title: Juvenile idiopathic arthritis and athletic participation: are we adequately preparing for sports integration?
abstract: Children with juvenile idiopathic arthritis (JIA) now have well-controlled disease due to improved therapies and management strategies. Children with JIA are more active than in the past and often participate in dynamic, high-loading sports. Standard measures of disease control include examination findings, laboratory values, and patient-directed surveys. However, these standards do not address the subtle deficits in biomechanics and neuromuscular control, which could place affected joints at higher risk for injury. Currently, there are limited evidence-based guidelines to structure conditioning recommendations as to the fitness and mechanics needed to provide safe integration into sports in this population; therefore, tools that objectively measure function with high accuracy and precision may be warranted. Previous work using 3-dimensional motion analysis demonstrated usefulness in guiding physical therapy treatment to correct these deficits. The use of a multidisciplinary team, including physical therapy, rheumatology, and sports medicine, is crucial for preparing these children to return to play. We suggest that the child transition into a sport preparatory-conditioning program to address any underlying deficits. A pediatric exercise specialist who is sensitive to the needs of this population can work with a physical therapist to then appropriately integrate the child safely into sport. Encouraging an active lifestyle is vital to the management of JIA and does not worsen the symptoms associated with childhood arthritis.
authors.affiliation: Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of Pediatric Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Alysha
authors.initials: A
authors.lastname: Taxter
authors.forename: Kim Barber
authors.initials: KB
authors.lastname: Foss
authors.forename: Paula
authors.initials: P
authors.lastname: Melson
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Ford
authors.forename: Michael
authors.initials: M
authors.lastname: Shaffer
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Myer
mesh_terms: D001171:Arthritis, Juvenile / Q000534:rehabilitation*; D002648:Child; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000534:rehabilitation*; D019468:Disease Management; D006801:Humans; D026741:Physical Therapy Modalities; D012219:Rheumatology / Q000379:methods*; D013177:Sports; D013178:Sports Medicine / Q000379:methods*