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Motor performance and functional ability in preschool- and early school-aged children with Juvenile Idiopathic
Janjaap van der Net1, Patrick van der Torre, Raoul Hh Engelbert
1Dept, of pediatric physical therapy and pediatric exercise physiology, Children's Hospital at the University Medical Centre at Utrecht, Suite: KB 02,056,0, PO Box 85090, 3508 AB Utrecht, The Netherlands. J.vandernet@umcutrecht.nl.
Insights
Young children with Juvenile Idiopathic Arthritis (JIA) show varying motor and functional skill impairments. Preschoolers with JIA experience more motor delays, while early school-aged children face functional skill deficits.
Area of Science:
- Pediatric Rheumatology
- Child Development
- Rehabilitation Medicine
Background:
- Juvenile Idiopathic Arthritis (JIA) affects children's motor and functional abilities.
- Understanding these impacts is crucial for timely intervention and support.
Purpose of the Study:
- To assess motor performance and functional skills in young children with JIA.
- To identify differences in impairments between preschool-aged (PSA) and early school-aged (ESA) children with JIA.
Main Methods:
- Cross-sectional study of 56 children with JIA, categorized as PSA and ESA.
- Motor performance assessed using Bayley Scales of Infant Development II (BSID2) and Movement Assessment Battery for Children (M-ABC).
- Functional skills evaluated with the Pediatric Evaluation of Disability Inventory (PEDI).
Main Results:
- Preschool-aged children with JIA exhibited delayed motor performance (45% severely delayed) and some functional skill deficits.
- Early school-aged children with JIA showed normal motor performance but impaired functional skills (70% with deficits in mobility).
- Disease onset and duration correlated with motor performance and functional outcomes.
Conclusions:
- Preschoolers with JIA are more prone to motor impairments, while older children experience functional skill limitations.
- Polyarticular disease course is linked to greater motor and functional deficits.
- Clinical follow-up and rehabilitation should target both motor performance and functional skills in young JIA patients.
Objective:
To describe the level of motor performance and functional skills in young children with JIA.
Methods:
In a cross-sectional study in 56 preschool-aged (PSA) and early school- aged children (ESA) with JIA according to ILAR classification, motor performance was measured with the Bayley Scales of Infant Development II (BSID2) and the Movement Assessment Battery for Children (M-ABC). Functional skills were measured with the Pediatric Evaluation of Disability Inventory (PEDI). Disease outcome was measured with a joint count on swelling/range of joint motion, functional ability and joint pain.
Results:
Twenty two PSA children (mean age 2.1 years) with a mean Developmental Index of the BSID2 of 77.9 indicating a delayed motor performance; 45% of PSA children showed a severe delayed motor performance. Mean PEDI scores were normal, 38% of PSA scored below -2 SD in one or more domains of the PEDI. Thirty four ESA children (mean age 5.2 years) with a mean M-ABC 42.7, indicating a normal motor performance, 12% of ESA children had an abnormal score. Mean PEDI scores showed impaired mobility skills, 70% of ESA children scored below -2 SD in one or more domains of the PEDI. Disease outcome in both age groups demonstrated low to moderate scores. Significant correlations were found between age at disease onset, disease duration and BSID2 or M-ABC and between disease outcome and PEDI in both age cohorts.
Conclusion:
More PSA children have more impaired motor performance than impaired functional skills, while ESA children have more impairment in functional skills. Disease onset and disease duration are correlated with motor performance in both groups. Impaired motor performance and delayed functional skills is primarily found in children with a polyarticular disease course. Clinical follow up and rehabilitation programs should also focus on motor performance and functional skills development in young children with JIA.
