Grant: Travel Awards - Institute Community Support

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children, affecting 1 in 1000 children each year. Not only do children with JIA experience joint swelling, but also chronic pain, decreased muscular fitness and decreased function. In healthy and clinical populations strength training demonstrates a decrease pain perception and increase muscular fitness and function; however a paucity of research using strength training in JIA exists. This pilot study aimed to understand the effects of a 6 week, 3 times a week, home-based strength training program in children with JIA. The primary outcome was a comprehensive measure of pain reported on a tablet application (before exercise, after exercise and end of each day). Secondary outcomes included inflammation, muscle strength, muscle thickness and functional ability. Seven participants (14.4 years) completed a total of 12.4 ± 3.8 out of a possible 18 exercise sessions. Significant pain changes did not exist throughout the exercise program (p>0.05). Pain before exercise was significantly correlated to perceived exercise difficulty (p<0.05). Muscle thickness at the leg increased from before to after the 6 weeks (p<0.05). No other significant differences existed (p>0.05). The results of this pilot study suggest pain is extremely variable between individuals, showing a need for a larger study examining the effects of strength training on pain in JIA. As well, this suggests that pain is a barrier to physical activity as it can increase the perceived difficulty of exercise. Strength training is also able to improve muscular fitness. Although initial results are promising, further research is required to attain definitive results on pain, inflammation, muscle strength and function. If strength training is feasible and beneficial in this population, the Canadian Healthcare System would benefit economically by decreasing the need for pain medication, physiotherapists, and occupational therapists.