Background/Purpose: The purpose of this study was to examine factors associated with physical activity (PA) in children with JIA.  PA is important for the physical, psychological and social development of all children. In children with JIA, PA can also improve disease sequelae, yet previous literature has reported that this population has lower PA levels than their healthy peers. There is little research regarding what keeps children with JIA from being active outside of disease-related physical impairments, such as pain and stiffness. There is a large body of research on healthy children that supports a biopsychosocial analysis of PA and suggests the importance of physical, psychological and social factors. The present study examined the relationship between PA in children with JIA and three modifiable factors—gross motor proficiency (GMP), perceived physical competence and parent-perceived physical competence of the child—which were derived from a biopsychosocial model reported in the literature on healthy children. 

Methods: This cross-sectional study sampled 40 children with JIA between 8-12 years old. Demographic and clinical variables were collected through self-reports.  GMP was collected using the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition.  The results were compared to a normative sample using a one-sample t-test. The revised 38-question Child Health Assessment Questionnaire was used as a measure of perceived physical competence using a self-report for the child and a proxy-report for the parent.  PA level was collected using the Intensity Score of the Children’s Assessment of Participation and Enjoyment. Spearman’s rho correlations examined associations between variables and logistic regression examined the associations of the independent variables with PA level. The relationships of weight percentile, pain level and disease duration with PA in the sample were examined for use as covariates.

Results: The study subjects had significantly impaired GMP compared to a normative sample (p<0.001). Of the three independent variables, only GMP was associated with PA levels in the sample (p=0.01). GMP was also related to the parent’s perception of the child’s physical competence (p=0.04), but not related to the child’s self-perceived competence.  The perception of physical competence of the parent and the child were related to each other (p=0.001), but significantly different (p=0.04). Weight percentile, disease duration and pain level were not associated with PA.

Conclusion: This study found GMP was both significantly impaired as well as strongly associated with PA levels. These findings may have developmental and safety implications in this population.  Although the perception of physical competence of the parent and the child were not directly related to the outcome, significant associations among the independent variables suggest that they may still influence PA in this population. Future researchers should continue to build upon these results and explore what other variables may influence PA in children with JIA using a biopsychosocial approach, which may be different from what affects the healthy population.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/factors-associated-with-physical-activity-in-older-children-with-juvenile-idiopathic-arthritis/