Risum Kristine, Hansen Bjørge Herman, Selvaag Anne Marit, Molberg Øyvind, Dagfinrud Hanne, Sanner Helga
Section for Orthopaedic Rehabilitation, Oslo University Hospital, Rikshospitalet, Postboks 4950 Nydalen, 0424, Oslo, Norway.
Department of Health Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Pediatr Rheumatol Online J. 2018 Oct 17;16(1):64. doi: 10.1186/s12969-018-0281-6.
Knowledge about objectively measured levels of physical activity (PA) and PA participation (included facilitators and barriers for PA) in patients with juvenile idiopathic arthritis (JIA) diagnosed in the era of biologics is limited. We aimed to compare objectively measured PA in patients with oligo- and polyarticular JIA diagnosed in the biologic era with controls and to examine associations between PA and disease variables; furthermore, to explore participation in PA, physical education (PE) and facilitators and barriers for PA participation in patients and controls.
The study cohort included 60 patients (30 persistent oligo JIA/30 poly-articular disease) and 60 age- and sex-matched controls. Age range was 10-16 years and 83% were female. PA was measured with accelerometry for seven consecutive days. Disease activity, current treatment, disease duration, functional ability, pain and fatigue were assessed. Structured interviews were applied to explore participation in PA and PE, and PA facilitators and barriers.
Patients spent less time in daily vigorous PA than controls, (mean(SE) 21(2) min vs. 26(2) min, p = 0.02), while counts per minute (cpm), steps daily, sedentary time and light and moderate PA did not differ. No differences were found between JIA subgroups. The use of biologic medication was associated with higher cpm and lower sedentary time. Most patients and controls participated in organized or unorganized PA and PE, and enjoyment was the most reported facilitator for PA participation. More patients than controls reported pain as a PA barrier.
The PA levels and participation in patients with oligo- and polyarticular JIA are mostly comparable to controls, but patients still need to be encouraged to increase vigorous PA. Enjoyment is the most important facilitator for PA participation in patients with JIA.
在生物制剂时代被诊断为幼年特发性关节炎（JIA）的患者中，关于客观测量的身体活动（PA）水平以及PA参与情况（包括PA的促进因素和障碍）的知识有限。我们旨在比较在生物制剂时代被诊断为少关节型和多关节型JIA的患者与对照组之间客观测量的PA，并研究PA与疾病变量之间的关联；此外，探讨患者和对照组参与PA、体育教育（PE）的情况以及PA参与的促进因素和障碍。
研究队列包括60名患者（30名持续性少关节型JIA/30名多关节型疾病患者）和60名年龄及性别匹配的对照组。年龄范围为10 - 16岁，83%为女性。使用加速度计连续七天测量PA。评估疾病活动度、当前治疗、疾病持续时间、功能能力、疼痛和疲劳情况。采用结构化访谈来探讨PA和PE的参与情况以及PA的促进因素和障碍。
患者每天进行剧烈PA的时间比对照组少（平均（标准误）21（2）分钟对26（2）分钟，p = 0.02），而每分钟计数（cpm）、每日步数、久坐时间以及轻度和中度PA并无差异。JIA亚组之间未发现差异。使用生物药物与较高的cpm和较低的久坐时间相关。大多数患者和对照组参与了有组织或无组织的PA和PE，并且享受是报告最多的PA参与促进因素。报告疼痛作为PA障碍的患者比对照组多。
少关节型和多关节型JIA患者的PA水平和参与情况大多与对照组相当，但仍需鼓励患者增加剧烈PA。享受是JIA患者PA参与的最重要促进因素。
