THU0718-HPR OVERVIEW OF THE MOST EFFECTIVE PHYSIOTHERAPY MANAGEMENT METHODS IN PEDIATRIC RHEUMATOLOGY
Authors: Emmanuella Ioannou
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The majority of patients with pediatric rheumatologic conditions present with joint pain, morning stiffness and a high degree of fatigue which in turn affect their functional status, psychological wellbeing and activities of daily living (ADLs). Juvenile idiopathic arthritis - with a prevalence of 0.1-0.2/100 children- is the most common chronic pediatric rheumatic disease. When compared to healthy children, patients with juvenile idiopathic arthritis show decreased physical fitness, which necessitates systematic physiotherapy management. <h3>Objectives</h3> The current research was carried out to investigate the most reported physiotherapy methods for the management of common pediatric rheumatology conditions. <h3>Methods</h3> Pubmed and Google scholar databases were searched. Keywords were categorized into three groups. The first group included the most common pediatric rheumatologic conditions (juvenile chronic arthritis, juvenile spondyloarthropathy, juvenile psoriatic arthritis, dermatomyositis, systemic lupus erythematosus, vasculitis, scleroderma); the second group included physiotherapy management methods (physiotherapy, physical therapy, hydrotherapy, aquatic therapy); and the third group included outcomes (pain, pediatric pain, range of movement, quality of life, activities of daily living). Only primary research studies regarding patients with the aforementioned pediatric rheumatologic conditions were included. <h3>Results</h3> Notable variability was observed between studies as regards to applied methods and recorded outcomes. Additionally, results were not separately reported for the different diseases. Nevertheless, findings indicate that physiotherapy and hydrotherapy rehabilitation methods, focusing on reducing joint pain, joint protection, conservation of energy, and conservation of joint range of motion, achieved the treatment goals of maintaining and/or improving joint mobility and strength, improving pain and function, as well as improving the psychological wellbeing, without increasing fatigue or joint symptoms. <h3>Conclusion</h3> Despite heterogeneity in study design and methodology, current evidence shows that various physiotherapy methods contribute to the achievement of treatment goals and improve the quality of life in pediatric rheumatology. <h3>References</h3> [1] American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines. Guidelines for the management of rheumatoid arthritis: 2002 Update. Arthritis &amp; Rheumatism 2002;46:328–46. doi:10.1002/art.10148. [2] Klepper SE. Exercise in pediatric rheumatic diseases. Current Opinion in Rheumatology 2008;20:619–624. [3] Long AR, Rouster-Stevens KA. The role of exercise therapy in the management of juvenile idiopathic arthritis: Current Opinion in Rheumatology 2010;22:213–7. doi:10.1097/BOR.0b013e328335d1a2. [4] Takken T, Van Brussel M, Engelbert RHH, van der Net JJ, Kuis W, Helders PP. Exercise therapy in juvenile idiopathic arthritis. Cochrane Database of Systematic Reviews 2008. doi:10.1002/14651858.CD005954.pub2. <h3>Disclosure of Interests</h3> None declared