Skip to main content

Advertisement

Log in

The benefits of physical therapy in juvenile idiopathic arthritis

  • Review
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children and an important cause of short-term and long-term disability. Recommended physiotherapy activity programs are essential for controlling JIA associated complications such as stiffness, deformity, muscle contractures, and cramps. It is uncertain if physiotherapy (PT) can significantly enhance prognosis and quality of life (QOL). In this review we focused on the specific effects of various PT on JIA manifestations. To conduct a literature review, the databases PubMed, Scopus, and DOAJ (last access in June 2023) were searched. The PubMed search returned a total of 952 articles, Scopus returned 108, and DOAJ returned no results. After screening, the final list included 18 papers on PT treatment for JIA patients. In children with JIA, targeted PT exercise may have the ability to improve strength, posture, aerobic conditioning, gait, functional mobility, and reduce pain.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Data availability

Not applicable to this article as no datasets were generated or analyzed during the current study.

References

  1. La Bella S, Rinaldi M, Di Ludovico A, Di Donato G, Di Donato G, Salpietro V, Chiarelli F, Breda L (2023) Genetic background and molecular mechanisms of juvenile idiopathic arthritis. Int J Mol Sci. https://doi.org/10.3390/ijms24031846

    Article  PubMed  PubMed Central  Google Scholar 

  2. Oen K (2002) Long-term outcomes and predictors of outcomes for patients with juvenile idiopathic arthritis. Best Pract Res Clin Rheumatol. PMID: 12387804

  3. Malviya A, Johnson-Lynn S, Avery P, Deehan D, Foster H (2009) Juvenile idiopathic arthritis in adulthood and orthopaedic intervention. Clin Rheumatol. https://doi.org/10.1007/s10067-009-1266-0

    Article  PubMed  Google Scholar 

  4. Spamer M, Gerogi M, Häfner R, Händel H, König M, Haas JP (2012) Physiotherapie bei der juvenilen idiopathischen arthritis. Z Rheumatol. https://doi.org/10.1007/s00393-011-0867-6

    Article  PubMed  Google Scholar 

  5. Prieur AM (2005) 8 Spondyloarthropathies in childhood. Baillieres Clin Rheumatol. https://doi.org/10.1016/s0950-3579(98)80020-4

    Article  Google Scholar 

  6. Cakmak A, Bolukbas N (2005) Juvenile rheumatoid arthritis: physical therapy and rehabilitation. South Med J. https://doi.org/10.1097/01.smj.0000146588.22557.a5

    Article  PubMed  Google Scholar 

  7. Takken T, van der Net J, Kuis W, Helders PJM (2003) Aquatic fitness training for children with juvenile idiopathic arthritis. Rheumatology (Oxford). https://doi.org/10.1093/rheumatology/keg386

    Article  PubMed  Google Scholar 

  8. Klepper SE (1999) Effects of an eight-week physical conditioning program on disease signs and symptoms in children with chronic arthritis. Arthritis Care Res. https://doi.org/10.1002/1529-0131(199902)12:1%3C52::aid-art9%3E3.0.co;2-x

    Article  PubMed  Google Scholar 

  9. Azab AR, Kamel HFA, Basha MA, Alrawaili SM, Aloraini GS, Hassan SM, Ewais NF, Elnaggar RK (2022) Impact of clinical pilates exercise on pain, cardiorespiratory fitness, functional ability, and quality of life in children with polyarticular juvenile idiopathic arthritis. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph19137793

    Article  PubMed  PubMed Central  Google Scholar 

  10. Elnaggar RK, Elshafey MA (2016) Effects of combined resistive underwater exercises and interferential current therapy in patients with juvenile idiopathic arthritis. Am J Phys Med Rehabil. https://doi.org/10.1097/phm.0000000000000347

    Article  PubMed  Google Scholar 

  11. El-Shamy SM, Alayat MSM, Abdelgalil AA, Alshehri MA (2018) Long-term effect of pulsed Nd:YAG laser in the treatment of children with juvenile rheumatoid arthritis: a randomized controlled trial. Photomed Laser Surg. https://doi.org/10.1089/pho.2018.4444

    Article  PubMed  Google Scholar 

  12. Field T, Hernandez-Reif M, Seligman S, Krasnegor J, Sunshine W, Rivas-Chacon R, Schanberg S, Kuhn C (1997) Juvenile rheumatoid arthritis: benefits from massage therapy. J Pediatr Psychol. https://doi.org/10.1093/jpepsy/22.5.607

    Article  PubMed  Google Scholar 

  13. Upadhyay J, Lemme J, Cay M, Van Der Heijden H, Sibai D, Goodlett B, Lo J, Hoyt K, Taylor M, Hazen MM, Halyabar O, Meidan E, Schreiber R, Chang MH, Nigrovic PA, Jaimes C, Henderson LA, Ecklund K, Sundel RP (2021) A multidisciplinary assessment of pain in juvenile idiopathic arthritis. Semin Arthritis Rheum. https://doi.org/10.1016/j.semarthrit.2021.05.011

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ravelli A, Martini A (2007) Juvenile idiopathic arthritis. Lancet. https://doi.org/10.1016/s0140-6736(07)60363-8

    Article  PubMed  Google Scholar 

  15. Fredriksen B, Mengshoel AM (2000) The effect of static traction and orthoses in the treatment of knee contractures in preschool children with juvenile chronic arthritis: a single-subject design. Arthritis Rheum. https://doi.org/10.1002/1529-0131(200012)13:6%3C352::aid-art4%3E3.0.co;2-o

    Article  Google Scholar 

  16. Roberts JM, Wilson K (1999) Effect of stretching duration on active and passive range of motion in the lower extremity. Br J Sports Med. https://doi.org/10.1136/bjsm.33.4.259

    Article  PubMed  PubMed Central  Google Scholar 

  17. Emery HM, Bowyer SL, Sisung CE (1995) Rehabilitation of the child with a rheumatic disease. Pediatr Clin North Am. https://doi.org/10.1016/s0031-3955(16)40062-3

    Article  PubMed  Google Scholar 

  18. Baydogan SN, Tarakci E, Kasapcopur O (2015) Effect of strengthening versus balance-proprioceptive exercises on lower extremity function in patients with juvenile idiopathic arthritis. Am J Phys Med Rehabil. https://doi.org/10.1097/phm.0000000000000279

    Article  PubMed  Google Scholar 

  19. van Brussel M, van Doren L, Timmons BW, Obeid J, van der Net J, Helders PJM, Takken T (2009) Anaerobic-to-aerobic power ratio in children with juvenile idiopathic arthritis. Arthritis Care Res. https://doi.org/10.1002/art.24536

    Article  Google Scholar 

  20. Giannini MJ, Protas EJ (1993) Comparison of peak isometric knee extensor torque in children with and without juvenile rheumatoid arthritis. Arthritis Care Res. https://doi.org/10.1002/art.1790060207

    Article  PubMed  Google Scholar 

  21. Takken T, van Brussel M, Engelbert RHH, Van der Net J, Kuis W, Helders PJM (2008) Exercise therapy in juvenile idiopathic arthritis. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.cd005954.pub2

    Article  PubMed  PubMed Central  Google Scholar 

  22. Singh-Grewal D, Schneiderman-Walker J, Wright V, Bar-Or O, Beyene J, Selvadurai H, Cameron B, Laxer RM, Schneider R, Silverman ED, Spiegel L, Tse S, Leblanc C, Wong J, Stephens S, Feldman BM (2007) The effects of vigorous exercise training on physical function in children with arthritis: a randomized, controlled, single-blinded trial. Arthritis Care Res. https://doi.org/10.1002/art.23008

    Article  Google Scholar 

  23. Bayraktar D, Savci S, Altug-Gucenmez O, Manci E, Makay B, Ilcin N, Unsal E (2019) The effects of 8-week water-running program on exercise capacity in children with juvenile idiopathic arthritis: a controlled trial. Rheumatol Int. https://doi.org/10.1007/s00296-018-4209-8

    Article  PubMed  Google Scholar 

  24. Gualano B, Sà Pinto AL, Perondi B, Leite Prado DM, Omori C, Tavares Almeida R, Sallum AME, Almeida Silva CA (2010) Evidence for prescribing exercise as treatment in pediatric rheumatic diseases. Autoimmun Rev. https://doi.org/10.1016/j.autrev.2010.04.001

    Article  PubMed  Google Scholar 

  25. Kuntze G, Nesbitt C, Whittaker JL, Nettel-Aguirre A, Toomey C, Esau S, Doyle-Baker PK, Shank J, Brooks J, Benseler S, Emery CA (2018) Exercise therapy in juvenile idiopathic arthritis: a systematic review and meta-analysis. Arch Phys Med Rehabil. https://doi.org/10.1016/j.apmr.2017.05.030

    Article  PubMed  Google Scholar 

  26. Lelieveld OTHM, Armbrust W, van Leeuwen MA, Duppen N, Geertzen JHB, Sauer PJJ, van Weert E (2008) Physical activity in adolescents with juvenile idiopathic arthritis. Arthritis Rheum. https://doi.org/10.1002/art.24102

    Article  PubMed  Google Scholar 

  27. Sandstedt E, Fasth A, Eek MN, Beckung E (2013) Muscle strength, physical fitness and well-being in children and adolescents with juvenile idiopathic arthritis and the effect of an exercise programme: a randomized controlled trial. Pediatr Rheumatol Online J. https://doi.org/10.1186/1546-0096-11-7

    Article  PubMed  PubMed Central  Google Scholar 

  28. Houghton KM, Macdonald HM, McKay HA, Guzman J, Duffy C, Tucker L, LEAP Study Investigators (2018) Feasibility and safety of a 6-month exercise program to increase bone and muscle strength in children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J. https://doi.org/10.1186/s12969-018-0283-4

    Article  PubMed  PubMed Central  Google Scholar 

  29. Arman N, Tarakci E, Tarakci D, Kasapcopur O (2019) Effects of video games-based task-oriented activity training (Xbox 360 Kinect) on activity performance and participation in patients with juvenile idiopathic arthritis: a randomized clinical trial. Am J Phys Med Rehabil. https://doi.org/10.1097/phm.0000000000001001

    Article  PubMed  Google Scholar 

  30. Gäre BA & Fasth A (1995) The natural history of juvenile chronic arthritis: a population based cohort study. I. Onset and disease process. J Rheumatol. PMID: 7738954

  31. Hodges PW, van den Hoorn W, Wrigley TV, Hinman RS, Bowles KA, Cicuttini F, Wang Y, Bennell K (2016) Increased duration of co-contraction of medial knee muscles is associated with greater progression of knee osteoarthritis. Man Ther. https://doi.org/10.1016/j.math.2015.07.004

    Article  PubMed  Google Scholar 

  32. Ringold S, Wallace C, Rivara FP (2009) Health-related quality of life, physical function, fatigue, and disease activity in children with established polyarticular juvenile idiopathic arthritis. J Rheumatol. https://doi.org/10.3899/jrheum.081028

    Article  PubMed  Google Scholar 

  33. Elnaggar RK, Mahmoud WS, Moawd SA, Azab AR (2021) Impact of core stability exercises on bone mineralization and functional capacity in children with polyarticular juvenile idiopathic arthritis: a randomized clinical trial. Clin Rheumatol. https://doi.org/10.1007/s10067-020-05219-9

    Article  PubMed  Google Scholar 

  34. Kuntze G, Nesbitt C, Nettel-Aguirre A, Esau S, Scholz R, Brooks J, Twilt M, Toomey C, Mosher D, Ronsky JL, Benseler S, Emery CA (2020) Gait Adaptations in youth with juvenile idiopathic arthritis. Arthritis Care Res (Hoboken). https://doi.org/10.1002/acr.23919

    Article  PubMed  Google Scholar 

  35. Thornton J, Ashcroft D, O’Neill T, Elliot R, Adams J, Roberts C, Rooney M, Symmons D (2008) A systematic review of the effectiveness of strategies for reducing fracture risk in children with juvenile idiopathic arthritis with additional data on long-term risk of fracture and cost of disease management. Health Technol Assess. https://doi.org/10.3310/hta12030

    Article  PubMed  Google Scholar 

  36. Zak M, Hassager C, Lovell DJ, Nielsen S, Henderson CJ, Pedersen FK (1999) Assessment of bone mineral density in adults with a history of juvenile chronic arthritis: a cross-sectional long-term followup study. Arthritis Rheum. https://doi.org/10.1002/1529-0131(199904)42:4%3C790::aid-anr24%3E3.0.co;2-g

    Article  PubMed  Google Scholar 

  37. d’Angelo MD, Di Donato G, Breda L, Chiarelli F (2021) Growth and puberty in children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J. https://doi.org/10.1186/s12969-021-00521-5

    Article  PubMed  PubMed Central  Google Scholar 

  38. Gannotti ME, Nahorniak M, Gorton GE 3rd, Sciascia K, Sueltenfuss M, Synder M, Zaniewski A (2007) Can exercise influence low bone mineral density in children with juvenile rheumatoid arthritis? Pediatr Phys Ther. https://doi.org/10.1097/pep.0b013e318036a25e

    Article  PubMed  Google Scholar 

  39. Henderson CJ, Lovell DJ, Specker BL, Campaigne BN (1995) Physical activity in children with juvenile rheumatoid arthritis: quantification and evaluation. Arthritis Care Res. https://doi.org/10.1002/art.1790080210

    Article  PubMed  Google Scholar 

  40. Sothern MS, Loftin M, Suskind RM, Udall JN, Blecker U (1999) The health benefits of physical activity in children and adolescents: implications for chronic disease prevention. Eur J Pediatr. https://doi.org/10.1007/s004310051070

    Article  PubMed  Google Scholar 

  41. Epps H, Ginnelly L, Utley M, Southwood T, Gallivan S, Sculpher M, Woo P (2005) Is hydrotherapy cost-effective A randomised controlled trial of combined hydrotherapy programmes compared with physiotherapy land techniques in children with juvenile idiopathic arthritis. Health Technol Assess. https://doi.org/10.3310/hta9390

    Article  PubMed  Google Scholar 

  42. Broström E, Nordlund MM, Cresswell AG (2004) Plantar- and dorsiflexor strength in prepubertal girls with juvenile idiopathic arthritis. Arch Phys Med Rehabil. https://doi.org/10.1016/j.apmr.2003.11.017

    Article  PubMed  Google Scholar 

  43. Rashed AM, Abdel-Wahab N, Moussa EMM, Hammam N (2018) Association of hand grip strength with disease activity, disability and quality of life in children and adolescents with Juvenile Idiopathic Arthritis. Adv Rheumatol. https://doi.org/10.1186/s42358-018-0012-1

    Article  PubMed  Google Scholar 

Download references

Funding

This manuscript received no external funding.

Author information

Authors and Affiliations

Authors

Contributions

ADL wrote the manuscript and realized the figure and table. SLB and GDD wrote the manuscript. JF edited the manuscript in correct English. FC and LB coordinated, reviewed, and approved the final version of the manuscript. All authors have read and agreed to the published version of the manuscript. All authors take full responsibility for the integrity and accuracy of all aspects of the work.

Corresponding author

Correspondence to Armando Di Ludovico.

Ethics declarations

Conflicts of interest

The authors declare no conflict of interest.

Informed consent

Not applicable.

Institutional review board

Not applicable.

Disclaimer

No part of the review, including its graphics, are copied or published elsewhere in whole or in part.

Additional information

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

Di Ludovico, A., La Bella, S., Di Donato, G. et al. The benefits of physical therapy in juvenile idiopathic arthritis. Rheumatol Int 43, 1563–1572 (2023). https://doi.org/10.1007/s00296-023-05380-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-023-05380-9

Keywords

Navigation