Oslo University Hospital, Rikshospitalet and University of Oslo, Oslo, Norway.
Oslo University Hospital, Ullevål and Norwegian School of Sports Sciences, Oslo, Norway.
Arthritis Care Res (Hoboken). 2019 Dec;71(12):1611-1620. doi: 10.1002/acr.23818.
To perform a comprehensive evaluation of and identify correlates for physical fitness in consecutive patients with juvenile idiopathic arthritis (JIA) who have been diagnosed in the era of biologics and to compare the results with those obtained in healthy controls.
The study cohort included 60 patients with JIA (50 girls) ages 10-16 years and 60 age- and sex-matched controls. The JIA group included 30 patients with persistent oligoarticular JIA and 30 patients with extended oligoarticular or polyarticular disease. Measures of physical fitness included cardiorespiratory fitness (CRF) by peak oxygen uptake (Vo ) during a continuous graded treadmill exercise test, muscle strength by isokinetic and isometric knee and hand grip evaluations, and bone mineral density (BMD) and body composition by dual-energy x-ray absorptiometry. Physical activity was assessed by accelerometry.
Forty-two percent of the patients were being treated with biologic drugs. Patients with JIA demonstrated lower muscle strength and total body BMD compared to controls, but there were no differences in CRF and body composition. Physical fitness was comparable between the persistent oligoarticular and extended oligoarticular/polyarticular-JIA groups. In patients with JIA, we identified associations between higher vigorous physical activity and higher CRF and muscle strength, but did not find any association between physical fitness and disease variables.
In this cohort of patients with JIA, we found suboptimal muscle strength and BMD compared to controls, but no differences in CRF and body composition. Vigorous physical activities appeared important for optimizing muscle strength and CRF in patients with JIA; the importance of such activities should be highlighted in patient education.
对生物制剂时代诊断的连续幼年特发性关节炎（JIA）患者进行全面的体能评估并确定相关因素，并与健康对照者进行比较。
研究队列包括 60 例 JIA（50 例女孩）患者，年龄 10-16 岁，以及 60 例年龄和性别匹配的对照者。JIA 组包括 30 例持续性少关节炎型 JIA 和 30 例扩展少关节炎或多关节炎型 JIA。体能测量包括通过连续递增跑步机运动试验测量心肺适能（CRF）峰值摄氧量（Vo ）、等速和等长膝关节和手握力评估肌肉力量，以及通过双能 X 射线吸收仪测量骨矿物质密度（BMD）和身体成分。通过加速度计评估身体活动。
42%的患者正在接受生物药物治疗。与对照组相比，JIA 患者的肌肉力量和全身 BMD 较低，但 CRF 和身体成分无差异。持续性少关节炎型和扩展少关节炎/多关节炎型 JIA 组之间的体能无差异。在 JIA 患者中，我们发现较高的剧烈身体活动与较高的 CRF 和肌肉力量之间存在关联，但未发现体能与疾病变量之间存在任何关联。
在本队列的 JIA 患者中，我们发现与对照组相比，肌肉力量和 BMD 较差，但 CRF 和身体成分无差异。剧烈身体活动似乎对 JIA 患者的肌肉力量和 CRF 优化很重要；在患者教育中应强调此类活动的重要性。
