Background/Purpose: Juvenile arthritis (JA) is characterized by joint pain, stiffness, and decreased mobility, potentially affecting participation in physical activity (PA). Current guidelines from the CDC and WHO recommend that children engage in at least 60 minutes of PA daily. While research in PA level and JA has been conducted in European countries, data on physical activity levels among children with arthritis in the United States remain limited. It is not well understood whether U.S. children with arthritis meet recommended PA targets or how PA engagement relates to their broader health outcomes. This study aims to assess whether a current diagnosis of arthritis is associated with lower PA levels among a nationally representative sample of U.S. children and adolescents.

Methods: This cross-sectional analysis assessed adherence to daily PA recommendations among U.S. children with JA compared to peers without JA, using 2016–2021 National Survey of Children’s Health (NSCH) data, a nationally representative survey that investigates health of pediatric population in the U.S. Univariable and multivariable logistic regression models examined the association between JA and meeting daily PA recommendations. A sensitivity analysis using ordinal logistic regression assessed PA frequency (“0 days,” “1–3,” “4–6,” “daily”). Models were adjusted for potential confounders like age, sex, race, ethnicity, and socioeconomic status.

Results: Children with JA were less likely to meet daily PA recommendations than peers without arthritis (13.5% vs. 17.0%; p = 0.05) and had higher rates of obesity (23.3% vs. 13.9%; p < 0.001), physical limitations, pain (69.9% vs. 10.3%; p < 0.001) and comorbidities (55.2% vs. 30.6%; p < 0.001). However, in adjusted analyses, arthritis was not significantly associated with meeting PA guidelines (aOR = 1.34; 95% CI: 0.78–2.32; p = 0.29). Similarly, arthritis was not significantly associated with PA level in ordinal logistic regression (aOR = 1.17; 95% CI: 0.81–1.69; p = 0.41). Female sex, older age, presence of mental health conditions, and obesity (aOR for ≥95th percentile = 0.64; 95% CI: 0.52–0.78), were negatively associated with PA. Sports participation was strongly associated with meeting guidelines for PA (aOR = 1.58; 95% CI: 1.44–1.74; p < 0.001)

Conclusion: In a large nationally representative U.S. sample, children and adolescents with and without arthritis demonstrated low adherence to the CDC and WHO-recommended PA levels. Overall, arthritis was not found to be a statistically significant predictor of PA levels in unadjusted or adjusted analyses. These findings might suggest that while arthritis poses challenges, it may not be a key independent barrier to PA. Efforts to increase PA should address modifiable barriers like obesity and mental health, and promote sports participation, especially among older children with JA.

Table 1

Forest Plot

« Back to ACR Convergence 2025

ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-between-juvenile-arthritis-and-physical-activity-levels-in-u-s-children-a-cross-sectional-study-using-the-2016-2021-national-survey-of-childrens-health/