# Exercise as it relates to Disease/The impact of physical activity in children with juvenile rheumatoid arthritis

This is a critical analysis on the article “Physical Activity in Children with Juvenile Rheumatoid Arthritis: Quantification and Evaluation”

## What is the background to this research?

* Rheumatoid arthritis(RA) is an autoimmune disease that occurs in the smaller joints such as the ones in the feet and hands. The immune system attacks the healthy tissue of the joint lining causing pain through joint damage and inflammation. It is not known what directly causes rheumatoid arthritis whoever it appears to be more prominent in those who smoke and/or have a family history of it. With early identification those of suffer from it can still have an active lifestyle.

## Where is the research from?

* This paper was published in 1995 by the American College of Rheumatology. The research was conducted and revised by Carol J Henderson, Daniel Lovell, MD, MPH (Division of Rheumatology), Bonny L. Specker (Division of Neonatology, Children's Hospital Medical Centre, Cincinnati, Ohio). Barbara N. Campaigne (American College of Sports Medicine, Indianapolis, Indiana). This paper was also supported by several foundations; Children’s Hospital Research Foundation of Cincinnati, the Schmidlapp Foundation, the NIH and the Arthritis Foundation.

## What kind of research was this?

* This kind of research consisted of three standardised methods conducted simultaneously. By conducted the three standardised tests it allowed the researchers to achieve a more valid and reliable data set and make a clearer conclusion.

## What did the research involve?

* The research involved a study population of 23 Juvenile Rheumatoid Arthritis(JRA) patients and 23 healthy control individuals. The study population consisted of both male and female children aged 5-11 years old. All JRA were screened using the American College of Rheumatology diagnostic criteria (can be found linked in the further information and resources) and had no other chronic illnesses. The goal of comparing the physical activity levels of healthy children and those suffering with Rheumatoid Arthritis. Physical activity monitoring was over a three-day period using the following methods; the Caltrac, UCSM motion sensor device and a 3-day diary log.

## What were the basic results?

* From the 3 standardised tests the 3-day activity diary revealed that there was a significantly lower volume of daily physical activity in mild to moderate JRA patients as opposed to the control group. In the daily body movement data collect by both the Caltrac and UCMS there was little difference between the two groups.

## What conclusions can we take from this research?

* What can be observed from this study is that JRA patients with the mild to moderate disease participate in a lower amount of physical activity than that of the healthy control group.

## Practical advice

* Physical activity can still be undertaken by those with JRA as this study showed that there was little difference in the daily amount between those effected and those who were not. Daily physical activity can remain consistent by introducing low impact exercises to reduce the amount of strain placed on individual’s joints.

## References and Additional Resources

Additional Resources:
https://academic.oup.com/ptj/article-abstract/72/5/365/2728916 Another study assessing the difference in exercise response in children with RA and without to compare data and results to achieve.
https://www.nejm.org/doi/pdf/10.1056/NEJM196710052771406 An article on early diagnosis in JRA to understand the importance of identification and to assist in identifying symptoms that allow for diagnosis.
References:
* ↑ Arthritis Australia. (2018). Rheumatoid arthritis — Arthritis Australia. [online] Available at: https://arthritisaustralia.com.au/types-of-arthritis/rheumatoid-arthritis/ [Accessed 19 Sep. 2018].
* ↑ Henderson, C. (2018). Physical activity in children with juvenile rheumatoid arthritis: quantification and evaluation. - PubMed - NCBI. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/7794985 [Accessed 19 Sep. 2018].
* ↑ New England Journal of Medicine. (2018). Juvenile Rheumatoid Arthritis | NEJM. [online] Available at: https://www.nejm.org/doi/pdf/10.1056/NEJM196710052771406 [Accessed 19 Sep. 2018].
* ↑ Jasso Giannini, M. and Protas, E. (1992). Exercise Response in Children with and without Juvenile Rheumatoid Arthritis: A Case-Comparison Study. Physical Therapy, [online] 72(5), pp.365-372. Available at: https://academic.oup.com/ptj/article-abstract/72/5/365/2728916 [Accessed 19 Sep. 2018].