Safety and feasibility of a six week resistance training program in children with juvenile idiopathic arthritis

Abstract

BACKGROUND Chronic pain is a common condition in children with juvenile idiopathic arthritis (JIA), affecting their ability to participate in physical activity, a necessary and integral part of a child’s growth and maturation. Resistance training specifically displays a paucity of research in children with JIA, and could potentially be a beneficial form of exercise training for this population. The purpose of this study was to determine the safety, feasibility, and effects of a six week resistance training program on pain in children with JIA. METHODS Seven JIA patients (8-18 years) participated in a home-based, three days per week exercise training program. Pain was measured using an electronic pain diary (PinGo©) for Android tablets. Participants answered questions initially a week prior to training, once a day on non-exercise days and three times a day (before exercise, after exercise, and end of day) on exercise days for a total of seven weeks. Secondary outcome measures included muscle size, muscle strength, and functional ability, measured at baseline and following the 6 week exercise program. Statistical analyses included attaining the average number of exercise sessions completed, pain changes over the seven weeks (averaged over the initial week and then biweekly) via repeated measures ANOVA, dependent t tests between before and after exercise pain intensity and affect, and dependent t tests between secondary outcomes. RESULTS Seven participants completed an average of 13.0 ± 3.6 exercise sessions out of a possible 18. The repeated measures ANOVA revealed no significant differences between pain scores over the seven weeks within each individual (p>0.05). When all participants were pooled dependent t tests before and after exercise showed no differences in pain intensity or pain affect (p>0.05). Secondary measures revealed a significant difference between vastus lateralis thickness before compared to after training (p<0.05). CONCLUSIONS The results of this study suggest that a 6 week home-based resistance training program was tolerable in children with JIA and did not cause a clinically significant increase in pain or any other adverse events. The uniqueness of this exercise program was that it was home-based, allowing children to undertake this emerging form of healthcare within their home environment. As well, the training program was able to significantly improve aspects of fitness in this population. Further research of resistance training in children with JIA is necessary to attain definitive results of its effects and optimal levels of resistance exercise in this population.