Skip to main content

Advertisement

SpringerLink
Log in

Assessment of quality of life and physical activity in patients with oligoarticular juvenile idiopathic arthritis in remission

  • RESEARCH
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

The purpose of this study was to evaluate physical activity (PA) and health-related quality of life (HRQOL) in children with oligoarticular juvenile idiopathic arthritis (JIA) in remission in comparison with healthy peers and to determine the disease-related factors affecting PA levels. This study was conducted with 50 oligoarticular JIA patients in remission and 50 healthy peers between 9 and 14 years. Demographic and clinical characteristics, laboratory parameters, and treatments were noted from electronic medical records. HRQOL was assessed with the Pediatric Quality of Life Inventory (PedsQL). PA was evaluated with the Physical Activity Questionnaire for Children (PAQ-C). Oligoarticular JIA patients had significantly lower self-reported median PedsQL scores in the domains of school functioning and social functioning compared to the control group (67.5 (10) vs. 75 (25), p = 0.001 and 70 (15) vs. 85 (26.3), p < 0.001, respectively). The median PAQ-C score was 2.6 (1.1) in patients with JIA and 3 (0.9) in their healthy peers (p = 0.02). The PAQ-C score was 2.8 (1.2) in patients < 8 years at the disease onset and 2.3 (1) in those aged ≥ 8 years (p = 0.022). There was no significant difference in the number of affected joints, type of affected joint, MTX and biologic agent treatment, and remission with or without drugs with the total score of the PedsQL and PAQ-C. All PedsQL domains were positively correlated with the PAQ-C.

  Conclusion: Oligoarticular JIA patients demonstrated lower PA and HRQOL scores compared to healthy controls despite favorable disease control.

What is Known:

• Oligoarticular JIA has fewer functional limitations and disabilities compared to other JIA subtypes.

• As JIA can affect all aspects of a child’s life, there is a need to improve the quality of life related to the disease.

What is New:

• It should be considered that patients with oligoarticular JIA may show lower PA and HRQOL scores compared to healthy controls despite favorable disease control.

• Since there may be a relationship between PA and HRQOL, factors that may affect PA should be investigated to provide a holistic approach to JIA treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

CHAQ:

Childhood Health Assessment Questionnaire-Disability Index

HRQOL:

Health-related quality of life

JIA:

Juvenile idiopathic arthritis

PA:

Physical activity

PAQ-C:

Physical Activity Questionnaire for Children

PedsQL:

Pediatric Quality of Life Inventory

References

  1. Zaripova LN, Midgley A, Christmas SE, Beresford MW, Baildam EM, Oldershaw RA (2021) Juvenile idiopathic arthritis: from aetiopathogenesis to therapeutic approaches. Pediatr Rheumatol 23;19(1):135. https://doi.org/10.1186/s12969-021-00629-8

  2. Okamoto N, Yokota S, Takei S, OkuraY KT, Shimizu M et al (2019) Clinical practice guidance for juvenile idiopathic arthritis (JIA) 2018. Mod Rheumatology 29(1):41–59. https://doi.org/10.1080/14397595.2018.1514724

    Article  Google Scholar 

  3. Sezer M, Aydın F, Kurt T, Tekgöz N, Tekin ZE, Karagöl C et al (2021) Prediction of inactive disease and relapse in oligoarticular juvenile idiopathic arthritis. Mod Rheumatol 31(5):1025–1030. https://doi.org/10.1080/14397595.2020.1836788

    Article  PubMed  Google Scholar 

  4. Singh G, Athreya BH, Fries JF, Goldsmith DP (1994) Measurement of health status in children with juvenile rheumatoid arthritis. Arthritis Rheum 37(12):1761–1769. https://doi.org/10.1002/art.1780371209

    Article  CAS  PubMed  Google Scholar 

  5. Bos GJ, Lelieveld OT, Armbrust W, Sauer PJ, Geertzen JH, Dijkstra PU (2016) Physical activity in children with juvenile idiopathic arthritis compared to controls. Pediatr Rheumatol 7;14(1):42. https://doi.org/10.1186/s12969-016-0102-8

  6. Fazaa A, Sellami M, Ouenniche K, Miladi S, Kassab S, Chekili S et al (2021) Physical activity assessment in children and adolescents with juvenile idiopathic arthritis compared with controls. Arch Pediatr 28(1):47–52. https://doi.org/10.1016/j.arcped.2020.10.008

    Article  PubMed  Google Scholar 

  7. Gueddari S, Amine B, Rostom S, Badri D, Mawani N, Ezzahri M et al (2014) Physical activity, functional ability, and disease activity in children and adolescents with juvenile idiopathic arthritis. Clin Rheumatol 33(9):1289–1294. https://doi.org/10.1007/s10067-014-2576-4

  8. Ringold S, Angeles-Han ST, Beukelman T, Lovell D, Cuello CA, Becker ML et al (2019) 2019 American College of Rheumatology/Arthritis Foundation guideline for the treatment of juvenile idiopathic arthritis: therapeutic approaches for non-systemic polyarthritis, sacroiliitis, and enthesitis. Arthritis Care Res 71(6):717–734. https://doi.org/10.1002/acr.23870

    Article  Google Scholar 

  9. Sampasa-Kanyinga H, Colman I, Goldfield GS, Janssen I, Wang JL, Podiniz I et al (2020) Combinations of physical activity, sedentary time, and sleep duration and their associations with depressive symptoms and other mental health problems in children and adolescents: a systematic review. Int J Behav Nutr Phys Act 5;17(1):72. https://doi.org/10.1186/s12966-020-00976-x

  10. Kowalski KC, Crocker PRE, Donen RM (2004) The Physical Activity Questionnaire for Older Children (PAQ-C) and Adolescents (PAQ-A) manual. University of Saskatchewan, Saskatoon, Canada

    Google Scholar 

  11. Listing M, Mönkemöller K, Liedmann I, Niewerth M, Sengler C, Listing J et al (2018) The majority of patients with newly diagnosed juvenile idiopathic arthritis achieve a health-related quality of life that is similar to that of healthy peers: results of the German multicenter inception cohort (ICON). Arthritis Res Ther 30;20(1):106–16. https://doi.org/10.1186/s13075-018-1588-x

  12. Barth S, Haas JP, Schlichtiger J, Molz J, Bisdorff B, Michels H et al (2016) Long-term health-related quality of life in German patients with juvenile idiopathic arthritis in comparison to German general population. PLoS One 26;11(4):e0153267. https://doi.org/10.1371/journal.pone.0153267

  13. Haverman L, Grootenhuis MA, Van den Berg JM, Van Veenendaal M, Dolman KM, Swart JF et al (2012) Predictors of health-related quality of life in children and adolescents with juvenile idiopathic arthritis: results from a web-based survey. Arthritis Care Res (Hoboken) 64(5):694–703. https://doi.org/10.1002/acr.21609

    Article  CAS  PubMed  Google Scholar 

  14. Solans M, Pane S, Estrada MD, Serra-Sutton V, Berra S, Herdman M et al (2008) Health-related quality of life measurement in children and adolescents: a systematic review of generic and disease-specific instruments. Value Health 11(4):742–764. https://doi.org/10.1111/j.1524-4733.2007.00293.x

    Article  PubMed  Google Scholar 

  15. Varni J, Seid M, Kurtin P (2001) PedsQL 4.0: reliability and validity of the pediatric Quality of life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care 39(8):800–812. https://doi.org/10.1097/00005650-200108000-00006

  16. Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J et al (2001) (2004) International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton. J Rheumatol 31(2):390–392. PMID: 14760812

    Google Scholar 

  17. Erdim L, Ergün A, Kuğuoğlu S (2019) Reliability and validity of the Turkish version of the Physical Activity Questionnaire for Older Children (PAQ-C). Turk J Med Sci. 11;49(1):162–169. https://doi.org/10.3906/sag-1806-212

  18. Chen SR, Lee YJ, Chiu HW, Jeng C (2008) Impact of physical activity on heart rate variability in children with type 1 diabetes. Childs Nerv Syst 24(6):741–747. https://doi.org/10.1007/s00381-007-0499-y

    Article  PubMed  Google Scholar 

  19. Consolaro A, Giancane G, Schiappapietra B, Davi S, Calandra S, Lanni S et al (2016) Clinical outcome measures in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 18;14(1):23. https://doi.org/10.1186/s12969-016-0085-5

  20. Wallace CA, Giannini EH, Huang B, Itert L, Ruperto N (2011) American College of Rheumatology provisional criteria for defining clinical inactive disease in select categories of juvenile idiopathic arthritis. Arthritis Care Res 63(7):929–936. https://doi.org/10.1002/acr.20497

    Article  Google Scholar 

  21. Shoop-Worrall SJW, Kearsley-Fleet L, Thomson W, Verstappen SMM, Hyrich KL (2017) How common is remission in juvenile idiopathic arthritis: a systematic review. Semin Arthritis Rheum 47(3):331–337. https://doi.org/10.1016/j.semarthrit.2017.05.007

    Article  PubMed  PubMed Central  Google Scholar 

  22. Risum K, Hansen BH, Selvaag AM, Molberg Ø, Dagfinrud H, Sanner H (2018) Physical activity in patients with oligo- and polyarticular juvenile idiopathic arthritis diagnosed in the era of biologics: a controlled cross-sectional study. Pediatr Rheumatol Online J 17;16(1):64. https://doi.org/10.1186/s12969-018-0281-6

  23. Charuvanij S, Chaiyadech C (2019) Health-related quality of life in children with early-stage juvenile idiopathic arthritis. Musculoskeletal Care 17(2):215–220. https://doi.org/10.1002/msc.1393

    Article  PubMed  Google Scholar 

  24. Fair DC, Rodriguez M, Knight AM, Rubinstein TB (2019) Depression and anxiety in patients with juvenile idiopathic arthritis: current insights and impact on quality of life, a systematic review. Open Access Rheumatol 1(11):237–252. https://doi.org/10.2147/OARRR.S174408

    Article  Google Scholar 

  25. Wu H, Wu F, Li Y, Lai J, Su G, Cui S et al (2021) The quality of life in Chinese juvenile idiopathic arthritis patients: psychometric properties of the Pediatric Quality Of Life Inventory generic core scales and rheumatology module. Health Qual Life Outcomes 30;19(1):37. https://doi.org/10.1186/s12955-021-01683-2

  26. Amine B, Rostom S, Benbouazza K, Abouqal R, Hajjaj-Hassouni N (2009) Health related quality of life survey about children and adolescents with juvenile idiopathic arthritis. Rheumatol Int 29(3):275–279. https://doi.org/10.1007/s00296-008-0672-y

    Article  PubMed  Google Scholar 

  27. Ferro MA, Gorter JW, Boyle MH (2015) Trajectories of depressive symptoms during the transition to young adulthood: the role of chronic illness. J Affect Disord 174:594–601. https://doi.org/10.1016/j.jad.2014.12.014

    Article  PubMed  Google Scholar 

  28. Hanns L, Cordingley L, Galloway J, Norton S, Carvalho LA, Christie L et al (2018) Depressive symptoms, pain and disability for adolescent patients with juvenile idiopathic arthritis: results from the Childhood Arthritis Prospective Study. Rheumatology 1;57(8):1381–1389. https://doi.org/10.1093/rheumatology/key088

  29. Ezzahri M, Amine B, Rostom S, Badri D, Mawani N, Gueddari S et al (2014) Factors influencing the quality of life of Moroccan patients with juvenile idiopathic arthritis. Clin Rheumatol 33(11):1621–1626. https://doi.org/10.1007/s10067-014-2489

    Article  CAS  PubMed  Google Scholar 

  30. Lundberg V, Lindh V, Eriksson C, Petersen S, Eurenius E (2012). Health‐related quality of life in girls and boys with juvenile idiopathic arthritis: self‐ and parental reports in a cross‐sectional study. Pediatr Rheumatol Online J 17;10(1):33. https://doi.org/10.1186/1546‐0096‐10‐33

  31. Giancane G, Swart JF, Castagnola E, Groll AH, Horneff G, Huppertz HI et al (2020) Opportunistic infections in immunosuppressed patients with juvenile idiopathic arthritis: analysis by the Pharmachild Safety Adjudication Committee. Arthritis Res Therapy 7;22(1):71 https://doi.org/10.1186/s13075-020-02167-2

  32. Bomba M, Meini A, Molinaro A, Cattalini M, Oggiano S, Fazzi E et al (2013) Body experiences, emotional competence, and psychosocial functioning in juvenile idiopathic arthritis. Rheumatol Int 33(8):2045–2052. https://doi.org/10.1007/s00296-013-2685-4

    Article  PubMed  Google Scholar 

  33. Singh-Grewal D, Schneiderman-Walker J, Wright V, Bar-Or O, Beyene J, Selvadurai H et al (2007) The effects of vigorous exercise training on physical function in children with arthritis: a randomized, controlled, single-blinded trial. Arthritis Rheum 15;57(7):1202–1210. https://doi.org/10.1002/art.23008

  34. Kuntze G, Nesbitt C, Whittaker JL, Nettel Aguirre A, Toomey C, Esau S et al (2018) Exercise therapy in juvenile idiopathic arthritis: a systematic review and meta analysis. Arch Phys Med Rehabil 99(1):178–193.e1. https://doi.org/10.1016/j.apmr.2017.05.030

  35. Moore JB, Hanes JC Jr, Barbeau P, Gutin B, Treviño RP, Yin Z (2007) Validation of the Physical Activity Questionnaire for Older Children in children of different races. Pediatr Exerc Sci 19(1):6–19. https://doi.org/10.1123/pes.19.1.6

    Article  PubMed  Google Scholar 

  36. Gobbi E, Elliot C, Varnier M, Carraro A (2016) Psychometric properties of the Physical Activity Questionnaire for older children in Italy: testing the validity among a general and clinical pediatric population. PLoS One 26;11(5). https://doi.org/10.1371/journal.pone.0156354

  37. Heale LD, Houghton KM, Rezaei E, Baxter-Jones ADG, Tupper SM, Muhajarine N et al (2021) Clinical and psychosocial stress factors are associated with decline in physical activity over time in children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 29;19(1):97. https://doi.org/10.1186/s12969-021-00584-4

  38. Nørgaard M, Twilt M, Andersen LB, Herlin T (2016) Accelerometry-based monitoring of daily physical activity in children with juvenile idiopathic arthritis. Scand J Rheumatol 45(3):179–87. https://doi.org/10.3109/03009742.2015.1057862

  39. Sherman G, Nemet D, Moshe V, Consolaro A, Ravelli A, Ruperto N et al (2018) Disease activity, overweight, physical activity and screen time in a cohort of patients with juvenile idiopathic arthritis. Clin Exp Rheumatol 36(6):1110–1116. PMID: 29600947

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey

    Merve Cansu Polat, Elif Çelikel, Zahide Ekici Tekin, Vildan Güngörer, Tuba Kurt, Nilüfer Tekgöz, Müge Sezer, Cüneyt Karagöl, Serkan Coşkun, Melike Mehveş Kaplan, Nimet Öner & Banu Çelikel Acar

Authors
  1. Merve Cansu Polat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elif Çelikel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zahide Ekici Tekin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vildan Güngörer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tuba Kurt
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nilüfer Tekgöz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Müge Sezer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Cüneyt Karagöl
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Serkan Coşkun
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Melike Mehveş Kaplan
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Nimet Öner
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Banu Çelikel Acar
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

M.C.P. wrote the main manuscript text. M.M.K., T.K., M.S., and N.T. collected the data. S.C., N.Ö., and C.K. processed the data. B.Ç.A., E.Ç., Z.E.T., V.G., and M.C.P. reviewed the literature. All authors reviewed the manuscript.

Corresponding author

Correspondence to Merve Cansu Polat.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study described has been carried out in accordance with abovementioned standards and has been approved by the Ethics Committee of Ankara City Hospital (ethics approval number: E2-21-1094).

Conflict of interest

The authors declare no competing interests.

Additional information

Communicated by Tobias Tenenbaum

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Polat, M.C., Çelikel, E., Tekin, Z.E. et al. Assessment of quality of life and physical activity in patients with oligoarticular juvenile idiopathic arthritis in remission. Eur J Pediatr 183, 955–964 (2024). https://doi.org/10.1007/s00431-023-05367-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-023-05367-5

Keywords

Search

Navigation