, 5 CNO patients were in clinical, one in radiological and 5 in clinical and radiological remission. 7 did not receive any therapy at the time of assessment. The results of the exercise test and of the accelerometry did not show any significant difference between CNO and HC. However, reported sports participation was lower in patients with CNO and PedsQL3.0 and 4.0 showed significant lower values in most of the scores indicating reduced HRQOL.ConclusionAlthough most CNO patients showed a favorable course of disease without any relevant differences in objective measurements of physical activity and fitness versus HC at the time of assessment, questionnaires revealed perceived limitations. Further studies are needed to measure HRQOL and to validate questionnaires in patients with CNO against objective measures including more participants with a higher level of disease activity.
Highlights
Chronic non-bacterial osteomyelitis (CNO) is an autoinflammatory disorder of the skeletal system of yet unknown etiology
Moderate physical activity (MPA) time spent in moderate physical activity, VPA time spent in vigorous physical activity biopsy)
Results are Spearman correlation coefficients (r) and the respective probability of a type I error (p) MPA time spent in moderate physical activity, VPA time spent in vigorous physical activity, Moderate and vigorous activity (MVPA) time spent in moderate and vigorous physical activity, Wpeak maximal power in cycle ergometry, HRpeak peak heart rate in cycle ergometry, VO2peak peak oxygen uptake in cycle ergometry, RQpeak peak respiratory quotient, visual analogue scales (VAS) visual analogue scale
Summary
Chronic non-bacterial osteomyelitis (CNO) is an autoinflammatory disorder of the skeletal system of yet unknown etiology. Patients present with local bone pain and inflammation and - to our experience - often suffer from functional impairment with significant disabilities of daily life. Chronic non-bacterial osteomyelitis (CNO) is an autoinflammatory disease of yet unknown etiology, which is mainly affecting the metaphysis of long bones, the pelvis, vertebral bodies and the clavicles or almost every site of the skeleton in children and adolescents [1,2,3]. Affected youths usually present with localized inflammation, including bone pain, swelling and warmth, often combined with functional impairment. HRQoL is a multidimensional concept that incorporates measures of physical symptoms, functional status, and disease impact on psychological and social functioning, in accordance with the definition of health proposed by the WHO. HRQoL instruments (generic and diseasespecific) have been developed and used to measure the
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