FRI0475-HPR Comparison the effect to the lower extremity functions of strengthening exercises and proprioceptive-balance exercises in juvenile idiopathic arthritis
Authors: N. Baydogan, E. Tarakcı, O. Kasapcopur
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Juvenile idiopathic arthritis (JIA) is the most common chronic pediatric rheumatic disease and an important cause of acquired impairment and disability in children and adolescents (1). Patients with JIA commonly experience acute and chronic pain, decreased mobility, and joint stiffness leading to restrictions on activities and isolation from their peers (2).Knee is the most commonly affected joint in JIA (3). Physical therapy for patients with JIA has been aimed at managing pain and inflammation, preserving range of motion, and maintaining muscle strength through rest and limiting the strain on arthritic joints (4,5). The best therapeutic exercise program for children with arthritis is as yet unknown. <h3>Objectives</h3> The aim of the study was to compare the effect to the lower extremity functions of strengthening exercises and proprioceptive-balance exercises in Juvenile Idiopathic Arthritis. <h3>Methods</h3> 30 patients (6-18 ages) were included in this study. The patients were divided into 2 groups randomly. The first group received a program of treatment consisting of bicycle ergonometer, stretching exercises, strengthening exercises, cold application, second group received a program of treatment consisting of bicycle ergonometer, strengthening exercises, proprioceptive-balance exercises, cold application for 3 days in a week through 12 weeks. The patients' pain by The Visual Analog Scale (VAS), range of motion (ROM) by goniometer, muscle strength by Hand Held Dynamometer (HHD), balance by Berg Balance Test (BBT), Flamingo Balance Test (FBT), Functional Reach Test (FRT), walking by Video-Based Observational Gait Analiysis (VBOGA), functional status by 10 meters walking duration test (10mWT), 10 steps climbing duration test (10SC), the functional abilities by Childhood Health Assessment Questionaire (CHAQ) were evaluated. <h3>Results</h3> After treatment in both groups, the scores of VAS decreased, muscle strength and ROM increased (p&lt;0.05). The changes of BBT, FBT, FRT, 10mWT, 10SC, VBOYA, CHAQ scores were significant in both groups. All scores, except CHAQ, were different significantly between groups (p&lt;0,05). <h3>Conclusions</h3> According to the results of the study, in the patients with JIA, thanks to exercise therapy, a decrease in pain, increases in ROM and muscle power, an improvement in balance, a progress in walking and functional abilities were obtained. The balance-proprioception exercises were found to be more to the strengthening exercises. <h3>References</h3> Petty RE, Cassidy JT. Chronic arthritis. In: Cassidy JT, Petty RE, editor. Textbook of Pediatric Rheumatology. Elsevier Saunders Company; 5th edition 2005. pp. 206-341. Moe N, Rygg M. Epidemiology of juvenile chronic arthritis in Northern Norway: a ten-year retrospective study. Clin Exp Rheumatol 1998;16:99-101. Warren RW, Perez MD, Curry MR, Wilking AP, Myones LB. Juvenile Idiopathic Arthritis (Juvenile Rheumatoid Arthritis). In Koopman WJ, editor. Arthritis and Allied Conditions. Lippincott Williams &amp; Wilkins, Philadelphia, 2001; pp. 781-96. Klepper SE. Exercise in pediatric rheumatic diseases. Curr Opin Rheumatol 2008;20:619–24. Long AR, Rouster-Stevens KA. The role of exercise therapy in the management of juvenile idiopathic arthritis. Curr Opin Rheumatol 2010;22:213–17. <h3>Disclosure of Interest</h3> None Declared