Lower extremity isometric joint torque in children with juvenile chronic arthritis.

OBJECTIVE: To determine the intratester reliability of joint torque testing with a hand-held dynamometer (HHD) during contractions of four major lower extremity muscles in children with juvenile chronic arthritis (JCA) and to compare results for children with JCA to results for children without disability. METHODS: Eleven children with JCA and 14 children with normal musculoskeletal function were tested with a HHD using isometric muscle contractions of the right quadriceps, hamstrings, tibialis anterior and triceps surae. RESULTS: Intratester reliability values exceeded the 0.92 level, regardless of the number of trials, for all motions tested. Statistically lower joint torque values were found in a subgroup of children with JCA for contractions of the tibialis anterior (p=0.003) and triceps surae (p=0.05) muscles. CONCLUSIONS: HHD offers a reliable means of testing the joint torque generated with contraction of these lower extremity muscles in children with JCA. Findings in children with JCA compared to children without disability agree with previous reports concerning quadriceps muscle function, but also point to concerns for muscles associated with generating ankle joint torque.

Perceived ability to manage juvenile chronic arthritis among adolescents and parents: development of a questionnaire to assess medical issues, exercise, pain, and social support.

OBJECTIVE: To develop a questionnaire to assess perceived ability to manage juvenile chronic arthritis (JCA) among adolescents and parents. METHODS: The questionnaire contained 24 (parents' version) and 23 (adolescents' version) questions accompanied by visual analog scales in the areas of knowledge, skill, behavior, attitudes, and self-efficacy. One hundred seven persons participated in the examination of validity and 25 in the examination of test-retest reliability. RESULTS: Factor analyses indicated that the questionnaire, now termed the MEPS (abbreviation for "medical issues, exercise, pain, and social support") questionnaire, contained 4 underlying dimensions: medical issues, exercise, pain, and social support, including 9, 4, 7, and 4 questions, respectively. The content of the questionnaire was judged mainly to be easily understood, relevant, and exhaustive. Intraclass correlation coefficients for the test-retest reliability of the questionnaire answers over a week ranged from 0.68 to 0.96 for single questions. CONCLUSION: The MEPS questionnaire appears to be a valid and reliable tool for assessing the perceived ability to manage JCA. Whether it is sufficiently responsive to interventions remains to be investigated.