Level and correlates of physical activity among children and adolescents with juvenile idiopathic arthritis compared to controls: results from a German nationwide prospective observational cohort study

Springer Science and Business Media LLC - 2024
Florian Milatz1, Sandra Hansmann2, Jens Klotsche1, Martina Niewerth1, Tilmann Kallinich3,4, Frank Dressler5, Johannes-Peter Haas6, Rainer Berendes7, Gerd Horneff8,9, Markus Hufnagel10, Frank Weller-Heinemann11, Daniel Windschall12,13, Ralf Trauzeddel14, Moritz Klaas15, Hermann Girschick15, Prasad T. Oommen16, Ivan Foeldvari17, Serdar Mustafa Cantez18, Annette F. Jansson19, Matthias Hartmann6, Joachim Peitz-Kornbrust9, Kirsten Minden3,1
1Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany
2Department of Neuropediatrics, Developmental Neurology and Social Paediatrics, University of Tuebingen, Tuebingen, Germany
3Department of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
4Programme area Systems Rheumatology, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany
5Department of Paediatric Pneumology, Allergology and Neonatology, Children’s Hospital, Hannover Medical School, Hannover, Germany
6German Centre for Paediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
7Pediatric Rheumatology, Children’s Hospital St. Marien, Landshut, Germany
8Department of Paediatric and Adolescent Medicine, University Hospital of Cologne, Cologne, Germany
9Department of Pediatric Rheumatology, Asklepios Kinderklinik Sankt Augustin, Sankt Augustin, Germany
10Division of Pediatric Infectious Diseases and Rheumatology, Department of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
11Department of Pediatrics and Adolescent Medicine, Pediatric Rheumatology, Eltern-Kind-Zentrum Prof. Hess, Klinikum Bremen-Mitte, Bremen, Germany
12Clinic of Paediatric and Adolescent Rheumatology, Northwest German Centre for Rheumatology, St. Josef-Stift Sendenhorst, Sendenhorst, Germany
13Medizinische Fakultät, Universität Halle-Wittenberg, Halle, Germany
14Department of Paediatrics, Helios Klinik Berlin-Buch, Berlin, Germany
15Children’s Hospital, Vivantes Klinikum Friedrichshain, Berlin, Germany
16Department of Pediatric Oncology, Hematology and Clinical Immunology, Division of Pediatric Rheumatology, University Hospital, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
17Hamburg Centre for Paediatric and Adolescent Rheumatology, Schön Klinik Hamburg Eilbek, Hamburg, Germany
18Department of Pediatrics and Neonatology, Division of Pediatric Rheumatology, University Hospital of Marburg and Gießen, Gießen, Germany
19Department of Rheumatology & Immunology, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany

Tóm tắt

Physical active lifestyles are essential throughout growth and maturation and may offer potential preventive and therapeutic benefit in patients with juvenile idiopathic arthritis (JIA). Insufficient physical activity (PA), in contrast, can lead to aggravation of disease-related symptoms. This study aimed to i) examine PA levels in children and adolescents with JIA compared to general population controls and ii) investigate correlates of pronounced physical inactivity in order to identify risk groups for sedentary behaviour. Data from children and adolescents with JIA and population controls aged 3 to 17 years documented in the National Pediatric Rheumatologic Database (NPRD) and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) were used. Self-reported PA was collected from parents/guardians of children up to 11 years of age or adolescents 12 years of age and older. To compare PA-related data, age- and sex-specific pairwise analyses were conducted considering NPRD/KiGGS participants' data from 2017. Correlates of physical inactivity among patients were identified using a linear regression model. Data of 6,297 matched-pairs (mean age 11.2 ± 4.2 years, female 67%, patients’ disease duration 4.5 ± 3.7 years, persistent oligoarthritis 43%) were available for evaluation. Almost 36% of patients aged 3–17 years (vs. 20% of controls) achieved the WHO recommended amount of PA, while PA steadily decreased with age (18% of patients aged ≥ 12 years) and varied between JIA categories. Female adolescents and patients with enthesitis-related arthritis were least likely to achieve the minimum recommended level of PA. Physical inactivity was associated with female sex, higher age at disease onset, longer disease duration, more functional disability (C-HAQ) and higher disease activity (cJADAS-10). Depending on JIA category, children and adolescents with JIA were similarly or even more likely to achieve the WHO recommended minimum level of PA compared to general population controls. However, since a large proportion of young JIA patients appear to be insufficiently physically active, engagement in targeted efforts to promote PA is urgently needed.

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