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Effect of Strengthening Versus Balance-Proprioceptive Exercises on Lower Extremity Function in Patients with Juvenile Idiopathic Arthritis

A Randomized, Single-Blind Clinical Trial

Baydogan, Saime Nilay MSc, PT; Tarakci, Ela PhD, PT; Kasapcopur, Ozgur MD

American Journal of Physical Medicine & Rehabilitation: June 2015 - Volume 94 - Issue 6 - p 417–428
doi: 10.1097/PHM.0000000000000279
Original Research Articles: CME Article . 2015 Series . Number 6

Objective The aim of this study was to investigate the effects of two exercise programs on lower extremity function in patients with juvenile idiopathic arthritis.

Design Thirty patients with juvenile idiopathic arthritis participated in this study. Pain, passive range of motion, muscle strength, balance, and functional abilities were assessed with the Numeric Rating Scale, goniometer, handheld dynamometer, Flamingo Balance Test, Functional Reach Test, 10-meter walking test, 10-stair climbing test, and Childhood Health Assessment Questionnaire. Participants were randomly assigned to the strengthening exercise group (group 1, n = 15) or the proprioceptive-balance exercise group (group 2, n = 15).

Results Intragroup analysis showed statistically significant improvements in all outcome measures except muscle strength in the hip and ankle after strengthening exercises in group 1. However, statistically significant improvements were found in all outcome measures after the proprioceptive-balance exercises in group 2. Intergroup analysis showed statistically significant improvement in all outcome measures in group 2 except for the Numeric Rating Scale, Childhood Health Assessment Questionnaire, and passive range of motion scores and hip extension and knee flexion muscle strengths.

Conclusions This study demonstrates that exercise treatment significantly improves musculoskeletal symptoms in patients with juvenile idiopathic arthritis. However, balance-proprioceptive exercises prove to be effective more than strengthening exercises for improving lower extremity function such as walking, climbing stairs, and balance in patients with juvenile idiopathic arthritis.

From the Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation (SNB, ET) and Medical Faculty of Cerrahpasa, Department of Pediatric Rheumatology (OK), Istanbul University, Istanbul, Turkey.

All correspondence and requests for reprints should be addressed to: Saime Nilay Baydogan, MSc, PT, İstanbul Üniversitesi, Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Demirkapı Cad. Karabal Sk. Bakırköy Ruh ve Sinir Hastalıkları Hastanesi Bahçesi içi 34740 Bakırköy, Istanbul, Türkiye.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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