Review Article

Juvenile Rheumatoid Arthritis: Physical Therapy and Rehabilitation

Authors: Aysegul Cakmak, MD, Nalan Bolukbas, MD

Abstract

Juvenile arthritis is one of the most prevalent chronic diseases in the childhood period (ages 0 to 16 years). This disease was first defined in the first half of the 16th century. In the course of time, its differential diagnosis and characteristics have been determined, and it has been classified. Incidence and prevalence values are 10 to 20 in 100,000 and 56 to 113 in 100,000, respectively. Various factors are suggested for its underlying cause. Its denomination is also in dispute. Treatment of juvenile arthritis includes education, medical treatment, physical therapy, and occupational therapy. This article summarizes the objectives and methods of physical therapy and rehabilitation that are important parts of treatment.


Key Points


* Juvenile arthritis is one of the most common chronic diseases in the childhood period.


* Juvenile arthritis may lead to functional deficiency in the musculoskeletal system and blindness.


* Juvenile rheumatoid arthritis is arbitrarily defined as arthritis beginning before the age of 16 years; nevertheless, onset before 6 months of age has been considered rare.


* Treatment of juvenile arthritis includes education, medical treatment, and physical and occupational therapy; a multidisciplinary approach is necessary for successful treatment.


* This report summarizes the methods and objectives of physical therapy, which is one of the essential parts of treatment.

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References

1. Cassidy JT. Juvenile rheumatoid arthritis, in Ruddy S, Harris ED Jr, Sledge CB (eds). Kelley’s Textbook of Rheumatology. Philadelphia, WB Saunders Co, 6th ed, 2001, 1297–1313.
 
2. White PH. Juvenile Chronic Arthritis; Clinical Features, in Klippel JH, Dieppe PA (eds).Rheumatology. London, Mosby, 2nd ed, 1998, pp 5.18.1–5.18.10.
 
3. Sawhney S, Woo P. Diagnosis and management of juvenile idiopathic arthritis: current statistics.Indian Pediatr 2001;38:1083–1090.
 
4. Hafner R, Truckenbrodt H, Spamer M, et al. Rehabilitation in children with juvenile chronic arthritis.Baillieres Clin Rheumatol 1998;12:329–361.
 
5. Prieur AMF. Juvenile chronic arthritis: management, in Klippel JH, Dieppe PA (eds). Rheumatology.London, Mosby, 2nd ed, 1998, pp 5.21.1–5.21.10.
 
6. Emery HM, Bowyer SL, Sisung CE. Rehabilitation of the child with a rheumatic disease, Pediatr Clin North Am 1995;42:1263–1283.
 
7. Malleson PN. Management of childhood arthritis, II: chronic arthritis. Arch Dis Child 1997;76:541–544.
 
8. Emery HM, Bowyer SL. Physical modalities of therapy in pediatric rheumatic diseases. Rheum Dis Clin North Am 1991;17:1001–1014.
 
9. Dincer F, Celiker R, Basgoze O, Ozker R. The results of early rehabilitation in juvenile chronic arthritis. Ital J Rheum Reumatismo 1991;43:1–13.
 
10. Scull SA. Juvenile rheumatoid arthritis, in Tecklin JS (ed). Pediatric Physical Therapy. Philadelphia, JB Lippincott Co, 2nd ed, 1994, pp 337–362.
 
11. Barnes LW. Physical therapy management of juvenile arthritis, in Banwell F, Gall V (eds). Physical Therapy Management of Arthritis. New York, Churchill Livingstone, 1988, pp 159–194.
 
12. Klepper SE. Effects of an eight-week physical conditioning program on disease signs and symptoms in children with chronic arthritis. Arthritis Care Res 1999;12:52–60.
 
13. Cetin A, Celiker R, Dincer F, et al. Bone mineral density in children with juvenile chronic arthritis.Clin Rheumatol 1998;17:551–553.
 
14. Celiker R, Bal S, Bakkaloglu A, et al. Factors playing a role in the development of decreased bone mineral density in juvenile chronic arthritis. Rheumatol Int 2003;23:127–129.
 
15. Irdesel J. Juvenil kronik artrit’te fizik tedavi ve rehabilitasyon, XVIII: Ulusal Fiziksel Tip ve Rehabilitasyon Kongresi Ozet Kitapcigi. Kemer-Antalya, Turkey, 2001, pp 99–103.
 
16. André M, Hagelberg S, Stenström CH. Education in the management of juvenile chronic arthritis: changes in self-reported competencies among adolescents and parents of young children. Scand J Rheumatol 2001;30:323–327.
 
17. Schaller JG. Chronic arthritis in children: juvenile rheumatoid arthritis. Clin Orthop Rel Res1984;182:79–89.
 
18. Field T, Morrow C, Valdeon C, et al. Massage reduces anxiety in child and adolescent psychiatric patients. J Am Acad Child Adolesc Psychiatry 1992;31:124–131.
 
19. Field T, Hernandez-Reif M, Seligman S, et al. Juvenile rheumatoid arthritis: benefits from massage therapy. J Pediatr Psychol 1997;22:607–617.
 
20. Bacon MC, Nicholson C, Binder H, et al. Juvenile rheumatoid arthritis: aquatic exercise and lower-extremity function. Arthritis Care Res 1991;4:102–105.
 
21. Work Group Recommendations: 2002 Exercise and Physical Activity Conference, St Louis, Missouri. Arthritis Rheumatol (Arthritis Care Res) 2003;49:453–454.
 
22. Silver R, Lawton S, Ansell BM. A comparison of Vitrathene moulded with Tweeklon ready-made wrist work splints in juvenile chronic arthritis. Int Rehabil Med 1982;4:97–100.
 
23. Orlin MN, McPoil TG. Plantar pressure assessment. Phys Ther 2000;80:399–409.
 
24. Ward DJ, Tidswell ME. Rheumatoid arthritis and juvenile chronic arthritis, in Downie PA (ed). Cash’s Textbook of Orthopaedics and Rheumatology for Physiotherapists. New Delhi, Jaypee Brothers, 1985, pp 304–347.
 
25. Hannah RE, Cottrill SD. The Canadian collar: a new cervical spine orthosis. Am J Occup Ther1985;39:171–177.
 
26. Scull SA. Juvenile rheumatoid arthritis, in Campbell SK (ed). Physical Therapy for Children.Philadelphia, WB Saunders Co, 1994, pp 207–225.