Land-Jump Performance in Patients with Juvenile Idiopathic Arthritis (JIA): A Comparison to Matched Controls

Abstract

Objective. The purpose of this study was to determine if high functioning children with Juvenile Idiopathic Arthritis (JIA) with minimal disease activity have different biomechanics during high loading tasks compared to controls. Patients were included if they had minimal inflammation documented in one or both knees. Methods. The subject groups consisted of eleven patients with JIA and eleven sex, age, height, and weight matched controls. Sagittal plane kinematic and kinetics were calculated during a drop vertical jump maneuver. The Child Health Assessment Questionnaire (CHAQ) was collected on each patient with JIA. Results. The subjects with JIA had increased knee (P = .011) and hip flexion (P < .001) compared to control subjects. Subjects with JIA also demonstrated decreased knee extensor moments during take-off (P = .028) and ankle plantar flexor moments during landing (P = .024) and take-off (P = .004). In the JIA group, increased hip extensor moments were predictive of increased disability (R 2 = .477, S E E = .131). Conclusions. Patients with JIA may demonstrate underlying biomechanical deviations compared to controls. In addition, biomechanical assessment of hip extensor mechanics during dynamic tasks may provide an objective assessment tool to determine overall function in patients with JIA.

Preliminary Evidence of Altered Biomechanics in Adolescents With Juvenile Fibromyalgia

“…For biomechanical assessments, participants wore 43 retro-reflective markers placed on standardized locations with a minimum of three markers per segment, including bilateral lower extremities (e.g., foot, shank, thigh) and trunk (e.g., pelvis, thorax) (20). A static trial was collected first in which the participant stood still, aligned with the laboratory coordinate system, in order to measure the participants’ neutral (zero) alignment.…”

“…For example, adults with fibromyalgia and youth with rheumatic conditions are weaker in lower extremity strength compared to healthy controls (13–16). Such biodynamic deviations can alter their joint mechanics, exacerbate chronic pain, and consequently increase their risk of falls as demonstrated in adults with fibromyalgia (9, 17–19) and adolescents with other rheumatic or chronic pain conditions (20–22). The increased risk for functional deficits and pain flares with physical activity for patients with JFM can interfere with their ability to safely engage in exercise, and contribute to a downward progression of disability, pain-related fear, and activity avoidance into adulthood.…”

Can Modified Neuromuscular Training Support the Treatment of Chronic Pain in Adolescents?

“…For example, patients with juvenile idiopathic arthritis have demonstrated altered landing mechanics during a drop vertical jump task when compared with control subjects, and these biomechanical deficits were also found to be predictive of higher disability (6). In addition, results from our laboratory indicate that adolescents with fibromyalgia exhibit decreased knee extension, knee flexion, and hip abduction strength and dynamic stability when compared with their active peers (30).…”

A Feasibility Study of the Effect of Intra-Articular Corticosteroid Injection on Isokinetic Muscle Strength in Children With Juvenile Idiopathic Arthritis

“…Participants in our study did not undertake any strengthening exercises post injection. The failure of knee extensor strength to improve to be equivalent to strength of the unaffected limb implies that exercise programs following intra-articular corticosteroid injection may be warranted, not only with the aim of improving strength but to improve function and address abnormalities in gait biomechanics that have been noted in children with JIA with inactive inflammation (1,16,39).…”