Physical fitness and its relationship to other indices of health status in children with chronic arthritis.
OBJECTIVE
To compare aerobic and anaerobic fitness of a group of children w-th chronic arthritis with that of healthy controls, and to explore the relationship between physical fitness and other indices of health status in these children.


METHODS
Thirty-one children aged 8 to 17 years with chronic arthritis of varying type and severity and 16 physically healthy controls participated in the study. Using a cycle ergometer, aerobic fitness was assessed by measuring peak oxygen uptake achieved in a 15 s period during exercise to volitional fatigue. Anaerobic fitness was assessed by measuring peak power in the legs in a 5 s period and total work completed (Wingate test). Joint pain experienced over the week before testing and during testing was measured using a 10 cm visual analog scale. Self-esteem was measured using the Self Perception Profile for Children Questionnaire.


RESULTS
There were no significant differences between mean peak O2 uptake or mean peak anaerobic power for patients and controls; however, the mean values for both controls and patients were significantly lower than reported values for healthy children. Peak O2 uptake controlled for age, sex, and sum of skinfolds was negatively associated with disease severity, measured by physician global assessment (p = 0.04), but peak power was not. Neither aerobic nor anaerobic fitness were associated with disease activity measured by physician global assessment or active joint count, or with disease duration. There was a tendency for children with active arthritis to experience less pain during fitness testing than over the previous week (p = 0.06). Testing did not seem to exacerbate joint symptoms. Self-ratings of athletic competence were significantly correlated with peak O2 uptake achieved for children with arthritis (r = 0.43, p = 0.02), but not for controls. Global self-esteem was moderately correlated with self-rated athletic competence in controls (r = 0.49, p = 0.09), but was not in children with arthritis.


CONCLUSIONS
In this sample of children, most of whom had limited joint involvement, we failed to demonstrate significant group differences in fitness between patients and controls. Disease severity may be related to fitness levels, but psychosocial factors may perhaps be more important determinants of fitness. Children with arthritis seem to have realistic perceptions of their own physical capabilities, and even those children who are less fit and perceive themselves as having less athletic competence do not appear to have lowered self-esteem.
Malleson
P N
PN
Department of Pediatrics, School of Human Kinetics, University of British Columbia, Vancouver, Canada.
Bennett
S M
SM
MacKinnon
M
M
Jespersen
D K
DK
Coutts
K D
KD
Turner
S P
SP
McKenzie
D C
DC
D000293:Adolescent; D001171:Arthritis, Juvenile / Q000503:physiopathology*; D015535:Arthritis, Psoriatic / Q000503:physiopathology*; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010809:Physical Fitness; D012649:Self Concept; D013167:Spondylitis, Ankylosing / Q000503:physiopathology*