Physical fitness low in kids with arthritis

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - Aerobic and anaerobic exercise capacity is decreased in children and adolescents with so-called juvenile idiopathic arthritis or JIA, according to the results of two studies by Dutch investigators.

The findings of a third study suggest that although the exercise capacity of these children is diminished, adherence to an exercise program can improve their functional level. All three studies are reported in the medical journal Arthritis and Rheumatism.

In the first two studies, Dr. Tim Takken, from University Medical Center Utrecht, and colleagues examined the exercise capacity of 62 children and 22 adolescents with JIA.

"The biggest finding was the reduction in the anaerobic exercise capacity --the ability to make short sprints, etc.," Takken told Reuters Health.

In both age groups, maximal oxygen consumption and average power were impaired in the JIA group compared to healthy controls. Peak power also tended to be lower in the JIA group.

"We need to find ways to increase the daily activities of children with arthritis," Takken said, such as increasing extra-curricular sport activities. "Currently, we are running a nationwide program to stimulate sports and physical activities in children with arthritis."

In the third study, Dr. Debbie Ehrmann Feldman, from the University of Montreal, and colleagues used parental questionnaires to assess how well 175 children with JIA stuck to their medical and exercise therapy.

The researchers found that patients with moderate to good adherence to medical therapy had lower disease scores than those with poor adherence. Similarly, moderate to good adherence to exercise were tied to better functional scores.

"Mounting evidence shows that children with JIA can improve their physical fitness through carefully structured and supervised aquatic or land-based physical conditioning programs with no increase in disease activity," Dr. Susan Klepper, from Columbia University in New York, writes in a related editorial.

The present findings, she says, "suggest that anaerobic training may also be beneficial, particularly with regard to improving functional capacity and performance of both basic and more complex daily activities."

SOURCE: Arthritis and Rheumatism, August 15, 2007.