Physical activity in children with Juvenile Idiopathic Arthritis compared to controls.

G J F Joyce Bos,Pieter J J Sauer,Wineke Armbrust,Otto T H M Lelieveld,Jan H B Geertzen,Pieter U Dijkstra

doi:10.1186/s12969-016-0102-8

Abstract

BackgroundTo compare physical activity (PA) in children with juvenile idiopathic arthritis (JIA) with controls and to analyse the effect of disease specific factors on PA in children with JIA treated according to current treatment regimes.MethodsPA was measured with a 7-day activity diary and expressed as physical activity level (PAL). Moderate to vigorous physical activity (MVPA) (hours/day) and sedentary time (hours/day) was determined. In children with JIA, medication, the number of swollen and/or painful joints, disease activity, functional ability, pain and well-being was determined. Multivariate regression analysis was performed to analyze differences in PA between JIA and controls, adjusted for influences of age, gender, season, Body Mass Index (BMI) and to analyze predictors of PA in JIA patients.ResultsSeventy-six children with JIA (26 boys and 50 girls, mean ± SD age 10.0 ± 1.4 years) and 131 controls (49 boys and 82 girls, mean ± SD age 10.4 ± 1.2 years) participated in this study. Children with JIA had a significantly lower PAL (0.10, p = 0.01) corrected for age, BMI, gender and season. They spent less time in MVPA (0.41 h/day, p = 0.06) and had a significantly higher mean time spent in sedentary activities (0.59 h/day, p 0.02) compared to controls. The activity level of children with JIA was related to age, gender, season, feeling of well-being and pain.ConclusionChildren with JIA have a lower PAL, spent less time in MVPA and spent more time on sedentary activities compared to controls despite current medical treatment and PA encouragement.Trial registrationData of the children with JIA are from the Rheumates@work study ISRCTN92733069.

Highlights

To compare physical activity (PA) in children with juvenile idiopathic arthritis (JIA) with controls and to analyse the effect of disease specific factors on PA in children with JIA treated according to current treatment regimes
Of the children with JIA 75 % (57) were on medication, 36 % (27) did not have any disease activity according to the assessment by the pediatric rheumatologist and 46 % (35) of the children with JIA did not have any swollen and/or painful joints
This study shows that the physical activity level of children with JIA, treated according to recent treatment guidelines [12], is lower compared to controls

Summary

Introduction

To compare physical activity (PA) in children with juvenile idiopathic arthritis (JIA) with controls and to analyse the effect of disease specific factors on PA in children with JIA treated according to current treatment regimes. The treatment of Juvenile Idiopathic Arthritis (JIA) has changed in the past decade, due to insights in pathogenesis and the availability of new medication biologic drugs [1]. It is expected that the new treatment options reduce the burden of having JIA including improved physical activity (PA) levels. Activity is more encouraged in children with JIA and PA is considered to be safe [8,9,10]. In the Netherlands, there is consensus to encourage children with JIA to be physically active even when there are signs of active

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