TY - JOUR T1 - Exercise as Medicine for Children with Arthritis JF - The Journal of Rheumatology JO - J Rheumatol SP - 1103 LP - 1105 DO - 10.3899/jrheum.170461 VL - 44 IS - 8 AU - BRIAN M. FELDMAN Y1 - 2017/08/01 UR - http://www.jrheum.org/content/44/8/1103.abstract N2 - Childhood arthritis, including juvenile idiopathic arthritis (JIA)1, is a group of diseases whose face has changed over the last 3 decades. Phenomenal new treatment approaches, available widely in developed and some developing nations2,3, have turned once crippling disorders into conditions for which new challenges have emerged.While the severe, deforming, and crippling effects of arthritis are to a large degree a thing of the past (at least in resource-rich nations), children with arthritis still face a number of challenges. Most children with JIA have ongoing pain4,5, and many do not have the same level of social and role participation as their healthy peers.Traditional approaches to therapy for children who have arthritis centered around strengthening and range of motion exercises targeted toward specific joints. For example, many of my arthritis patients, well into the 1990s, were admitted to a rehabilitation center for splinting, pool therapy, and individual joint exercises.With the onset of more powerful biologic and nonbiologic disease-modifying treatments, this is now rarely necessary.In more recent years the approach of many, including our team, is to shift the focus of therapy toward fitness exercise — an “exercise as medicine” approach. This is predicated on the knowledge that children with arthritis are less active than their peers and are in poorer physical condition6. By reversing poor physical fitness, it is possible that … Address correspondence to Dr. B.M. Feldman, 555 University Ave., Toronto, Ontario M5G 1X8, Canada. E-mail: brian.feldman{at}sickkids.ca ER -