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.

BackgroundRegular physical education (PE) can help adolescents achieve the recommended amount of daily physical activity and provide immediate health benefits, by positively affecting musculo-skeletal development, mental health and social behavior. Adolescents with juvenile idiopathic arthritis (JIA) are less physically active and have lower fitness levels than their healthy peers [1]. Moreover, pain and fatigue are one of the most frequent complaints and identified as one of the causes behind impaired (social) functioning [2].ObjectivesTo describe the participation rate in PE and to assess its relationship to pain and fatigue in adolescents with JIA.MethodsCross-sectional data of adolescents with JIA recorded in the National Paediatric Rheumatological Database (NPRD) in the year 2015 were considered for the analyses. Disease characteristics were provided by rheumatologists along with patient-reported outcomes and participation in PE. Relationship to PE was assessed by using spearman's correlation.ResultsIn 2015, a total of 3,289 adolescents with JIA (females 66%, mean disease duration 5 years, persistent oligoarthritis 30%) aged 13 to 17 were recorded. About 60% of the patients reported to participate in PE “always” (56% of girls, 69% of boys), whereas about 18% stated to be fully exempt from participating in PE (20% of girls, 14% of boys). Significant differences were observed among JIA subtypes, whereby patients with enthesitis-related arthritis participated more frequently than patients with rheumatoid factor-positive polyarthritis (64% vs. 46%). The mean pain level was 2.1, the mean fatigue level 1.8. Participation in PE was negatively correlated with self-reported pain intensity (r=-0.43) and fatigue (r=-0.32). Significant associations were found between PE attendance and age, sex, disease duration, functional status as well as disease activity measured by CHAQ and JADAS3–10, respectively (p<0.05).Conclusions6 of 10 adolescents with JIA participate in PE always, whereby higher rates of self-reported attendance are associated with less severe pain and fatigue. Since exercise programs in JIA lead to significant improvements in quality of life, it is likely that physical education attendance plays an important role in pain reduction and social functioning improvement in JIA.References van Brussel M et al. Aerobic and anaerobic exercise capacity in children with juvenile idiopathic arthritis. Arthritis Rheum 2007;57:891–7.Eyckmans L et al. What does it mean to grow up with juvenile idiopathic arthritis? A qualitative study on the perspectives of patients. Clin Rheumatol. 2011;30:459–65. AcknowledgementsThe National Paediatric Rheumatological Database has been funded by the German Children Arthritis Foundation (Deutsche Kinder-Rheumastiftung).Disclosure of InterestF. Milatz: None declared, M. Niewerth: None declared, N. Geisemeyer: None declared, J. Peitz: None declared, C. Rietschel: None declared, T. Lutz: None declared, A. Holl-Wieden: None declared, K. Minden Speakers bureau: Pfizer, Roche, Pharm-Allergan