Introduction
JIA, muscle atrophy, fatigue, swelling, upper limb muscle strength, pain, weakness, non-traumatic
DISEASE PROGRESSION, MUSCLE ATROPHY, DISEASE, JUVENILE IDIOPATHIC ARTHRITIS, COMPLICATIONS
Juvenile idiopathic arthritis (JIA) is the most common cause of rheumatism in children in developed countries. Its prevalence ranges from 3.8 to 400/100,000 in Europe, and JIA affects about 4,000 patients in France (The symptoms of JIA are mainly swelling, stiffness and pain in the affected joints, as well as fatigue. The subsequent weakness and muscle atrophy result in reduced joint mobility, preventing some activities of daily life (To anticipate the possible complications related to disease progression, it is widely recommended to practice physical activity during childhood (6-12 years) and adolescence (13-17 years), preferably non-traumatic activity (e.g. swimming, walking, cycling …). Engaging in physical activity during these periods also helps to prevent and limit direct symptoms. However, there are no specific recommendations for physical activity in children with JIA. The following recommendations on physical activities issued by the World Health Organization (WHO) in 2010 are frequently used: “Children and youth aged 5–17 should accumulate at least 60 min of moderate- to vigorous-intensity physical activity daily. Amounts of physical activity greater than 60 min provide additional health benefits. Most of the daily physical activity should be aerobic. Vigorous-intensity activities should be incorporated, including those that strengthen muscle and bone, at least three times per week” (Children with JIA present reduced functional capacities, practice less physical activity and sleep more than average children, regardless of disease level (The progressive decrease in the level of physical activity observed over time in patients with JIA could be associated with disease activity of JIA (in an inverse correlation), and with higher psychosocial stress related to the disease (Many physical exercise programs have been evaluated in children with JIA, including mainly aquatic exercises, muscle strengthening, proprioception, endurance, and Pilates (Recently, a study among 23 children with JIA showed a direct correlation between hand grip strength and both quality of life (with an inverse correlation with disease activity), and functional capacity, with upper limb muscle strength measured by dynamometry (To optimize prescriptions and recommendations for physical exercise for patients with JIA, additional studies are needed to define the nature of the physical activity that confers health benefits without exacerbating underlying inflammatory stress associated with the disease. Therefore, we propose to conduct the pilot “ATHLETIQUE” study, which aims to evaluate the impact of a program combining adapted physical activity (APA) sessions with the use of a pedometer watch, on disease activity in children with JIA, and to assess the effectiveness and safety of this intervention.The study is expected to yield improvements in disease activity, physical fitness and weight control, an overall improvement in quality of life, and increased muscle strength, decreased pain, and increased functional capacities.