Advances in the treatment of juvenile idiopathic arthritis (JIA) have led to improved patient outcomes1. Canadian researchers have demonstrated that patients with JIA (except rheumatoid factor-positive polyarticular JIA) have a 70–90% chance of attaining inactive disease by 2 years postdiagnosis2. Inactive disease was defined using modified Wallace criteria3. They also determined that all but those with polyarthritis have ∼50% probability of remission within 5 years of diagnosis. Patients had to demonstrate inactive disease after stopping medication for at least 12 months to be considered in remission2.
While achieving such remission is a critical goal, how well does this translate into “good health” overall? The World Health Organization defines “health” as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity4. So, are children with JIA healthy?
Research suggests that those affected by JIA are less active and more easily fatigued than many of their peers. They have lower aerobic and anaerobic capacity5. Muscle weakness and anemia contribute to reduced fitness, but deconditioning from inadequate physical activity probably plays a greater role. Decreased bone mineral composition is also prevalent, which may relate to disease severity, corticosteroid use, physical inactivity, and poor calcium intake6. Patients with JIA participate less in physical education and sports because of disease symptom severity, side effects of treatment, or fears that exercise may worsen their disease7. Many with lower extremity arthritis also have impaired balance, which may affect their ability to play sports8. Delayed motor development can also affect sport readiness, as has been demonstrated in preschoolers with JIA9. …
Address correspondence to Dr. LeBlanc. E-mail: Claire.Leblanc{at}MUHC.MCGILL.CA