The Role of Aquatic-Based Plyometric Exercises for Patients With Juvenile Idiopathic Arthritis
Condition: Juvenile Idiopathic Arthritis
MeSH terms: Arthritis; Arthritis, Juvenile
Study type: Interventional

Summary: 
      This study was designed to assess the effect of a 12-week aqua-plyometric (AquaPlyo) training
      on muscle strength, bone health, and physical ability in children with juvenile idiopathic
      arthritis (JIA). Forty-eight patients with JIA were randomly allocated to the AquaPlyo group
      (n = 24, received an aquatic-based plyometric training program, twice/week, over 12 weeks) or
      the control group (n = 24, received standard exercise program). Both groups were assessed for
      muscle strength, bone health, and physical ability pre and post-treatment.
    

Detailed description: 
      Forty-eight patients with JIA were recruited from the pediatric rheumatology clinics of three
      large referral hospitals in Riyadh, Saudi Arabia. The study included patients who had a
      confirmed diagnosis of Polyarticular JIA (according to the criteria set forth by the
      International League of Associations for Rheumatology), aged 12-18 years, identified being
      stable cases, and did not participate in a regular exercise program (in the past six months).
      Patients who had fixed deformities, a history of joint surgery, or whose radiological
      investigations revealed erosive changes of bone, ankylosing, or fractures were excluded.

      Outcome measures

        1. Muscle strength: The peak concentric torque of the right and left quadriceps muscle was
           measured through an Isokinetic Dynamometer.

        2. Bone health: Areal bone mineral density, volumetric bone density, and bone mineral
           content of the lumbar spine and neck of femur were measured through Dual-Energy X-ray
           Absorptiometry (DEXA) scanning.

        3. Physical ability: The physical performance was assessed using the 6-minute walk test.

      The AquaPlyo group received a 12-week AquaPlyo training, 45 minutes per session, two times a
      week for 12 consecutive weeks, in conformity with the National Strength and Conditioning
      Association guidelines and American Academy of Pediatrics safety standards. The AquaPlyo
      program consisted of ten unilateral and bilateral lower limb plyometrics in the form of
      hopping/bounding/jumping activities conducted in a water medium. The AquaPlyo training
      included a warm-up for 10 minutes and a cool-down for 5 minutes. The control group received
      the standard exercise program, 45 minutes per session, two times a week for 12 consecutive
      weeks. The program consisted of flexibility exercise, strength training, weight-bearing,
      proprioceptive training, and free treadmill walking or cycle ergometry.
    

Intervention name(s): Aqua-Plyometric Exercise; Standard physical therapy
Intervention type(s): Other; Other
Intervention description(s): The aqua-plyometric training was conducted for 45 minutes, twice weekly, for 12 successive weeks. The training was geared toward the lower body and was conducted under close supervision of a licensed pediatric physical therapist in accordance with the safety performance guidelines defined by the American Academy of Pediatrics and the US National Strength and Conditioning Association.; The program encompassed the standard exercises for patients with JIA (aerobic, weight-bearing, proprioceptive, flexibility, and strengthening exercises). The training was conducted for 40 minutes, two times a week for 12 successive weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A prospective, dual-arm, randomized controlled trial
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment