BackgroundKnowledge is sparse regarding facilitators and barriers for participation in physical activity (PA) in patients with juvenile idiopathic arthritis (JIA) and whether they differ from controls. Furthermore, knowledge about preferences for leisure time physical activities and participation in physical education (PE) in school in JIA patients is limited.ObjectivesTo explore participation in PA and PE in JIA patients, and to explore facilitators and barriers for PA participation in JIA and matched controls.MethodsThe study cohort included 60 JIA patients (50 girls, 10 boys) and 60 controls individually matched for age and sex randomly selected from the Norwegian Population Registry. Of the JIA patients, 30 had persistent oligoarthritis and 30 had polyarticular disease (extended oligoarthritis and polyarticular RF +/-). The patients were aged 10–16 years and recruited consecutively at Oslo University Hospital in 2015. Participation in PA and facilitators and barriers for PA participation, were explored with structured interviews. The interview guide was developed for this study based on literature review and clinical experience. Differences between the study groups were analyzed using the McNemar test.ResultsParticipation in physical activities was not significantly different between JIA patients and controls (Table 1). The most commonly practiced organized physical activities in both groups were dancing and soccer, and the most commonly practiced unorganized physical activities were jogging, training at fitness center and strength exercising at home. Participation in PE is shown in Table 1. Fun was the most reported facilitator for participation in PA both in patients and controls, 40 (67%) vs 45 (75%), respectively, p=0.32. Becoming fit was an often reported facilitator in patients and controls, 12 (20%) vs 21 (35%) respectively, p=0.07. Being with friends was a facilitator more often reported by controls than patients, 13 (22%) in controls vs 1 (2%) patient (p<0.001). Less pain was a facilitator in 4 patients, but not in any controls (p=0.06). 26 (43%) patients and 19 (32%) controls reported barriers for participating in PA (p=0.46). More controls reported time as a PA barrier, 11 (18%) vs 3 (5%) (p=0.02), while more patients reported pain as a barrier; 18 (30%) vs 8 (13%) (p=0.03). Disease activity was a barrier in 4 (7%) patients.Table 1.Participation in physical activity (PA) and physical education (PE)JIA (n=60)Controls (n=60)p-value Participation in PA (organized/unorganized)51 (85)56 (93)0.14Participation in organized PA38 (63)47 (78)0.11Participation in unorganized PA41 (68)42 (70)1.00Participation in PE<0.001Always42 (70)59 (98)Always (sometimes with modification)16 (27)0 (0)Sometimes2 (3)1 (2)Numbers are n (%),ConclusionsThe majority of JIA patients and controls participated in organized or unorganized PA. Fun was the most reported facilitator in patients, followed by becoming fit and having less pain. Pain was the dominant PA barrier in patients, while time was the most frequently reported barrie...
BackgroundPrevious studies indicate that juvenile idiopathic arthritis (JIA) patients have lower levels of physical activity (PA), spend more time in sedentary PA and less time in moderate and vigorous PA than controls. Associations between PA and disease variables in JIA patients are inconclusive. To our knowledge, this study is the first to compare objectively measured PA in JIA patients treated in the era of biologics with healthy controls whose data collection were conducted at the same time as the patients.ObjectivesTo compare objectively measured levels and intensity of PA in JIA patients who have had access to biological treatment from disease onset with age- and sex-matched controls from the general population. Furthermore, to compare PA between JIA patients with persistent oligo- and poly-articular disease, and to examine associations between PA and disease variables in patients.MethodsPatients, 10–16 years, with persistent oligo- or poly-articular disease (extended oligoarthritis and polyarticular RF +/-), were recruited consecutively at Oslo University Hospital in 2015. Age- and sex-matched controls were selected randomly from the Norwegian Population Registry. PA was measured with accelerometers during 7 consecutive days. The general level of PA was determined by counts per minute (cpm) and steps daily. Cut-off points for different PA categories of intensity were used as described by Evenson1. Present pain, and pain and fatigue during the previous week were assessed in all participants. Disease activity, functional ability, diasease duration, use of medication and lower extremity joints with active arthritis were registered in patients. Differences between study groups were analyzed with paired or unpaired analyses as appropriate.ResultsAcceptable data from the accelerometers were retrieved in 53 matched pairs, of which 45 (85%) were female. Mean age was 13.3±2.2 years in patients and 13.2±2.6 years in controls, p=0.55. 26 (49%) patients had polyarticular disease. No significant differences were found in cpm or steps daily, or in time spent in sedentary PA, light PA or moderate PA in patients vs controls (Table 1). However, patients spent significantly less time in vigorous PA than controls. No significant differences in PA variables were found between JIA subgroups. The use of biologic medication correlated weakly with cpm, r=0.30, p=0.03, while no other disease variables correlated significantly with cpm or with vigorous PA (all r<0.30, p=NS).Table 1.Physical activityJIA (n=53)Controls (n=53)p-value Counts per minute457±194483±1350.45Steps daily9219±26799772±25750.27Sedentary daily (min)575±69571±580.66Light PA daily (min)189±48183±420.39Moderate PA daily (min)33±1137±120.08Vigorous PA daily (min)21±1226±140.04Achieves 60 min MVPA daily n (%)17 (32)26 (49)0.09Numbers are mean ± SD or N (%).ConclusionsGeneral level of physical activity and time spent in sedentary PA, light PA and moderate PA in JIA patients treated in the biological era are comparable with controls. However, patients spend less time ...
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