Background
Methods
Recruitment
Measurement
Exercise intervention
Monitoring / adherence
Safety and feasibility
Sample size
Statistical analysis
Results
Variable | All participants (n = 13) | Girls (n = 7) | Boys (11 = 6) |
---|---|---|---|
Age (years) | 13.0(2.0) | 13.5 (2.3) | 12.4(1.6) |
Ethnicity (tt Asian/Caucasian/ Other) | 3/8/2 | 1/5/1 | 2/3/ 1 |
Tanner stage (# 1/2/3/4/5) | 3/3/4/2/1 | 1 /2/3/1/0 | 2/ 1/1/ 1/1 |
Maturity offset (years) | 0.07(1.8) | 1.0 (1.9) | −1.0 (1.0) |
Height (cm) | 149.7(8.3) | 150.0(9.6) | 149.4 (7.4) |
Height z-score | −0.61 (0.83) | −0.80(0.%) | −0.39 (0.66) |
Weight (kg) | 42.6(7.0) | 41.1 (43.9) | 41.1 (5.0) |
Weight z-score | −0.39 (1.26) | −0.48(1.21) | − 0.28 (1.42) |
BMI (kg/m2) | 18.8(2.6) | 19.4 (2.2) | 18.5(3.1) |
BMI z-score | −0.07 (1.26) | 0.02(0.87) | −0.19 (1.69) |
Clinical outcomes | |||
Time since diagnosis (months) | 57 (47) | 78 (23) | 34 (49) |
JIA subtvpes - polyarticular course | 4 (2 poly RF negative, 2 oligo extended) | 3 (2 poly RF negative, 1 oligo extended) | 1 (oligo extended) |
JIA subtypes - oligoarticular course | 9 (2 oligo persistent. 3 ERA. 2 psoriatic, 2 undi fterentiated) | 4 (2 psoriatic, 1 oligo persistent, 1 undifferentiated) | 5 (3 ERA, 1 oligo persistent, 1 undifferentiated) |
Medications (n) | 7 NSAIDS,9 DMARDs, 4 Biologies | 5 NSAIDS, 6 DMARDs, 3 biologies | 2 NSAIDS, 3 DMARDs, 1 biologic |
Fracture history | 4 | 1 distal radius, 1 nasal | 1 distal radius, 1 distal tibia |
Dietary calcium intake (mg) | 740 (410) | 468 (196) | 1058 (364) |
Clinical measure | Baseline | 3-months | 6-months | 12-months | p-value |
---|---|---|---|---|---|
Median active joint counta | 0 (0, 0) range 0–1 | 0 (0,0.5) range 0–7 | 0 (0, 0) range 0–1 | 0 (0,0) range 0–2 | |
Median restricted joint count | 0 (0, 0) range 0–3 | 0 (0,0) range 0–13 | 0 (0, 0) range 0–3 | 0 (0,0) range 0–1 | |
Median active enlhesitis count | 1.0 (1.5) | 0 (0.0) range 0–3 | 0 (0.0) range 0–0 | 0 (0.0.5) range 0–4 | |
Functional ability (CHAQ, range 0–3) | 0.20 (0.42) | 0.38 (0.54) | 0.46 (0.53) | 0.33 (0.48) | 0.216 |
Pain (VAS, range 0–100) | 26.0 (26.6) | 15.5 (20.8) | 25.4 (20.4) | 18.0(22.5) | 0.334 |
JAQQ score (range 1–7) | 2.6 (1.0) | 2.3 (1.2) | 2.3 (1.0) | 2.4 (1.2) | 0.384 |
PA Score (range 1–5) | 2.3 (0.6) | 2.6 (0.72) | 2.2 (0.5) | 2.3 (0.9) | 0.469 |
Fatigue (PedsQL. range 0–100) | 57.0 (18.2) | 66.0 (18.0) | 69.9 (18.9) | 67.3 (17.2) | 0.034b |
Physical self-worth (CYPSPP. range 0–4) | 3.3 (0.6) | 3.2 (.6) | 3.3 (0.7) | 3.4 (0.6) | 0.966 |
Adherence
Pain, injury and flare
Clinical outcomes
Bone outcomes
Variable | Baseline | 6-months | 12-months | Baseline – 6-months changed | Baseline – 12-months changed |
---|---|---|---|---|---|
LS BMC (g) | 32.6 (8.4) | 35.0 (8.3) | 37.0 (9.1) | 0.3 (− 0.9, 1.6) | 1.2 (− 0.5, 2.8) |
LS BMC z-score | −0.09 (0.64) | − 0.14 (0.65) | − 0.14 (0.65) | − 0.04 (− 0.24, 0.16) | −0.02 (− 0.28, 0.23) |
Distal tibia Tt.BMD (mg/cm3) | 223.1 (34.1) | 223.8 (28.7) | 234.9 (29.5) | 2.7 (−5.0, 10.5) | 15.0 (5.0, 25.0)a |
z-score | − 0.98 (1.73) | − 1.10 (1.47) | − 0.86 (1.60) | − 0.15 (− 0.44, 0.13) | 0.06 (− 0.30, 0.43) |
# with z-score < − 2 | 3 | 2 | 3 | ||
Distal tibia BV/TV | 0.141 (0.026) | 0.141 (0.022) | 0.144 (0.026) | −0.001 (− 0.006, 0.004) | 0.001 (− 0.005, 0.007) |
z-score | − 0.74 (1.48) | − 0.79 (1.30) | − 0.69 (1.46) | − 0.08 (− 0.31, 0.15) | 0.01 (− 0.29, 0.30) |
# with z-score < − 2 | 4 | 3 | 3 | ||
Distal tibia Ct.Th (mm) | 0.69 (0.15) | 0.69 (0.17) | 0.77 (0.14) | −0.002 (− 0.054, 0.050) | 0.075 (0.009, 0.142)b |
z-score | −1.35 (1.62) | − 1.65 (1.59) | − 1.08 (1.62) | − 0.62 (− 1.14, − 0.10)d | −0.23 (− 0.91, 0.44) |
# with z-score < − 2 | 4 | 4 | 2 | ||
Distal tibia F.Load (N) | 3628 (845) | 3825 (771) | 4121 (878) | 4.8 (− 204.9, 214.6) | 190.2 (−81.1, 461.5) |
z-score | −1.57 (1.58) | − 1.58 (1.14) | − 1.33 (1.39) | −0.08 (− 0.40, 0.25) | 0.13 (− 0.29, 0.55) |
# with z-score < − 2 | 4 | 4 | 4 | ||
Distal radius Tt.BMD (mg/cm3)c | 251.3 (37.7) | 245.5 (29.4) | 242.3 (33.8) | −0.5 (− 14.2, 13.1) | 1.5 (− 16.6, 19.6) |
z-score | 0.07 (0.83) | −0.26 (0.99) | − 0.47 (0.90) | − 0.42 (− 0.80, − 0.03)d | −0.60 (− 1.11, − 0.09)b |
# with z-score < − 2 | 0 | 0 | 0 | ||
Distal radius BV/TVc | 0.136 (0.022) | 0.139 (0.023) | 0.135 (0.027) | 0.002 (−0.004, 0.007) | − 0.004 (− 0.011, 0.004) |
z-score | −0.50 (0.97) | − 0.42 (1.01) | −0.67 (1.32) | 0.01 (− 0.27, 0.30) | −0.27 (− 0.64, 0.10) |
# with z-score < − 2 | 1 | 1 | 1 | ||
Distal radius Ct.Th (mm)c | 0.62 (0.15) | 0.60 (0.13) | 0.60 (0.16) | 0.03 (−0.03, 0.10) | 0.08 (− 0.01, 0.16) |
z-score | −0.21 (1.01) | − 0.61 (0.98) | −0.77 (0.83) | − 0.36 (− 0.97, 0.24) | −0.39 (− 1.18, 0.40) |
# with z-score < − 2 | 0 | 1 | 0 | ||
Distal radius F.Load (N)c | 1217 (392) | 1297 (393) | 1301 (375) | 27.6 (−43.7, 99.0) | − 10.2 (− 105.3, 84.8) |
z-score | −0.93 (1.47) | − 1.02 (1.32) | −1.25 (1.37) | − 0.22 (− 0.55, 0.12) | −0.38 (− 0.83, 0.06) |
# with z-score < − 2 | 3 | 2 | 3 |
Muscle outcomes
Variable | Baseline | 3-months | 6-months | 12-months | Baseline-3 monthsc | Baseline-6 monthsc | Baseline-12 monthsc |
---|---|---|---|---|---|---|---|
Grip strength, left (kg) | 19.5 (6.3) | 19.6 (6.1) | 19.8 (6.8) | 21.6 (6.1) | −0.8 (−2.2, 0.6) | −1.5 (−3.2, 0.2) | −0.7 (2.9, 1.5) |
Grip strength, right (kg) | 20.9 (6.0) | 22.3 (7.5) | 22.0 (6.6) | 23.7 (.1) | 0.6 (−0.6, 1.9) | −0.4 (−1.9, 1.0) | 0.5 (−1.4, 2.4) |
Peak power (W/kg) | 37.8 (5.5) | 39.3 (7.3) | 38.2 (5.5) | 39.3 (5.9) | 0.8 (−1.1, 2.7) | −0.9 (−3.3, 1.4) | − 0.7 (− 3.6, 2.3) |
Peak power z-score | − 0.79 (0.95) | −0.58 (0.98) | − 0.84 (0.94) | −0.70 (0.91) | 0.13 (− 0.21, 0.47) | −0.20 (− 0.61, 0.21) | −0.15 (− 0.67, 0.37) |
Peak force, right leg (Fmax/BW) | 2.84 (0.40) | 2.82 (0.39) | 2.80 (0.33) | 2.90 (0.33) | −0.00 (− 0.01, 0.01) | −0.01 (− 0.02, 0.00) | 0.21 (0.19, 0.22)a |
Peak force, right leg z-score | −0.82 (1.18) | − 0.52 (1.30) | −0.95 (1.16) | − 0.63 (1.07) | 0.31 (− 0.14, 0.75) | −0.12 (− 0.66, 0.41) | 0.21 (− 0.48, 0.89) |
Peak force, left leg | 2.75 (0.42) | 2.94 (0.41) | 2.74 (0.31) | 2.80 (0.36) | −0.01 (− 0.02, 0.00) | −0.02 (− 0.03, − 0.003)b | 0.19 (0.17, 0.21)a |
Peak force, left leg z-score | − 1.15 (1.36) | −0.88 (1.25) | −1.16 (1.06) | − 1.02 (1.28) | 0.15 (− 0.29, 0.59) | −0.23 (− 0.78, 0.30) | −0.23 (− 0.91, 0.45) |
KE Peak torque (N-m) | |||||||
60 °·s 1 | 182.0 (29.4) | 192.5 (38.9) | 203.4 (53.1) | 219.7 (65.5) | −3.4 (−21.9, 15.0) | −8.6 (− 31.3, 14.0) | − 5.8 (− 33.9, 22.3) |
180 °·s 1 | 145.1 (27.3) | 160.9 (29.5) | 167.7 (34.7) | 181.3 (49.5) | 7.3 (− 4.5, 19.0) | 4.5 (−9.9, 19.0) | 9.6 (−8.4, 27.6) |
KE Average power (W) | |||||||
60 °·s 1 | 44.1 (11.2) | 50.3 (15.2) | 53.1 (17.4) | 56.3 (22.7) | 0.1 (−6.5, 6.7) | −3.5 (−11.6, 4.6) | − 6.7 (− 16.8, 3.3) |
180 °·s 1 | 91.5 (24.6) | 105.6 (25.7) | 107.4 (27.1) | 112.0 (31.6) | 7.0 (−2.4, 16.4) | 2.1 (−9.4, 13.6) | −1.4 (− 15.7, 12.9) |
KE Total joint work (J) | |||||||
60 °·s 1 | 303.5 (91.8) | 318.0 (76.6) | 322.5 (89.1) | 360.7 (107.3) | −4.8 (−38.6, 29.0) | − 18.8 (− 60.3, 22.6) | −2.9 (− 54.3, 48.4) |
180 °·s 1 | 571.5 (162.1) | 635.8 (154.1) | 639.9 (156.7) | 667.8 (170.2) | 31.0 (−26.4, 88.5) | 4.2 (−66.2, 74.7) | −7.3 (− 94.8, 80.1) |