Cavallo Sabrina, Brosseau Lucie, Toupin-April Karine, Wells George A, Smith Christine A, Pugh Arlanna G, Stinson Jennifer, Thomas Roanne, Ahmed Sara, Duffy Ciarán M, Rahman Prinon, Àlvarez-Gallardo Inmaculada C, Loew Laurianne, De Angelis Gino, Feldman Debbie Ehrmann, Majnemer Annette, Gagnon Isabelle J, Maltais Désirée, Mathieu Marie-Ève, Kenny Glen P, Tupper Susan, Whitney-Mahoney Kristi, Bigford Sarah
Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Arch Phys Med Rehabil. 2017 May;98(5):1018-1041. doi: 10.1016/j.apmr.2016.09.135. Epub 2016 Dec 6.
To create guidelines focused on the use of structured physical activity (PA) in the management of juvenile idiopathic arthritis (JIA).
A systematic literature search was conducted using the electronic databases Cochrane Central Register of Controlled Trials, MEDLINE (Ovid), EMBASE (Ovid), and Physiotherapy Evidence Database for all studies related to PA programs for JIA from January 1966 until December 2014, and was updated in May 2015.
Study selection was completed independently by 2 reviewers. Studies were included if they involved individuals aged ≤21 years diagnosed with JIA who were taking part in therapeutic exercise or other PA interventions for which effects of various disease-related outcomes were compared with a control group (eg, no PA program or activity of lower intensity).
Two reviewers independently extracted information on interventions, comparators, outcomes, time period, and study design. The statistical analysis was reported using the Cochrane Collaboration methods. The quality of the included studies was assessed according to the Physiotherapy Evidence Database Scale.
Five randomized controlled trials (RCTs) fit the selection criteria; of these, 4 were high-quality RCTs. The following recommendations were developed: (1) Pilates for improving quality of life, pain, functional ability, and range of motion (ROM) (grade A); (2) home exercise program for improving quality of life and functional ability (grade A); (3) aquatic aerobic fitness for decreasing the number of active joints (grade A); and (4) and cardio-karate aerobic exercise for improving ROM and number of active joints (grade C+).
The Ottawa Panel recommends the following structured exercises and physical activities for the management of JIA: Pilates, cardio-karate, home and aquatic exercises. Pilates showed improvement in a higher number of outcomes.
制定关于在幼年特发性关节炎（JIA）管理中使用结构化体育活动（PA）的指南。
使用电子数据库Cochrane对照试验中央注册库、MEDLINE（Ovid）、EMBASE（Ovid）和物理治疗证据数据库，对1966年1月至2014年12月期间所有与JIA的PA计划相关的研究进行系统文献检索，并于2015年5月更新。
由2名评审员独立完成研究选择。纳入的研究需涉及年龄≤21岁、被诊断为JIA且参加了治疗性运动或其他PA干预措施的个体，将这些干预措施对各种疾病相关结局的影响与对照组进行比较（例如，无PA计划或强度较低的活动）。
两名评审员独立提取关于干预措施、对照、结局、时间段和研究设计的信息。使用Cochrane协作方法报告统计分析结果。根据物理治疗证据数据库量表评估纳入研究的质量。
5项随机对照试验（RCT）符合选择标准；其中4项为高质量RCT。制定了以下建议：（1）普拉提可改善生活质量、疼痛、功能能力和关节活动范围（ROM）（A级）；（2）家庭锻炼计划可改善生活质量和功能能力（A级）；（3）水中有氧运动可减少活动关节数量（A级）；（4）有氧搏击操可改善ROM和活动关节数量（C+级）。
渥太华小组推荐以下结构化运动和体育活动用于JIA的管理：普拉提、有氧搏击操、家庭锻炼和水中运动。普拉提在更多结局方面显示出改善效果。
