Development of a disability measurement tool for juvenile rheumatoid arthritis. The juvenile arthritis functional assessment report for children and their parents

Howe, Steven R.; Levinson, Joseph E.; Shear, Edith S.; Hartner, Sandra; McGirr, Gerri; Schulte, Marion; Lovell, Daniel J.

doi:10.1002/art.1780340713

Cited by 174 publications

(79 citation statements)

References 6 publications

(2 reference statements)

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“…A standard rheumatology joint exam was performed on the JRA patients (25). The Juvenile Arthritis Functional Assessment Report (JAFAR), a validated questionnaire designed to measure physical function limitation in routine daily activities in children with JRA, was administered to the parents of participating JRA patients (26). Assessment of the Steinbrocker functional class (27) was performed by one rheumatologist (DJL).…”

Section: Methodsmentioning

confidence: 99%

Predictors of total body bone mineral density in non‐corticosteroid‐treated prepubertal children with juvenile rheumatoid arthritis

Specker

et al. 1997

Arthritis & Rheumatism

103

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Objective. To determine the extent of significant osteopenia in prepubertal patients with juvenile rheumatoid arthritis (JRA) not treated with corticosteroids and to identify variables that are highly related to bone mineralization in this population.Methods. In a cross-sectional study, 48 JRA patients and 25 healthy control subjects ages 4.6-11.0 years were evaluated. Total body bone mineral density (TB BMD) was determined by Hologic dual energy x-ray absorptiometry. All patients were prepubertal (Tanner stage 1 or 11) and had never taken corticosteroids. For comparison, JRA patients were divided into c'lo~7' TB BMD (Z score 5-1) or "normal" TB BMD (Z score >-1).Results. The overall mean k SD TB BMD scores did not differ between the JRA subjects (0.75 2 0.06 gm/cm2) and controls (0.73 k 0.07 gm/cm2; P > 0.30).However, 29.2% of the JRA patients had low TB BMD, whereas only 16% would be expected to have low TB BMD based on the standard normal distribution (goodness of fit 2 = 4.84, P = 0.01). The mean Z score for the JRA patients with low TB BMD was -1.43, and for those with normal TB BMD, it was 0.32. The JRA subjects with low TB BMD were significantly younger, had more active articular disease, greater physical function limitation, higher erythrocyte sedimentation rate, higher joint count severity score, lower body mass index, lower lean body mass, less participation in organized sports, and more protein and vitamin D in their diet compared with JRA patients with normal TB BMD (all P < 0.05). Using logistic regression, a model including age at JRA onset, Juvenile Arthritis Functional Assessment Report (JAFAR) score, triceps skinfold percentiles, percentage US recommended daily allowance for dietary magnesium intake, and serum 1,25-dihydroxyvitamin D levels was able to accurately segregate 79.6% of the JRA subjects into either the low or normal TB BMD groups (2 = 20.5, P = 0.001).Conclusion. This study demonstrated that in a mildly to moderately ill prepubertal JRA population that had never been exposed to corticosteroids, almost 30% had significantly low TB BMD. The patients with low TB BMD had more active and severe articular disease and greater physical function limitation. Disease-related parameters in JRA appear to exert a negative effect on bone mineralization even in prepubertal children, which can be demonstrated despite the exclusion of corticosteroid-treated patients.

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Section: Methodsmentioning

confidence: 99%

Predictors of total body bone mineral density in non‐corticosteroid‐treated prepubertal children with juvenile rheumatoid arthritis

Specker

et al. 1997

Arthritis & Rheumatism

103

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“…The Juvenile Arthritis Functional Assessment Report (JAFAR), a validated report-based measure of childhood disability, was administered to the parents of participating JRA patients (8). Recruitment, instruction for completion, and followup review for each component of this study were performed by the same individual (CJH).…”

Section: Methodsmentioning

confidence: 99%

“…Each Caltrac was checked for accuracy prior to each subject's use by being programmed in the standard fashion and then mounted on a lever-arm to duplicate movement in a vertical plane at 2 selected speeds. In order to check monitor constancy over time, each programmed Caltrac was left overnight at rest for [8][9][10] hours, and the counts accumulated were compared to the Caltrac's original overnight calibration reading. The Caltrac has been validated and used in several studies of healthy children (11-13).…”

Section: Methodsmentioning

confidence: 99%

Physical activity in children with juvenile rheumatoid arthritis: Quantification and evaluation

Henderson

Lovell

Specker

et al. 1995

Arthritis & Rheumatism

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Objective. To measure daily physical activity in patients with juvenile rheumatoid arthritis (IRA] and in healthy controls, and to identify variables that may influence physical activity in IRA patients.Methods. Twenty-three prepubertal children, ages 5-11 years, with mild to moderate IRA and no prior exposure to systemic glucocorticosteroids, were compared to 23 healthy children of similar age. Physical activity was measured for 3 days (minimum of one weekend day] using 3 standardized methods simultaneously. Total body movement was assessed by the Caltrac accelerometer and the University of Cincinnati Motion Sensor (UCMS]. The Caltrac measured movement in the vertical plane; the UCMS measured movement of 10" or more from the horizontal plane. The type and intensity of daily physical activity was measured by the %day activity record, which also recorded the number of hours of daily sleep. Participation and duration of involvement in organized sports was ascertained by questionnaire. 114Results. The mean physical activity was significantly lower in JRA patients than in controls for the activity diary {P = 0.05). However, daily body movement measured by the Caltrac and UCMS were similar for both groups. Differences were seen in the number of hours of sleep per day (P = 0.02) and participation in strenuous activities (P < 0.01). IRA patients had significantly less participation in organized sports [P = 0.011.Conclusion. There was less daily physical activity by this group of JRA patients than for healthy ageand sex-matched control subjects.

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“…Juvenile Arthritis Functional Assessment Report-Parent (JAFAR-P; Howe et al, 1991). The Juvenile Arthritis Functional Assessment Report-Parent (JAFAR-P; Howe et al, 1991) is the parent version of the JAFAR-C with identical items and scoring.…”

Section: Parent-report Measuresmentioning

confidence: 99%

A longitudinal examination of the parent–child distress relationship in children with juvenile rheumatic disease.

Ryan¹,

Ramsey²,

Fedele³

et al. 2010

Rehabilitation Psychology

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Objective: To examine the longitudinal relationships between parent and child distress in a sample of children with juvenile rheumatic diseases (JRDs). Design: Cross-lagged panel correlation analysis tested the temporal precedence of parent distress versus child distress over a 1-year period. Participants: Thirty-seven children (ages 9–17 years; 22 girls) diagnosed with JRD and their parents completed self-report measures on 2 occasions (assessment interval M = 12 months). Primary Outcome Measures: Child Depression Inventory and Brief Symptom Inventory. Results: Significant cross-sectional parent–child distress associations were observed at both time points. Moreover, Time 1 parent distress predicted child distress at Time 2 after child-reported functional ability was controlled; Time 1 child distress was unrelated to Time 2 parent distress. Cross-lagged panel correlations demonstrated the temporal precedence of parent distress relative to child distress in the parent–child distress relationship. Conclusions: These preliminary findings underscore the importance of parent distress in parent–child transactional adjustment, and suggest a predominant role for parent distress in children's adjustment to JRDs.

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Development of a disability measurement tool for juvenile rheumatoid arthritis. The juvenile arthritis functional assessment report for children and their parents

Cited by 174 publications

References 6 publications

Predictors of total body bone mineral density in non‐corticosteroid‐treated prepubertal children with juvenile rheumatoid arthritis

Predictors of total body bone mineral density in non‐corticosteroid‐treated prepubertal children with juvenile rheumatoid arthritis

Physical activity in children with juvenile rheumatoid arthritis: Quantification and evaluation

A longitudinal examination of the parent–child distress relationship in children with juvenile rheumatic disease.

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