Exercise therapy for juvenile idiopathic arthritis
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BACKGROUND: Juvenile idiopathic arthritis (JIA) is the most prevalent childhood rheumatic disease and significantly impacts a child’s well-being by potentially leading to disability and long-lasting effects. It consists of all forms of arthritis developing before the age of 16, therefore managing this disease is not simple. JIA can lead to a host of different medical problems over time and requires early attention and adequate treatment to prevent these long-term consequences. However, many children still experience pain after traditional treatment, indicating a need for alternative treatment modalities. Exercise therapy is one form of treatment that can potentially enhance a child’s quality of life. LITERATURE REVIEW FINDINGS: Multiple forms of exercise therapy have been shown to improve quality of life, functional ability and pain in patients with JIA. Exercise does not worsen disease activity, including the number of joints affected. While there are a limited number of studies in the JIA population, studies on patients with rheumatoid arthritis, a rheumatic disease diagnosed in adulthood, demonstrate the potential for exercise therapy to alter the pathophysiology of the disease and lead to better immune function. Exercise may have the ability to affect children with JIA in the same way as the two diseases share a similar pathophysiology. PROPOSED PROJECT: The goal of the proposed randomized control trial is to measure the impact of an exercise intervention on the quality of life of children with JIA, the effect exercise on participant immune function and variations in response between each subtype of JIA. Children will either complete high intensity interval walking training three times a week or no exercise intervention for 10 weeks. Various outcomes including quality of life, functional status, pain and fitness level will be measured before and after the intervention. Blood analysis to assess changes in immune function and further analysis between subtypes will also be conducted. CONCLUSIONS: The use of exercise therapy as a management tool for JIA should be considered earlier on in the disease course. It has not been found to worsen the disease and has produced increases in quality of life, functional status and pain. The benefits of this therapy are widespread and are not limited to healthy individuals. SIGNIFICANCE: This will be the first time these analyses will be performed and, if improvement is seen, this could help guide a physician’s disease management plan. Data from this study could provide information on how exercise modifies the disease and how to design more structured exercise programs appropriate to each subtype of JIA. Exercise may begin to be incorporated into the treatment plan for these children to increase disease remission rates, reduce the amount and severity of disease flares and provide both physical and psychological benefits.