From the Faculty of Medicine, University of Toronto; Department of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada.
J Rheumatol. 2014 Feb;41(2):345-51. doi: 10.3899/jrheum.130734. Epub 2013 Dec 15.
Pain and reduced physical activity levels are common in children with juvenile idiopathic arthritis (JIA). Currently, there is no consensus about the role of physical activity in managing pain in JIA. The purpose of our study was to assess the relationship between physical activity level and pain in children ages 11 to 18 years with JIA.
A random sample of 50 patients with JIA were approached by mailed questionnaires. Physical activity was determined using the Physical Activity Questionnaire (PAQ). Pain measures included the Numerical Rating Scale (pain severity), SUPER-KIDZ body diagram (number of painful areas), and the Child Activities Limitations Inventory-21 (pain interference). Generalized linear models were used to assess the relationship between physical activity and pain, as well as the roles of sex and age.
The response rate was 84%. Thirty-four respondents completed the questionnaire package. The median age was 15 years. The mean PAQ score was 2.16/5. Physical activity declines with increasing age in youth with JIA (r = 0.53, p = 0.0014). Lower physical activity is associated with greater pain interference (r = 0.39, p = 0.0217) and more severe pain (r = 0.35, p = 0.0422).
Children with JIA report significantly less activity than healthy children based on PAQ scores, with physical activity declining throughout adolescence. Physical activity is inversely related to pain interference and severity in children with JIA. Our findings suggest that physical activity interventions may play an important role in the management of pain in JIA.
儿童幼年特发性关节炎（JIA）常伴有疼痛和身体活动水平降低。目前，对于身体活动在 JIA 疼痛管理中的作用尚未达成共识。本研究旨在评估 11 至 18 岁 JIA 患儿身体活动水平与疼痛之间的关系。
通过邮寄问卷的方式对 50 名 JIA 患者进行随机抽样。使用身体活动问卷（PAQ）确定身体活动水平。疼痛评估包括数字评分量表（疼痛严重程度）、SUPER-KIDZ 体图（疼痛区域数）和儿童活动限制量表-21（疼痛干扰）。采用广义线性模型评估身体活动与疼痛之间的关系，以及性别和年龄的作用。
回复率为 84%。34 名受访者完成了问卷调查。中位年龄为 15 岁。PAQ 评分的平均值为 2.16/5。JIA 青少年的身体活动随年龄增长而下降（r = 0.53，p = 0.0014）。较低的身体活动水平与更大的疼痛干扰（r = 0.39，p = 0.0217）和更严重的疼痛（r = 0.35，p = 0.0422）相关。
根据 PAQ 评分，JIA 患儿的活动量明显低于健康儿童，且身体活动随青春期而下降。身体活动与 JIA 患儿的疼痛干扰和严重程度呈负相关。我们的研究结果表明，身体活动干预可能在 JIA 疼痛管理中发挥重要作用。
