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Exercise Response in Children with and without Juvenile Rheumatoid Arthritis: A Case-Comparison Study

M Jasso Giannini, PhD, PT, was a doctoral student, School of Physical Therapy, Texas Woman's University, 1130 MD Anderson Blvd, Houston, TX 77030-2897, when this study was completed in partial fulfillment of her degree requirements.
EJ Protas, PhD, PT, is Professor and Assistant Dean, School of Physical Therapy, Texas Woman's University.

The primary purpose of the study was to compare the response to bicycle ergometer exercise in children with and without juvenile rheumatoid arthritis (JRA). Heart rate, exercise duration, highest work load completed, and peak oxygen consumption (peak O₂) were compared. A secondary purpose of the study was to determine the relationship between peak O₂ and articular disease severity. Thirty children with JRA and 30 controls matched for age, sex, and body surface area (BSA) were the subjects. Peak O₂ was determined by an open-circuit computerized gas analysis system. Peak O₂, highest work load completed, exercise duration, and peak heart rate were significantly lower among the children with JRA than their respective controls. Submaximal heart rate was significantly higher for the children with JRA. There was no difference in resting heart rate between the two groups. There was no relationship between peak O₂ and articular disease severity among the children with JRA. The results suggest that aerobic conditioning programs may be indicated soon after diagnosis for patients with JRA, regardless of the severity of their articular disease. One subject with JRA and 2 control subjects reported light-headedness and dizziness, and 1 subject with JRA complained of increased knee swelling. We recommend that physical therapists monitor patients for signs of exercise intolerance and joint symptoms during exercise training sessions.

Key Words: Bicycle ergometer • Child • Exercise • Juvenile arthritis • Oxygen consumption

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