title: Ottawa Panel Evidence-Based Clinical Practice Guidelines for Structured Physical Activity in the Management of Juvenile Idiopathic Arthritis.
abstract: To create guidelines focused on the use of structured physical activity (PA) in the management of juvenile idiopathic arthritis (JIA).
  
  
  
  A systematic literature search was conducted using the electronic databases Cochrane Central Register of Controlled Trials, MEDLINE (Ovid), EMBASE (Ovid), and Physiotherapy Evidence Database for all studies related to PA programs for JIA from January 1966 until December 2014, and was updated in May 2015.
  
  
  
  Study selection was completed independently by 2 reviewers. Studies were included if they involved individuals aged ≤21 years diagnosed with JIA who were taking part in therapeutic exercise or other PA interventions for which effects of various disease-related outcomes were compared with a control group (eg, no PA program or activity of lower intensity).
  
  
  
  Two reviewers independently extracted information on interventions, comparators, outcomes, time period, and study design. The statistical analysis was reported using the Cochrane Collaboration methods. The quality of the included studies was assessed according to the Physiotherapy Evidence Database Scale.
  
  
  
  Five randomized controlled trials (RCTs) fit the selection criteria; of these, 4 were high-quality RCTs. The following recommendations were developed: (1) Pilates for improving quality of life, pain, functional ability, and range of motion (ROM) (grade A); (2) home exercise program for improving quality of life and functional ability (grade A); (3) aquatic aerobic fitness for decreasing the number of active joints (grade A); and (4) and cardio-karate aerobic exercise for improving ROM and number of active joints (grade C+).
  
  
  
  The Ottawa Panel recommends the following structured exercises and physical activities for the management of JIA: Pilates, cardio-karate, home and aquatic exercises. Pilates showed improvement in a higher number of outcomes.
authors.affiliation: Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: scavallo@uottawa.ca.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Cavallo
authors.affiliation: Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Lucie
authors.initials: L
authors.lastname: Brosseau
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Karine
authors.initials: K
authors.lastname: Toupin-April
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: George A
authors.initials: GA
authors.lastname: Wells
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Smith
authors.affiliation: Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
authors.forename: Arlanna G
authors.initials: AG
authors.lastname: Pugh
authors.affiliation: Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Stinson
authors.affiliation: Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Roanne
authors.initials: R
authors.lastname: Thomas
authors.affiliation: School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
authors.forename: Sara
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
authors.forename: Ciarán M
authors.initials: CM
authors.lastname: Duffy
authors.affiliation: Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Prinon
authors.initials: P
authors.lastname: Rahman
authors.affiliation: Department of Physical Education and Sport, University of Granada, Granada, Spain.
authors.forename: Inmaculada C
authors.initials: IC
authors.lastname: Àlvarez-Gallardo
authors.affiliation: Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Laurianne
authors.initials: L
authors.lastname: Loew
authors.affiliation: Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Gino
authors.initials: G
authors.lastname: De Angelis
authors.affiliation: School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada; School of Public Health, Option Epidemiology, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Debbie Ehrmann
authors.initials: DE
authors.lastname: Feldman
authors.affiliation: School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
authors.forename: Annette
authors.initials: A
authors.lastname: Majnemer
authors.affiliation: School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
authors.forename: Isabelle J
authors.initials: IJ
authors.lastname: Gagnon
authors.affiliation: Department of Rehabilitation, Allied Health Science and Physiotherapy, Université de Laval, Quebec City, Quebec, Canada.
authors.forename: Désirée
authors.initials: D
authors.lastname: Maltais
authors.affiliation: Department of Kinesiology, Université de Montréal, Centre d'Éducation Physique et des Sports de l'Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Marie-Ève
authors.initials: MÈ
authors.lastname: Mathieu
authors.affiliation: School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada; Clinical Epidemiological Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Glen P
authors.initials: GP
authors.lastname: Kenny
authors.affiliation: Saskatoon Health Region, School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Tupper
authors.affiliation: Rehabilitation Services, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Kristi
authors.initials: K
authors.lastname: Whitney-Mahoney
authors.affiliation: Department of Physiotherapy, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Bigford
mesh_terms: D001171:Arthritis, Juvenile / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D059408:Pain Management; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular
keywords: Arthritis, juvenile; Exercise; Exercise therapy; Practice guideline; Rehabilitation