title: Can exercise influence low bone mineral density in children with juvenile rheumatoid arthritis?
abstract: OBJECTIVE
  Low bone mineral density (BMD) is a common secondary condition associated with juvenile idiopathic arthritis (JIA). The purpose of this review was evaluate the literature pertinent to designing an effective, safe weight-bearing exercise program to reduce the risk of low BMD in children with JIA.
  
  
  CONCLUSIONS
  Thirty-seven articles on the risk of low BMD and children with JIA, weight-bearing interventions to improve BMD in healthy children, or safety and efficacy of exercise interventions with children with JIA were critiqued on the basis of their design. Three highly rated studies confirmed the multifactorial nature of low BMD in children with JIA, two highly rated studies support the efficacy of weight-bearing interventions for increasing BMD in children who are healthy, and one moderately rated study demonstrated the safety of low impact exercise by children with JIA.
  Weight-bearing activities should be included in exercise programs for individuals with JIA, although more research is needed to determine the amount, duration, and frequency of weight-bearing activity needed to reduce the risk for low BMD.
authors.affiliation: University of Hartford, Hartford, Connecticut 06117, USA. gannotti@hartford.edu
authors.forename: Mary E
authors.initials: ME
authors.lastname: Gannotti
authors.forename: Maureen
authors.initials: M
authors.lastname: Nahorniak
authors.forename: George E
authors.initials: GE
authors.lastname: Gorton
authors.forename: Krystal
authors.initials: K
authors.lastname: Sciascia
authors.forename: Megan
authors.initials: M
authors.lastname: Sueltenfuss
authors.forename: Michelle
authors.initials: M
authors.lastname: Synder
authors.forename: Anna
authors.initials: A
authors.lastname: Zaniewski
mesh_terms: D001171:Arthritis, Juvenile / Q000503:physiopathology*; D015519:Bone Density; D002648:Child; D002657:Child Development; D015444:Exercise; D006801:Humans; D026741:Physical Therapy Modalities