Strong relationships between disease activity, foot-related impairments, activity limitations and participation restrictions in children with juvenile idiopathic arthritis.
OBJECTIVE
To assess possible relationships between disease activity, foot-related impairments, activity limitations and participation restrictions in children with juvenile idiopathic arthritis (JIA).


METHODS
Thirty-four children were studied. Disease activity was assessed with the Juvenile Arthritis Disease Activity Score in 71 joints (JADAS-71). Foot-related impairments, activity limitations and participation restrictions were measured with the Juvenile Arthritis Foot Disability Index (JAFI), the Childhood Health Assessment Questionnaire (CHAQ), self-reported or parent-reported and doctor-reported VAS scales. Relationships were quantified with Spearman's correlation coefficient.


RESULTS
The mean age was 12.4±3.7 years, the median disease duration 1.5 years (interquartile range (IQR) 1.0-4.0), 88% were girls, and 76% had polyarticular disease course. The median JADAS-71 score (range 0-101) was 6 (IQR 1-13). On the JAFI sub-scores (range 0-4) 88% of the children reported some foot-related impairments (median 1.1, IQR 0.4-2.0); 82% reported some foot-related activity limitations (median 0.9, IQR 0.3-2.0), and 65% reported some foot-related participation restrictions (median 0.6, IQR 0-2.1). The median CHAQ score was 0.9 (IQR 0.1-1.8). The JADAS-71 correlated with all impairment, activity limitation and participation restriction variables (r=0.48-0.81, p<0.01). Most of the impairment variables correlated with activity limitation (r=0.39, p<0.05 to r=0.92, p<0.01) and participation restriction variables (r=0.44, p<0.05 to r=0.81, p<0.01). All activity limitation variables correlated with participation restriction variables (r=0.62-0.84, p<0.01).


CONCLUSIONS
We observed strong relationships between disease activity, foot-related impairments, activity limitations and participation restrictions in children with JIA, and therefore suggest that standard screening for foot problems should be included in follow-up care for JIA patients.
Department of Rehabilitation Medicine, Centre for Rehabilitation and Rheumatology, Amsterdam, The Netherlands.
M
M
Dekker
A F
AF
Hoeksma
J H M
JH
Dekker
M A J
MA
van Rossum
K M
KM
Dolman
H
H
Beckerman
L D
LD
Roorda
D000203:Activities of Daily Living; D000293:Adolescent; D001171:Arthritis, Juvenile / Q000503:physiopathology*; D002648:Child; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D033023:Foot Joints / Q000503:physiopathology*; D006306:Health Surveys; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D012720:Severity of Illness Index