Physical activity in patients with oligo- and polyarticular juvenile idiopathic arthritis diagnosed in the era of biologics: a controlled cross-sectional study

Abstract

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.

Physical Fitness in Patients With Oligoarticular and Polyarticular Juvenile Idiopathic Arthritis Diagnosed in the Era of Biologics: A Controlled Cross‐Sectional Study

“…The latter is potentially important as advances in medical therapies could have an impact on physical fitness. Contrary to previous studies, our research group recently reported that objectively measured PA levels were comparable between patients with JIA and controls from the general population ; indicating that it would be informative to evaluate physical fitness in the same cohort. The aims of the present study were 3‐fold and included comparing physical fitness in patients with JIA who were diagnosed in the era of biologics with age‐ and sex‐matched controls from the general population, comparing physical fitness in patients with persistent oligoarticular JIA and those who had polyarticular disease to examine if disease severity is still of importance, and exploring associations between physical fitness and different disease variables.…”

“…We believe our findings suggest that JIA‐related disease factors no longer have an impact on physical fitness when multidisciplinary patient care is given in the era of biologics, but further studies are needed. Studying the same cohort, we have previously found comparable overall physical activity levels between patients and controls , which we believe contribute to our findings of no associations between disease variables and physical fitness.…”

“…The total body composition in our cohort of patients with JIA is more favorable than that which has been described in previous studies . Advances in the multidisciplinary management of JIA might explain this result, subsequently leading to PA levels being relatively comparable between patients and controls (), which is important for healthy body composition.…”

“…Some of the demographic characteristics of the study population and disease characteristics of the cohort of patients with JIA have previously been published , but are shown in Table for the sake of clarity and completeness. No significant difference was found in puberty stages (Table ) or in age at menarche among the girls.…”

I don’t want to think about it: a qualitative study of children (6 -18 years) with rheumatic diseases and parents' experiences with regular needle injections at home

“…Overall outcomes of rheumatic diseases (RD) in childhood have improved substantially due to new treatment programs, including the use of biologic agents and methotrexate combined with physical activity (1)(2)(3)(4). Children and parents must administer most of these drugs via regular needle injections.…”