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Evaluation of Static and Dynamic Postural Balance in Children With Juvenile Idiopathic Arthritis

Houghton, Kristin Michelle MD, MSc, FRCPC, Dip Sports Med; Guzman, Jaime MD, MSc, FRCPC

doi: 10.1097/PEP.0b013e31828a2978
Research Article

Purpose: To evaluate balance in children with lower limb involvement due to juvenile idiopathic arthritis (JIA).

Methods: Twenty-five children with JIA manifesting lower extremity arthritis within the previous year and 36 children who were healthy (aged 8–18 years) were assessed by using the Biodex Balance System (BBS) (Biodex, Shirley, New York). Single-leg static balance (BBS level 12) and bilateral static and dynamic balance (BBS levels 2 and 7) were measured. Lower extremity strength, disease activity, function, and pain were also assessed.

Results: Ten subjects with JIA (40%) could not complete single-leg balance testing, while all controls did (P < .0001). Bilateral dynamic balance was impaired only at BBS level 2 (most unstable). Lower extremity weakness correlated with poor balance.

Conclusion: A significant proportion of children with leg arthritis have impaired balance. Proprioceptive exercises may emerge as an important therapy in the treatment of lower extremity arthritis.

This report documents the balance impairments found in children with JIA. The authors suggest screening for balance impairment and the need for balance training in this population.

British Columbia Children's Hospital, Child Family Research Institute and the University of British Columbia, Vancouver, British Columbia, Canada.

Correspondence: Kristin Michelle Houghton, MD, MSc, FRCPC, Dip Sports Med, K4-123 ACB, British Columbia Children's Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada (khoughton@cw.bc.ca).

Grant Support: British Columbia Children's Hospital Telethon Grant, Vancouver, British Columbia, Canada.

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.