Can Exercise Influence Low Bone Mineral Density in Children with Juvenile Rheumatoid Arthritis?

Mary E. Gannotti, Maureen Nahorniak, George E. Gorton III, Krystal Sciascia, Megan Sueltenfuss, Michelle Synder & Anna Zaniewski 

Low bone mineral density (BMD) is a common secondary condition associated with juvenile idiopathic arthritis (JIA). The purpose of this review is to evaluate the literature pertinent to designing an effective, safe weight-bearing exercise program to reduce the risk of low BMD in children with JIA.

The authors critiqued thirty-seven articles on the risk of low BMD and children with JIA, weight-bearing interventions to improve BMD in healthy children, and safety and efficacy of exercise interventions with children with JIA, on the basis of their design. Three highly rated studies confirmed the multifactorial nature of low BMD in children with JIA, two others supported the efficacy of weight-bearing interventions for increasing BMD in children who are healthy, and one moderately rated study demonstrated the safety of low impact exercise by children with JIA.

In conclusion, the authors suggest that weight-bearing activities be included in exercise programmes for individuals with JIA, with futher research needed to determine the amount, duration, and frequency of weight-bearing activity needed to reduce the risk for low BMD.

Pediatric Physical Therapy, 2007 19(2), 128-139

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