Background/purpose: The purpose of this study was to examine factors associated with physical activity in children with juvenile idiopathic arthritis (JIA). Physical activity (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 children with JIA have markedly lower PA levels than their healthy peers. There is a paucity of research regarding what keeps children with JIA from being active. Studies in children with JIA suggest that low PA is the result of disease-related physical impairments, such as pain and stiffness. In literature on healthy children, there is a large body of research that supports a biopsychosocial analysis of PA and suggests the importance of physical, psychological and social factors. The present study investigated the relationship between PA in children with JIA and three of modifiable factors derived from a biopsychosocial model reported in the literature on healthy children. These are gross motor proficiency (GMP), perceived physical competence and parent-perceived physical competence of the child. These factors have not been examined together before in children with JIA. It was hypothesized that these factors would be associated with PA levels in children with JIA. The relationship among all factors was explored as a research question.
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 measured perceived physical competence using a self-report for the child and a proxy-report for the parent. Physical activity 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 gross motor proficiency compared to a normative sample (p<0.001). Of the three independent variables, only GMP was associated with PA levels in the sample. GMP was also related to the parent’s perception of the child’s physical competence, 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. Weight percentile, disease duration and pain level perceived by the child were not associated with PA.
Conclusions: The results partially support the hypotheses of this study. This study found GMP was both significantly impaired as well as strongly associated with PA levels. The other proposed independent variables—perceived physical competence and parent perception of their child’s competence—were not related to PA in the sample population, suggesting that perhaps these are not the most influential factors for PA levels of older children with JIA. Although perceived physical competence and the parent perception of their child’s physical competence were not related to the outcome, interesting relationships emerged when analyzing the findings. The subjects rated their perceived competence higher than their parents’, yet the parents had a more accurate appraisal of their child’s abilities, as measured by GMP. Therefore, although the psychological and social variables selected for the present study were not significantly related to PA, they may still be of interest for future investigations with different outcomes. In future studies examining PA levels in children with JIA, researchers may wish to explore psychological and social variables that are more relevant to the experiences of a child with JIA, which may be different from the healthy population.
|Commitee:||Kahn, Philip, Klepper, Susan, Sheikhzadeh, Ali, Weiner, Shira|
|School:||New York University|
|Department:||Environmental Health Medicine|
|School Location:||United States -- New York|
|Source:||DAI-B 76/12(E), Dissertation Abstracts International|
|Keywords:||Biopsychosocial, Gross motor, Juvenile arthritis, Physical activity|
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