Multicenter Study

. 2021 Jun 29;19(1):97.

doi: 10.1186/s12969-021-00584-4.

Clinical and psychosocial stress factors are associated with decline in physical activity over time in children with juvenile idiopathic arthritis

Liane D Heale^#¹, Kristin M Houghton^#², Elham Rezaei³, Adam D G Baxter-Jones⁴, Susan M Tupper³, Nazeem Muhajarine³, Susanne M Benseler⁵, Gilles Boire⁶, David A Cabral⁷, Sarah Campillo⁸, Gaëlle Chédeville⁸, Anne-Laure Chetaille⁹, Paul Dancey¹⁰, Ciaran Duffy¹¹, Karen Watanabe Duffy¹¹, Janet Ellsworth¹², Jaime Guzman⁷, Adam M Huber¹³, Roman Jurencak¹¹, Bianca Lang¹³, Ronald M Laxer¹⁴, Kimberly Morishita⁷, Kiem G Oen¹⁵, Ross E Petty⁷, Suzanne E Ramsey¹³, Johannes Roth¹¹, Rayfel Schneider¹⁴, Rosie Scuccimarri⁸, Lynn Spiegel¹⁴, Elizabeth Stringer¹³, Shirley M L Tse¹⁴, Lori B Tucker⁷, Stuart E Turvey⁷, Rae S M Yeung¹⁴, Alan M Rosenberg³; BBOP Study Group

Affiliations

¹ McMaster Children's Hospital and McMaster University, Hamilton, Canada.
² British Columbia Children's Hospital and University of British Columbia, 4480 Oak Street, Room K4-120, Vancouver, BC, V6H 3V4, Canada. khoughton@cw.bc.ca.
³ Jim Pattison Children's Hospital and University of Saskatchewan, Saskatoon, Canada.
⁴ University of Saskatchewan, Saskatoon, Canada.
⁵ Alberta Children's Hospital and University of Calgary, Calgary, Canada.
⁶ Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie- Centre Hospitalier Universitaire de Santé (CIUSSS de l'Estrie-CHUS) and University of Sherbrooke, Sherbrooke, Canada.
⁷ British Columbia Children's Hospital and University of British Columbia, 4480 Oak Street, Room K4-120, Vancouver, BC, V6H 3V4, Canada.
⁸ Montreal Children's Hospital and McGill University, Montreal, Canada.
⁹ le Centre Hospitalier Universitaire de Quebec, Quebec, Canada.
¹⁰ Janeway Children's Health and Rehabilitation Centre and Memorial University, St. John's, Canada.
¹¹ Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada.
¹² Stollery Children's Hospital and University of Alberta, Edmonton, Canada.
¹³ IWK Health Centre and Dalhousie University, Halifax, Canada.
¹⁴ The Hospital for Sick Children and University of Toronto, Toronto, Canada.
¹⁵ The Children's Hospital of Winnipeg and University of Manitoba, Winnipeg, Canada.

^# Contributed equally.

PMID: 34187498
PMCID: PMC8243495
DOI: 10.1186/s12969-021-00584-4

Multicenter Study

Clinical and psychosocial stress factors are associated with decline in physical activity over time in children with juvenile idiopathic arthritis

Liane D Heale et al. Pediatr Rheumatol Online J. 2021.

. 2021 Jun 29;19(1):97.

doi: 10.1186/s12969-021-00584-4.

Authors

Affiliations

¹ McMaster Children's Hospital and McMaster University, Hamilton, Canada.
² British Columbia Children's Hospital and University of British Columbia, 4480 Oak Street, Room K4-120, Vancouver, BC, V6H 3V4, Canada. khoughton@cw.bc.ca.
³ Jim Pattison Children's Hospital and University of Saskatchewan, Saskatoon, Canada.
⁴ University of Saskatchewan, Saskatoon, Canada.
⁵ Alberta Children's Hospital and University of Calgary, Calgary, Canada.
⁶ Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie- Centre Hospitalier Universitaire de Santé (CIUSSS de l'Estrie-CHUS) and University of Sherbrooke, Sherbrooke, Canada.
⁷ British Columbia Children's Hospital and University of British Columbia, 4480 Oak Street, Room K4-120, Vancouver, BC, V6H 3V4, Canada.
⁸ Montreal Children's Hospital and McGill University, Montreal, Canada.
⁹ le Centre Hospitalier Universitaire de Quebec, Quebec, Canada.
¹⁰ Janeway Children's Health and Rehabilitation Centre and Memorial University, St. John's, Canada.
¹¹ Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada.
¹² Stollery Children's Hospital and University of Alberta, Edmonton, Canada.
¹³ IWK Health Centre and Dalhousie University, Halifax, Canada.
¹⁴ The Hospital for Sick Children and University of Toronto, Toronto, Canada.
¹⁵ The Children's Hospital of Winnipeg and University of Manitoba, Winnipeg, Canada.

^# Contributed equally.

PMID: 34187498
PMCID: PMC8243495
DOI: 10.1186/s12969-021-00584-4

Abstract

Background: Physical activity (PA) patterns in children with juvenile idiopathic arthritis (JIA) over time are not well described. The aim of this study was to describe associations of physical activity (PA) with disease activity, function, pain, and psychosocial stress in the 2 years following diagnosis in an inception cohort of children with juvenile idiopathic arthritis (JIA).

Methods: In 82 children with newly diagnosed JIA, PA levels, prospectively determined at enrollment, 12 and 24 months using the Physical Activity Questionnaire for Children (PAQ-C) and Adolescents (PAQ-A) raw scores, were evaluated in relation to disease activity as reflected by arthritis activity (Juvenile Arthritis Disease Activity Score (JADAS-71)), function, pain, and psychosocial stresses using a linear mixed model approach. Results in the JIA cohort were compared to normative Pediatric Bone Mineral Accrual Study data derived from healthy children using z-scores.

Results: At enrollment, PA z-score levels of study participants were lower than those in the normative population (median z-score - 0.356; p = 0.005). At enrollment, PA raw scores were negatively associated with the psychosocial domain of the Juvenile Arthritis Quality of Life Questionnaire (r = - 0.251; p = 0.023). There was a significant decline in PAQ-C/A raw scores from baseline (median and IQR: 2.6, 1.4-3.1) to 24 months (median and IQR: 2.1, 1.4-2.7; p = 0.003). The linear mixed-effect model showed that PAQ-C/A raw scores in children with JIA decreased as age, disease duration, and ESR increased. The PAQ-C/A raw scores of the participants was also negatively influenced by an increase in disease activity as measured by the JADAS-71 (p < 0.001).

Conclusion: Canadian children with newly diagnosed JIA have lower PA levels than healthy children. The decline in PA levels over time was associated with disease activity and higher disease-specific psychosocial stress.

Keywords: Juvenile arthritis; Physical activity; Psychosocial stress.

PubMed Disclaimer

Conflict of interest statement

None identified. The authors declare that they have no competing interests.

Figures

**Fig. 1**
Correlation heat map at baseline. BMI, body mass index; PAQ-C/A score, physical activity questionnaire for children and adolescents; JADAS-71, Juvenile Arthritis Disease Activity Score; CHAQ, Child Health Assessment Questionnaire; JAQQ, Juvenile Arthritis Quality of Life Questionnaire; SLEC, Stressful Life Events Checklist

**Fig. 2**
Boxplot of PAQ-C/A raw score at baseline, 12 and 24 months follow up. * There was a significant change in PAQ score from baseline to 24-month (p = 0.003)

**Fig. 3**
a Physical activity scores (PAQ-C/A) over time in children with low number of active joints (dark circle) and high number of active joints (open square). PAQ-C/A data is logarithmically transformed, fixed effect coefficient from LME model. b Physical activity scores (PAQC/A) over time in children with low ESR (dark circle) and high ESR (open square). PAQ-C/A data is logarithmically transformed, fixed effect coefficient from LME model

See this image and copyright information in PMC

References

1. Bos GJ, Lelieveld OT, Armbrust W, Sauer PJ, Geertzen JH, Dijkstra PU. Physical activity in children with juvenile idiopathic arthritis compared to controls. Pediatr Rheumatol. 2016;14(1):42. doi: 10.1186/s12969-016-0102-8. - DOI - PMC - PubMed
1. Sherman G, Nemet D, Moshe V, et al. Disease activity, overweight, physical activity and screen time in a cohort of patients with juvenile idiopathic arthritis. Clin Exp Rheumatol. 2018;36(6):1110–1116. - PubMed
1. Risum K, Edvardsen E, Godang K, et al. Physical fitness in patients with oligo-and polyarticular juvenile idiopathic arthritis diagnosed in the era of biologics–a controlled cross-sectional study. Arthritis Care Res. 2019;71(12):1611–1620. doi: 10.1002/acr.23818. - DOI - PubMed
1. Bohr A, Nielsen S, Müller K, Pedersen FK, Andersen LB. Reduced physical activity in children and adolescents with juvenile idiopathic arthritis despite satisfactory control of inflammation. Pediatr Rheumatol. 2015;13(1):57. doi: 10.1186/s12969-015-0053-5. - DOI - PMC - PubMed
1. Nørgaard M, Twilt M, Andersen LB, Herlin T. Accelerometry-based monitoring of daily physical activity in children with juvenile idiopathic arthritis. Scand J Rheumatol. 2016;45(3):179–187. doi: 10.3109/03009742.2015.1057862. - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Consumer Health Information
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Clinical and psychosocial stress factors are associated with decline in physical activity over time in children with juvenile idiopathic arthritis

Affiliations

Clinical and psychosocial stress factors are associated with decline in physical activity over time in children with juvenile idiopathic arthritis

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous