Juvenile arthritis teens less physically active

By Michelle Rizzo

NEW YORK (Reuters Health) - Physical activity levels are low in adolescents with juvenile idiopathic arthritis, and this appears to be unrelated to disease activity, study findings in the journal Arthritis and Rheumatism indicate.

“The beneficial effects of physical activity on normal growth and development of children and adolescents have been widely recognized,” write Dr. Otto T. H. M. Lelieveld and colleagues from University Medical Center Groningen in the Netherlands. “To our knowledge, physical activity has not previously been studied in adolescents with juvenile idiopathic arthritis.”

Previously referred to as juvenile rheumatoid arthritis, juvenile idiopathic arthritis begins before the age of 16 years, causing pain, inflammation and cellular damage in the lining of the joints. The disease may have a variety of symptoms and degree of severity. The cause of disease is not known - idiopathic - but it is thought to be related to genetic and environmental factors.

The researchers conducted a study with 30 adolescents with juvenile idiopathic arthritis who were compared with 106 healthy peers. A 3-day activity diary and data from a bicycle ergometry test, which measured the amount of work done during exertion, were used to assess physical and aerobic capacity.

Subjects with juvenile idiopathic arthritis had significantly lower total calorie expenditure, activity-related calorie expenditure, and physical activity levels, compared with the healthy adolescents.

Adolescents with juvenile idiopathic arthritis spent significantly more time in bed and less time on moderate to vigorous physical activity. The authors report that only 23 percent of juvenile idiopathic arthritis patients met public health recommendations of spending least 1 hour per day in moderate to vigorous physical activity, compared with 66 percent of those in the reference group.

“No association was found between physical activity level and activity-related energy expenditure and disease activity and functional ability,” Lelieveld’s group reports.

Adolescents with juvenile idiopathic arthritis run the risk of losing the benefits of physical activity, Lelieveld told Reuters Health. “Low physical activity levels increase the risk of cardiovascular disease, diabetes and obesity. It can also result in a decline in physical fitness and “reinforces social isolation.”

“We have designed an intervention to improve physical activity in children with juvenile idiopathic arthritis,” Lelieveld continued. “It is an interactive e-learning program and a pilot will start beginning of 2009.” Its effectiveness will be assessed by a randomly assigned, controlled clinical trial.

SOURCE: Arthritis and Rheumatism, October 15, 2008.

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