Exercise in pediatric rheumatic diseases

Abstract

The present review discusses the current knowledge about exercise capacity and physical activity in children with rheumatic disease and examines the role of exercise in managing these conditions. Recent studies suggest exercise capacity is significantly impaired in a large proportion of children with juvenile idiopathic arthritis and other rheumatic diseases. These deficits are not limited to children with active inflammation. Children, especially girls, with rheumatoid factor positive polyarticular juvenile idiopathic arthritis, have the greatest deficits. Poor fitness and low levels of weight-bearing physical activity contribute to low bone mass and strength. Children and adolescents with juvenile dermatomyositis and systemic lupus erythematosus also exhibit impaired exercise capacity. There is some evidence that structured aerobic and neuromuscular training may improve exercise capacity, functional performance, and quality of life in children and adolescents with rheumatic disease. A sedentary lifestyle contributes to secondary impairments in aerobic and muscular fitness, bone health, and functional limitations in children and adolescents with rheumatic disease despite advances in the pharmacological management of these inflammatory conditions. Increased levels of moderate to vigorous physical activity and structured exercise may improve exercise capacity, performance of daily activities, and overall quality of life.