Exercise Participation: Juvenile Idiopathic Arthritis

To continue on with yesterday's topic, promoting participation in recreational activities for children with disabilities, today's topic will discuss specific recommendations for children with juvenile idiopathic arthritis (JIA). Research has shown that children with JIA can participate in exercise regimens without exacerbating the disease. In addition, research has shown that exercise for at least 6 weeks decreases disease activity, improves quality of life and decreases pain. In general, it is recommended that children with JIA participate in moderate fitness and strengthening activities.

There are precautions necessary to consider when recommending exercise or sports participation for children with JIA. Depending upon where the JIA is located, various risks may be present. For example, cervical arthritis makes a child at greater risk for neck injuries and temporomandibular joint disease may result in dental injuries. JIA may results in visual impairments making a child more susceptible to eye injury. If children have been diagnosed long term with JIA, research has shown aerobic fitness to be lower than typically developing peers.

In addition to the precautions, the following recommendations should be considered when suggesting exercise programs for children with JIA:
1. participation in contact sports or impact activities are permitted if the disease is well managed and the child has the physical capacity to participate in the sport (cervical spine should be screened with x-ray prior to contact sports)
2. activities should be pain free
3. if the JIA flares up, return to regular activity should be gradual
4. jaw protection and proper eye protection should be utilized

Overall, children with JIA may benefit from moderate fitness, flexibility and strengthening activities and may participate in exercise and sports without exacerbating the JIA.

Reference: Philpott, John F MD, Dip Sport Med; Houghton, Kristin MD, Dip Sport Med; Luke, Anthony MD, MPH, Dip Sport Med Physical Activity Recommendations for Children With Specific Chronic Health Conditions: Juvenile Idiopathic Arthritis, Hemophilia, Asthma, and Cystic Fibrosis Clinical Journal of Sport Medicine: May 2010 - Volume 20 - Issue 3 - pp 167-172 doi: 10.1097/JSM.0b013e3181d2eddd