Exercise testing and fitness training in juvenile idiopathic arthritis

Abstract

Juvenile Idiopathic Arthritis is the commonest rheumatic disease of childhood affecting 1:1000 children under the age of 16 years. Children with JIA have long been sidelined from physical activity due to active disease or irrational concerns that activity may in some way worsen disease. Children with JIA were able to complete quite rigorous procedures for aerobic and anaerobic fitness testing along with isometric and isokinetic muscle strength testing in our studies. We found that children with JIA are considerably deconditioned when compared to their normal peers and that they can safely participate in most forms of strenuous training when not suffering acute bouts of inflammation. They did not have any worsening of disease or severe pain with exercise and experienced likely benefits in function and activity promotion. A pilot study of muscle strength following intra-articular steroid injection showed that muscle strength was improved in the short term and a study using peak power output to predict maximal aerobic capacity showed a good correlation. This thesis shows that children with JIA can safely participate in exercise testing and training and that there may be significant benefits to encouraging activity in this group