BackgroundKnowledge about objectively measured levels of physical activity (PA) and PA participation (included facilitators and barriers for PA) in patients with juvenile idiopathic arthritis (JIA) diagnosed in the era of biologics is limited. We aimed to compare objectively measured PA in patients with oligo- and polyarticular JIA diagnosed in the biologic era with controls and to examine associations between PA and disease variables; furthermore, to explore participation in PA, physical education (PE) and facilitators and barriers for PA participation in patients and controls.MethodsThe study cohort included 60 patients (30 persistent oligo JIA/30 poly-articular disease) and 60 age- and sex-matched controls. Age range was 10–16 years and 83% were female. PA was measured with accelerometry for seven consecutive days. Disease activity, current treatment, disease duration, functional ability, pain and fatigue were assessed. Structured interviews were applied to explore participation in PA and PE, and PA facilitators and barriers.ResultsPatients spent less time in daily vigorous PA than controls, (mean(SE) 21(2) min vs. 26(2) min, p = 0.02), while counts per minute (cpm), steps daily, sedentary time and light and moderate PA did not differ. No differences were found between JIA subgroups. The use of biologic medication was associated with higher cpm and lower sedentary time. Most patients and controls participated in organized or unorganized PA and PE, and enjoyment was the most reported facilitator for PA participation. More patients than controls reported pain as a PA barrier.ConclusionThe PA levels and participation in patients with oligo- and polyarticular JIA are mostly comparable to controls, but patients still need to be encouraged to increase vigorous PA. Enjoyment is the most important facilitator for PA participation in patients with JIA.

Objective. To perform a comprehensive evaluation of and identify correlates for physical fitness in consecutive patients with juvenile idiopathic arthritis (JIA) who have been diagnosed in the era of biologics and to compare the results with those obtained in healthy controls.Methods. The study cohort included 60 patients with JIA (50 girls) ages 10-16 years and 60 age-and sexmatched controls. The JIA group included 30 patients with persistent oligoarticular JIA and 30 patients with extended oligoarticular or polyarticular disease. Measures of physical fitness included cardiorespiratory fitness (CRF) by peak oxygen uptake (Vo 2peak ) during a continuous graded treadmill exercise test, muscle strength by isokinetic and isometric knee and hand grip evaluations, and bone mineral density (BMD) and body composition by dual-energy x-ray absorptiometry. Physical activity was assessed by accelerometry.Results. Forty-two percent of the patients were being treated with biologic drugs. Patients with JIA demonstrated lower muscle strength and total body BMD compared to controls, but there were no differences in CRF and body composition. Physical fitness was comparable between the persistent oligoarticular and extended oligoarticular/ polyarticular-JIA groups. In patients with JIA, we identified associations between higher vigorous physical activity and higher CRF and muscle strength, but did not find any association between physical fitness and disease variables.Conclusion. In this cohort of patients with JIA, we found suboptimal muscle strength and BMD compared to controls, but no differences in CRF and body composition. Vigorous physical activities appeared important for optimizing muscle strength and CRF in patients with JIA; the importance of such activities should be highlighted in patient education.

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...