Accommodating Variable-Resistance Training in Patients With Juvenile Idiopathic Arthritis
Condition: Juvenile Idiopathic Arthritis
MeSH terms: Arthritis; Arthritis, Juvenile
Study type: Interventional

Summary: 
      This study was designed to investigate the effect of six weeks of accommodating
      variable-resistance training on muscle architecture, muscle strength, and functional
      performance in patients with juvenile idiopathic arthritis. Fifty-eight children with
      juvenile idiopathic arthritis were randomly allocated to the experimental group (n = 29,
      received the accommodating variable-resistance training) or the Control group (n = 29,
      received usual physical rehabilitation alone). Both groups were assessed for muscle
      architecture, muscle strength, and functional performance before and after treatment.
    

Detailed description: 
      Fifty-eight patients with juvenile idiopathic arthritis participated in the study. They were
      recruited from King Khalid Hospital and two other referral hospitals, in Riyadh, Saudi
      Arabia. They were between 12 and 18 years old, had poly-articular onset and bilateral knee
      involvement, were on stable doses of medications, and were not engaging in regular exercise
      regimens. Patients were excluded if they had fixed deformities, a history of joint surgery,
      or whose radiological investigations revealed erosive changes of bone, ankylosing, or
      fractures.

      Outcome measures

        1. Muscle architecture: the fascicle length, pennation angle, and thickness of the vastus
           lateralis muscle were assessed using a standard high-resolution ultrasound imaging
           system.

        2. Muscle strength: The peak concentric torque of the right and left knee extensors was
           measured through an isokinetic dynamometer.

        3. Functional capacity: Three tests were used; the 6-minute walk test, the timed up and
           down stairs test, and the 4x10 meter Shuttle Run test.

      The experimental group received a 6-week accommodating variable-resistance training, two
      times a week for six consecutive weeks, in conformity with the National Strength and
      Conditioning Association guidelines and American Academy of Pediatrics safety standards. The
      training protocol included maximum voluntary concentric knee flexor/extensor actions through
      a motion range between 10 and 90 degrees. Three sets of five to 10 repetitions at angular
      speeds of 240, 180, and 120 degrees/second were performed. The training started with a
      warm-up for 10 minutes and ended with a cool-down for 5 minutes.

      The control group received the standard exercise program, 45 minutes per session, two times a
      week for six consecutive weeks. The program consisted of flexibility exercise, strength
      training, weight-bearing, proprioceptive training, and free treadmill walking or cycle
      ergometry.
    

Intervention name(s): Accommodating variable-resistance training; Standard physical therapy
Intervention type(s): Other; Other
Intervention description(s): The training was conducted twice weekly for six successive weeks under the 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 training protocol included maximum voluntary concentric knee flexor/extensor actions. Three sets of five to 10 repetitions of maximum-effort concentric action at angular speeds of 240, 180, and 120 degrees/second.
The training started with a 10-minute warm-up exercise and ended up with a 5-minute cool-down exercise.; The program encompassed the standard exercises for patients with juvenile idiopathic arthritis (aerobic, weight-bearing, proprioceptive, flexibility, and strengthening exercises). The training was conducted for 45 minutes, two times a week for six 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