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Physical fitness levels in children with polyarticular juvenile rheumatoid arthritis
Insights
Children with juvenile rheumatoid arthritis (JRA) show lower physical fitness compared to healthy peers. This reduced fitness is not directly linked to disease severity, suggesting other factors influence activity levels.
Area of Science:
- Pediatric Rheumatology
- Exercise Physiology
- Child Health
Background:
- Juvenile rheumatoid arthritis (JRA) commonly presents with fatigue and extended exercise recovery.
- Physical conditioning is not a standard treatment for JRA, and children's fitness levels are understudied.
Purpose of the Study:
- To compare the physical fitness of children with polyarticular JRA to age- and sex-matched controls.
- To investigate the relationship between JRA disease activity and physical fitness levels.
Main Methods:
- Utilized the Health Related Physical Fitness Test (HRPFT) to assess 20 children (ages 6-11) with polyarticular JRA.
- Correlated fitness scores with joint counts and a composite articular severity index.
Main Results:
- Children with polyarticular JRA demonstrated significantly lower physical fitness than their healthy counterparts.
- No significant correlation was found between joint counts/disease severity and reduced fitness scores.
Conclusions:
- A standardized fitness test can effectively assess children with JRA.
- Physical fitness levels in JRA patients appear independent of disease activity measures.
- Concerns about exercise exacerbating JRA may contribute to observed low fitness levels.
Abstract:
Children with juvenile rheumatoid arthritis (JRA) often exhibit fatigue and prolonged exercise recovery. Improved fitness through physical conditioning has not been a goal of standard medical or physical treatment regimens for JRA, and fitness levels of children with JRA have rarely been studied. We compared physical fitness in 20 6 to 11-year-old patients with polyarticular JRA with sex-, age-, and size-matched controls, using the Health Related Physical Fitness Test (HRPFT), a national, standardized, norm-referenced test. We correlated fitness scores with summary joint counts, and with an articular severity index (sum of joint swelling, tenderness, pain, and limited range for each child). The results showed that children with polyarticular JRA were less physically fit than normally active (noncompetitively athletic) children of the same sex, age, and size. There was no statistically significant relationship between increased joint counts, and/or disease severity scores, and reduced fitness scores. This suggests that physical fitness levels are less related to degree of "disease activity" than is often thought. We conclude that (1) a readily available, nationally standardized fitness test can be used to assess children with JRA: and (2) fitness levels and measures of disease activity do not correlate. We believe that multiple factors, perhaps including family, physician, and school concerns about potential disease exacerbation following exercise, may account for the low fitness levels observed in children with JRA.