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Determinants of physical activity level in children and adolescents with juvenile idiopathic arthritis

Determinanten des körperlichen Aktivitätsniveaus bei Kindern und Jugendlichen mit juveniler idiopathischer Arthritis

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Abstract

Objective

One of the most frequently discussed physical parameters in juvenile idiopathic arthritis (JIA) is physical activity level. There is limited evidence about determinants of physical activity level in JIA. In this study, we aimed to investigate the determinants of physical activity level in children and adolescents with JIA.

Materials and methods

Thirty-two JIA patients and 18 age- and sex-matched healthy individuals were included in the study. The age range was 8–18 years. Sociodemographic and clinical data of the participants were recorded. In both groups, anthropometry, fatigue, pain, knee extension muscle strength, gait variables, functional exercise capacity assessed by six-minute walk test (6MWT), and arterial stiffness were evaluated. Physical activity level was assessed by an accelerometer.

Results

The disease activity level of the patients was low. Pain and fatigue scores were significantly higher in the JIA group compared to healthy controls (p < 0.05). Walking speed, physical activity level, time spent in low-intensity physical activity, time spent in moderate-to-vigorous-intensity physical activity, and 6MWT distance were significantly lower than in healthy controls (p < 0.05). Quadriceps muscle strength and arterial stiffness assessment results were similar in both groups (p > 0.05). In the JIA group, there was a positive correlation between physical activity and age, height, fat-free body mass, quadriceps muscle strength, and 6MWT distance (p < 0.05). Also, there was a negative correlation between physical activity and pain, fatigue, and cadence. Physical activity level was independently associated with 6MWT distance (42.9% of the variability).

Conclusion

In mildly affected JIA patients, gait speed, functional exercise capacity, and physical activity level are affected. Functional exercise capacity is a determinant of physical activity level in JIA.

Zusammenfassung

Ziele

Einer der am häufigsten diskutierten körperlichen Parameter bei juveniler idiopathischer Arthritis (JIA) ist der körperliche Aktivitätsgrad. Es gibt begrenzte Evidenz für die Determinanten des körperlichen Aktivitätsgrads bei JIA. In der vorliegenden Studie war es das Ziel, die Determinanten des körperlichen Aktivitätsgrads bei Kindern und Jugendlichen mit JIA zu untersuchen.

Material und Methoden

In die Studie wurden 32 JIA-Patienten und 18 gesunde Personen gleichen Alters und Geschlechts einbezogen. Die Altersspanne lag zwischen 8 und 18 Jahren. Soziodemografische und klinische Daten der Teilnehmer wurden dokumentiert. In beiden Gruppen wurden Anthropometrie, Erschöpfung, Schmerzen, Kniestreckungsmuskelkraft, Gangvariablen, funktionelle Übungskapazität durch 6‑min-Gehtest (6MWT) und arterielle Steifheit bewertet. Der körperliche Aktivitätsgrad wurde durch einen Beschleunigungsmesser beurteilt.

Ergebnisse

Die Krankheitsaktivität der Patienten war gering. Die Werte für Schmerz und Erschöpfung waren in der JIA-Gruppe bedeutend höher als in der gesunden Kontrollgruppe (p < 0,05). Gehgeschwindigkeit, Ausmaß der körperlichen Aktivität; Zeit, die mit körperlicher Aktivität geringer Intensität verbracht wurde; Zeit, die mit körperlicher Aktivität mittlerer bis hoher Intensität verbracht wurde, und die Distanz im 6MWT waren bedeutend niedriger als bei den gesunden Kontrollpersonen (p < 0,05). Die Ergebnisse zur Bewertung der Quadrizeps-Muskelkraft und arteriellen Steifigkeit waren in den Gruppen ähnlich (p > 0,05). In der JIA-Gruppe gab es positive Korrelationen zwischen körperlicher Aktivität und Alter, Größe, fettfreiem Körpergewicht, Quadrizeps-Muskelkraft und 6MGT-Distanz (p < 0,05). Außerdem gab es negative Korrelationen zwischen körperlicher Aktivität, Schmerzen, Erschöpfung und Schrittfrequenz. Der körperliche Aktivitätsgrad war in unabhängiger Weise mit der 6MWT-Distanz assoziiert (42,9 % der Variabilität).

Schlussfolgerung

Bei leicht betroffenen JIA-Patienten sind die Ganggeschwindigkeit, die funktionelle Belastbarkeit und der körperliche Aktivitätsgrad beeinträchtigt. Die funktionelle Trainingskapazität ist bei JIA ausschlaggebend für den körperlichen Aktivitätsgrad.

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Funding

This work was supported by the Research Fund of the Dokuz Eylül University. Project number: 2021.KB.SAG.038. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Health Science Institute, Dokuz Eylul University, Izmir, Turkey

    Berk Can Ozdemir & Aylin Tanriverdi

  2. Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey

    Sema Savci, Aylin Tanriverdi & Buse Ozcan Kahraman

  3. Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey

    Rana Isguder, Balahan Makay & Erbil Unsal

Authors
  1. Berk Can Ozdemir
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  2. Sema Savci
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  3. Aylin Tanriverdi
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  4. Buse Ozcan Kahraman
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  5. Rana Isguder
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Corresponding author

Correspondence to Berk Can Ozdemir.

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Conflict of interest

B.C. Ozdemir, S. Savci, A. Tanriverdi, B.O. Kahraman, R. Isguder, B. Makay, and E. Unsal declare that they have no competing interests.

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards.

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Ulf Müller-Ladner, Bad Nauheim

Uwe Lange, Bad Nauheim

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Ozdemir, B.C., Savci, S., Tanriverdi, A. et al. Determinants of physical activity level in children and adolescents with juvenile idiopathic arthritis. Z Rheumatol 83 (Suppl 1), 71–77 (2024). https://doi.org/10.1007/s00393-023-01340-7

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  • DOI: https://doi.org/10.1007/s00393-023-01340-7

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