SYSTEMATIC REVIEWS: CLINICAL BOTTOM LINE
“How can I apply this information?”
This systematic review supports the potential benefits of various types of exercise training in children with juvenile idiopathic arthritis (JIA). The evidence suggests that individuals with JIA can safely participate in exercise testing and exercise training without fear of harm. Since expert supervision of exercise training positively influenced outcomes in the studies, the role of the physical therapist is important to the functional well-being of this population. Evidence consistently supports that, in spite of advances in medical treatment, children with JIA are less physically active than their peers. In addition to targeting functional deficits through specialized interventions, therapists should promote achievement of recommended levels of physical activity. Therefore, clinicians treating children with JIA can play a key role in educating individuals, families, teachers, and caregivers regarding the safety and benefit of targeted exercise training in this population.
“What should I be mindful about when applying this information?”
The evidence suggests that specific supervised exercise programs improve functional outcomes of individuals with JIA. It is important to consider the practical accessibility of some of the specific programs presented in this review. Physical therapists should advocate on behalf of this patient population and educate referral sources on the value of physical therapy in the long-term management of JIA, to maximize function and peer-equivalent physical activity levels. There is a need for the development of an effective and sensitive instrument for measuring function and perception of function within this population. Finally, there appears to be value in interactive, media-based programs, which encourage consistent and successful participation in home exercise programs. Future research is needed to strengthen the evidence regarding specific forms of exercise training that are readily available to individuals with JIA.
Paula Melson, PT, DPT, MMS
Shannon Darnell, PT, MPT
Cincinnati Children's Hospital Medical Center