Description of physical activity in children with juvenile idiopathic arthritis using accelerometry.

OBJECTIVES: Juvenile idiopathic arthritis (JIA) can lead to functional impotence and reduced physical activity (PA) in patients. The objective of this study was to monitor the daily PA of children aged 6-18 years with JIA using accelerometry based on disease activity and individual abilities, and to compare this with age recommendations. METHODS: Patients volunteering for the study wore an accelerometer for 7 consecutive days; data were evaluated using a wGT3X ActiGraph™. The 2010 World Health Organization (WHO) recommendations were used for comparison. RESULTS: We collected accelerometry data for 24 patients of the University Hospital Center (UHC) of Besançon. Only two patients did not reach the recommendations of moderate-to-vigorous PA (MVPA). Time spent in MVPA was negatively correlated with age, BMI, number of joints with active arthritis, JADAS score, and visual analogue pain assessment (VAPA). Patients with active disease, those with upper extremity pain, and female patients had significantly lower PA scores. CONCLUSIONS: Almost all of the patients of the UHC of Besançon who accepted the study reached the WHO recommendations. Having an active disease, having painful upper limbs, or being a girl is associated with decreased PA.

Long-term outcome in patients with juvenile dermatomyositis: A case series.

BACKGROUND: Follow-up of juvenile dermatomyositis (JDM) patients has demonstrated the impact of the disease on several organs in the long term. OBJECTIVE: As there is little information on the long-term outcome of JDM, we aimed to assess long-term outcomes in a series of JDM patients. METHODS: After selection of JDM patients, a consultation with a dermatologist and a rheumatologist was held for each patient. Cutaneous, muscle, and disease damage was assessed using different validated scores including the abbreviated Cutaneous Assessment Tool (aCAT), 8-muscle Manual Muscle Testing (MMT8), Childhood Myositis Assessment Scale (CMAS), Myositis Damage Index (MDI), Childhood Health Assessment Questionnaire (CHAQ), and Health Assessment Questionnaire (HAQ). Long-term disease outcomes were recorded including growth and pubertal development, educational and vocational achievement, and development of comorbidities. RESULTS: Seven patients were included in the study. After a mean follow-up of 14.9±8.8 years, the mean aCAT score was 0.57±1.4 and only one patient had a positive aCAT activity score. The mean aCAT damage score was 1.4±1.3 and five (71%) patients had a score of ≥1. Five (71.4%) patients had normal muscle strength with an MMT8 score of >72, and none had severe muscle weakness (MMT8 ≤32, and CMAS<35). The mean total extent of damage according to the MDI was ≥1 in five (71%) patients and mainly involved the skin. Two (29%) patients had mild disability according to the CHAQ/HAQ disability index. In terms of quality of life, no patient had a score of<40 (1 SD below the mean for healthy controls). CONCLUSIONS: Based on validated cutaneous and musculoskeletal scores, our study demonstrated the good functional outcomes of JDM at long-term follow-up.