Milatz Florian, Klotsche Jens, Niewerth Martina, Geisemeyer Nils, Trauzeddel Ralf, Weißbarth-Riedel Elisabeth, Kallinich Tilmann, Peitz Joachim, Hartmann Matthias, Minden Kirsten
Epidemiology Unit, German Rheumatism Research Centre Berlin, Chariteplatz 1, 10117, Berlin, Germany.
Department of Paediatric Rheumatology, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
Pediatr Rheumatol Online J. 2019 Feb 11;17(1):6. doi: 10.1186/s12969-019-0306-9.
Regular school sports can help adolescents achieve the recommended amount of daily physical activity and provide knowledge, attitudes and behavioral skills that are needed in order to adopt and maintain a physically active lifestyle. Furthermore, it reaches all children including those that are at risk for engaging in more sedentary types of behavior. Since adolescents with juvenile idiopathic arthritis (JIA) are less involved in physical and social activities than their healthy peers, the objectives were to (1) estimate the prevalence of participation in school sports among patients with JIA; (2) determine the correlates associated with school sports absenteeism; and (3) investigate whether attendance in school sports has changed in the era of biologics.
Data from schoolchildren with JIA recorded in the German National Paediatric Rheumatologic Database (NPRD) in the years 2000 to 2015 were considered for the analyses. Data from the year 2015 were inspected to analyze correlates of school sports absenteeism. Whether school sports participation had changed between 2000 and 2015 was determined using linear mixed models.
During the 15-year period, the participation rates in school sports were determined in 23,016 patients. The proportion of patients who participated in school sports almost always steadily increased from 31% in 2000 to 64% in 2015 (β = 0.017, 95% confidence interval (CI) 0.015, 0.020), whereas the exemption rate simultaneously decreased from 44% in 2000 to 16% in 2015 [β = - 0.009, 95% CI -0.011, - 0.007]. In 2015, the data from 5879 patients (mean age 13.1 ± 3.3 years, female 65%, disease duration 5.9 ± 4.0 years, persistent oligoarthritis 37%) were available for evaluation. Full exemption from school sports (in 16.1% of cases) was associated with functional limitations, disease activity and any use of DMARDs, intra-articular glucocorticoid injections or physiotherapy.
School sports attendance among children and adolescents with JIA has increased significantly over the past 15 years. Possible explanations include improved functional ability probably due to better treatment options. The integration of patients with child acceptable symptom states who have previously been fully exempted from school sports needs to be addressed in the future.
常规学校体育活动有助于青少年达到建议的每日运动量，并提供养成和维持积极生活方式所需的知识、态度和行为技能。此外，它覆盖所有儿童，包括那些有久坐行为风险的儿童。由于患有幼年特发性关节炎（JIA）的青少年比健康同龄人更少参与体育和社交活动，本研究的目的是：（1）估计JIA患者参与学校体育活动的患病率；（2）确定与学校体育活动缺勤相关的因素；（3）调查在生物制剂时代学校体育活动的参与情况是否发生了变化。
分析2000年至2015年德国国家儿科风湿病数据库（NPRD）中记录的JIA学龄儿童的数据。检查2015年的数据以分析学校体育活动缺勤的相关因素。使用线性混合模型确定2000年至2015年期间学校体育活动的参与情况是否发生了变化。
在这15年期间，确定了23016例患者的学校体育活动参与率。参与学校体育活动的患者比例几乎一直稳步上升，从2000年的31%增至2015年的64%（β = 0.017，95%置信区间（CI）0.015，0.020），而豁免率同时从2000年的44%降至2015年的16%[β = -0.009，95%CI -0.011，-0.007]。2015年，有5879例患者的数据（平均年龄13.1±3.3岁，女性占65%，病程5.9±4.0年，持续性少关节炎占37%）可供评估。完全豁免参加学校体育活动（16.1%的病例）与功能受限、疾病活动以及使用任何抗风湿药物、关节内注射糖皮质激素或理疗有关。
在过去15年中，JIA儿童和青少年的学校体育活动参与率显著提高。可能的解释包括可能由于更好的治疗选择而使功能能力得到改善。未来需要解决那些以前完全豁免参加学校体育活动、但症状处于儿童可接受状态的患者的融入问题。
