The present study suggests that acute endurance exercise leads not only to decreased BP but even more reduces aPWV as a measure of AS even after 60 minutes of recovery. In particular, the investigation provides evidence that acute moderate-intensity exercise has a favorable effect on BP and aPWV during stress testing.

Summary:Background: Regular physical activity is known to reduce arterial pressure (BP). In a previous investigation, we could prove that even a single bout of moderate-intensity continuous exercise (MICE) causes a prolonged reduction in BP. Whether high-intensity interval training (HIIT) has a favourable infl uence on BP, and therefore may be followed subjects and methods by a prolonged BP reduction, should be examined on the basis of blood pressure response after exercise and during a subsequent stress test. Patients and methods: In 39 healthy men (aged 34 ± 8 years, BMI 24 ± 2), peripheral and central BP were measured noninvasively at rest and at the end of a 2-min cold pressor test (CPT) using a Mobil-O-Graph (24 PWA monitor, IEM). Following HIIT (6 x 1 min at 98% of the previously determined maximum wattage, 4-min rest between intervals) BP was measured again throughout 60 min of rest and thereafter during a CPT. The results were compared with those obtained before HIIT. Results: Similar to MICE, peripheral and central BPs were signifi cantly (p < 0.05) lower 45 min after HIIT. When analysing peripheral BP during a CPT before and after exercise, signifi cantly lower systolic (p < 0.001) and diastolic (p = 0.008) pressures were established after HIIT. This was true for systolic (p = 0.002) and diastolic (p = 0.006) central BP as well. Although there were no more signifi cant differences between pressures at rest before and 60 min after exercise, the increase in peripheral systolic pressure due to CPT was signifi cantly slower after HIIT (p = 0.019) when compared with BP during CPT before exercise. This was true for central systolic BP as well (p = 0.017). Conclusion: HIIT leads to a BP reduction, which can still be detected up to 45 min after completion of the training. Even 60 min after exercise, pressures during a CPT showed a reduced augmentation, indicating an attenuated hemodynamic response to stress testing after HIIT.

BackgroundRegular school sports can help adolescents achieve the recommended amount of daily physical activity and provide knowledge, attitudes and behavioral skills that are needed in order to adopt and maintain a physically active lifestyle. Furthermore, it reaches all children including those that are at risk for engaging in more sedentary types of behavior. Since adolescents with juvenile idiopathic arthritis (JIA) are less involved in physical and social activities than their healthy peers, the objectives were to (1) estimate the prevalence of participation in school sports among patients with JIA; (2) determine the correlates associated with school sports absenteeism; and (3) investigate whether attendance in school sports has changed in the era of biologics.MethodsData from schoolchildren with JIA recorded in the German National Paediatric Rheumatologic Database (NPRD) in the years 2000 to 2015 were considered for the analyses. Data from the year 2015 were inspected to analyze correlates of school sports absenteeism. Whether school sports participation had changed between 2000 and 2015 was determined using linear mixed models.ResultsDuring the 15-year period, the participation rates in school sports were determined in 23,016 patients. The proportion of patients who participated in school sports almost always steadily increased from 31% in 2000 to 64% in 2015 (β = 0.017, 95% confidence interval (CI) 0.015, 0.020), whereas the exemption rate simultaneously decreased from 44% in 2000 to 16% in 2015 [β = − 0.009, 95% CI -0.011, − 0.007]. In 2015, the data from 5879 patients (mean age 13.1 ± 3.3 years, female 65%, disease duration 5.9 ± 4.0 years, persistent oligoarthritis 37%) were available for evaluation. Full exemption from school sports (in 16.1% of cases) was associated with functional limitations, disease activity and any use of DMARDs, intra-articular glucocorticoid injections or physiotherapy.ConclusionsSchool sports attendance among children and adolescents with JIA has increased significantly over the past 15 years. Possible explanations include improved functional ability probably due to better treatment options. The integration of patients with child acceptable symptom states who have previously been fully exempted from school sports needs to be addressed in the future.

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Acute MCT decreased PP and reduces AIx@75 after 60 min of recovery. Furthermore, PP and AIx@75 showed reduced values after completion of MCT indicating attenuated hemodynamic response to stress testing after MCT. Moreover, higher physical conditioning status was associated with more favorable effects on stress test-related arterial compliance.

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ZUSAMMENFASSUNGKinder und Jugendliche mit chronischen rheumatischen Erkrankungen erleben oft vielfältige Belastungen, wie Schmerzen, Funktionsstörungen, Nebenwirkungen von Medikamenten, und sind nicht selten durch zeitintensive Therapien und Arztbesuche in ihrem sozialen Leben beeinträchtigt. So kann – trotz immer besserer Therapiemöglichkeiten – auch die psychische Gesundheit leiden. Verschiedene Forschungsverbünde (z. B. COACH) und Studien (z. B. KickCOVID) widmen sich zurzeit mittels spezifischer Fragebögen psychischen Symptomen von Kindern und Jugendlichen mit verschiedenen chronischen Erkrankungen (z. B. Mukoviszidose, juvenile idiopathische Arthritis, Typ-1-Diabetes). Psychische Komorbiditäten können im Kontext einer chronischen Erkrankung zu einer schlechteren Lebensqualität sowie zu einer geringeren Therapieadhärenz führen, welche wiederum das Outcome der Grunderkrankung beeinträchtigt. Eine umfassende Versorgung chronisch kranker junger Menschen sollte daher ein standardisiertes Screening auf psychische Komorbiditäten im Rahmen routinemäßiger Verlaufskontrollen beinhalten.

Background:Health risk behaviors (HRB) are defined as specific forms of behavior associated with increased susceptibility to a specific disease or ill health on the basis of epidemiological or social data. The social implications of HRB include being able to use them as a way to gain respect and acceptance from peers, establishing independence from parents, or providing a subjective feeling of maturity and adequate stress management [1].Objectives:Since chronically ill adolescents such as those suffering from JIA can develop a HRB that is challenging for optimal care the aim of this study was to compare the frequency of HRB in adolescents with JIA and their peers, and to determine whether they change during the course of disease.Methods:Patients ≤ 16 years of age with recently diagnosed JIA (< 12 months) were enrolled in the inception cohort of patients with newly diagnosed JIA (ICON), an ongoing prospective observational, controlled multicenter study started in 2010. Patients from the age of 13 who were questioned about their health behavior and followed up for at least 2 years were selected. HRB were quantified and compared with those of subjects from the general population after matching for age and sex. Data from 2-year follow-up (FU) were used to analyze correlates of multiple risk behavior defined as involvement in two or more risky behaviors.Results:A total of 209 adolescents with JIA (63% female, mean age at baseline 14.4±0.9, mean disease duration 2.6±2.0) and 138 healthy peers (55% female, mean age 14.5±1.0) were included. At baseline, 51% of patients were treated with a DMARD, 21% with a biologic (FU: 59% and 38%). The most common JIA category was rheumatoid factor negative polyarthritis (28%). While at baseline 20% of patients and 4% of controls did not engage in regular physical activity, the proportion at follow-up amounted to 16% and 10%, respectively (OR 3.69; 95%CI: 1.01-13.50). In both groups the proportion of regular smokers, alcohol consumers and drug users increased during the observation period. Significant group differences were found in terms of alcohol consumption and smoking habits, but not in relation to illicit and legal drugs (see table). Patients stated significantly more often that they had not used a condom during their last sexual intercourse (28% vs. 19% controls, p<0.05). Multiple risk behavior was associated with PedsQL™ total score (OR 0.96; 95%CI: 0.92-0.99) and disease duration (OR 0.75; 95%CI: 0.57-0.98).Forms of HRBBaseline2-year follow-upJIAN=209 (%)CGN=138 (%)JIAN=209 (%)CGN=138 (%)Inactivity/smoking/alcohol consumption Physical activity <1/week20.33.716.29.5 Active ≤2/week58.943.454.442.3 Regular smokers2.40.77.82.2 Regular alcohol consumers3.83.615.823.2Drug use 12-month prevalence1.91.48.18.0 Multiple consumers0.50.04.83.6Sexual intercourse Lifetime prevalence3.31.425.223.2 No condom use during last sexual intercourse28.650.028.019.4Conclusion:Although adolescents with JIA became more physically active during the course of the disease, they are as likely, or more likely, to take risky behaviors than their healthy peers, except for alcohol consumption. In order to achieve optimal outcomes, addressing emotional wellbeing and providing mandatory anticipatory guidance appears to be warranted in this population.References:[1]Villarreal-Rodriguez D et al. Adolescents with chronic disease and participation in risky behaviors. Medicina Universitaria 2013;15(58):21–25.Acknowledgments:ICON is supported by a grant from the German Federal Ministry of Education and Research (FKZ 01 ER 1504A)Disclosure of Interests:Florian Milatz: None declared, Ina Liedmann: None declared, Martina Niewerth: None declared, Jens Klotsche: None declared, Gerd Horneff Grant/research support from: AbbVie, Chugai, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Speakers bureau: AbbVie, Bayer, Chugai, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Frank Weller-Heinemann: None declared, Ivan Foeldvari Consultant of: Novartis, Daniel Windschall: None declared, Kirsten Minden Consultant of: GlaxoSmithKline, Sanofi, Speakers bureau: Roche