Commentary on “Physical Exercise and Physical Activity for Children and Adolescents With Juvenile Idiopathic Arthritis: A Literature Review”

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“How should I apply this information?”
Exercise programs for children with juvenile idiopathic arthritis (JIA) target on limiting the consequences of the disease such as pain and inflammation, preserve range of motion, maintain muscle strength, and limit strain on the arthritic joints. When general contraindications for exercising are applied, these exercise programs are safe and beneficial for children with JIA. A wide variety of exercise programs, land-based, Internet-based, and water-based aimed at strength or flexibility training, improve musculoskeletal symptoms and quality of life.
“What should I be mindful about when applying this information?”
Although the authors indicate the importance of combining different exercises and activities, they do not provide a clear answer to their initial research question regarding the level of efficacy. The reader should be cautious with the interpretation of this narrative review as methodological flaws (eg low reproducibility, partial appraisal of research for risk of bias, merging evidence-based with non-evidence-based literature, and no discrimination between disease phases and subtypes of JIA) bias the general statements made by the authors. The conclusion that physical activity and training in patients in the nonactive phase is safe and there is potential for (effective) improvement is a more appropriate conclusion and should be applied. Exercise training programs in children with active disease or impaired joint function might not be as beneficial as stated in this review.
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