Juveniilne idiopaatiline artriit ja füsioteraapia (0)

Juvenile idiopathic arthritis
Tartu Health Care Collage
 
 
In general
● Juvenile idiopathic arthritis (JIA) - the 
most common form of arthritis in 
children  and adolescents
● Autoimmune  disorder
● Commonly occurs in children from the 
ages  of 7 to 12
●  First defined in the first half of the 16th  
century
 
● Treatment includes: education, medical 
 
treatment, physical therapy , 
occupational therapy
● May lead to functional deficiency in the 
musculoskeletal system, blindness
 
 
Symptoms
● Non- specific
● Lethargy, reduced 
physical activity , 
and  poor appetite
● Pain
● Persistent 
swelling of the 
affected   joint (s)
 
●  Morning stiffness
 
● A multidisciplinary approach is 
necessary for the successful treatment 
of JIA, with the  active  involvement of 
pediatric rheumatologists, physiatrists, 
physiotherapists, occupational 
therapists, psychologists, and dieticians.
 
 
Rehabilitation
● Comprehensive rehabilitation  program  
must start early
● „An ounce of  prevention is worth a 
pound of  cure “
● Rehabilitation  management of childhood 
disease  differs from  adult  disease
 
 
● Patients with JIA tend  to keep their joints 
in the most comfortable  positions  
● Joint  volume  is maximum
● Weakness of extensor muscles
● Contracture of flexor muscles -> leads to 
loss of function
● Complete extension of the joint cannot 
be performed
 
 
● Because of pain, 
tiredness, 
stiffness -> less 
active -> systemic 
muscle  weakness, 
decreased 
flexibility
● One purposes of 
rehabilitation is to 
 
prevent growth  
retardation
 
● Osteoporosis
Objectives of 
rehabilitation
● Rehabilitation and physical therapy 
include : controlling pain, preventing 
limitation and restoring ROM in affected 
joints, maintaining and improving muscle 
strength , increasing and maintaining 
endurance for  activities of daily  living , 
minimizing the  effects  of inflammation, 
and ensuring normal growth and 
development .
 
 
● Raising awareness about the disease in 
patients and  families
●  Heat - cold  treatment, massage, electrical 
stimulation, and ultrasound
 
 
Heat treatment
● ...is used for decreasing the rigidity of 
joints, increasing the flexibility of the 
fibrous tissue in joint capsules and 
tendons, and decreasing pain and 
muscle spasms
●  Effect depends on  several factors
● Hot  shower or taking  bath  may be  good
● Applying treatment before stretching  
 
exercises will increase the efficiency of 
the treatment 
 
Massage
● ...can relieve the pain and prevent 
adhesions in the subcutaneous tissues
● Applied with heat treatment before 
stretching exercises
● Reccomended as a relaxtion therapy
 
 
Therapeutic exercises
● ...form the basis  of the treatment for children 
with JIA.
● Aquatic exercises, positioning , passive ROM 
exercises, and isometric exercises
● Exercises performed to  improve  aerobic 
capacity should be moderate in intensity and 
should not last more  than  30 minutes per day
● Stretching exercises to improve ROM. 
 
● The stretching exercises must be continued for 
 
a 10-second period, 5 to 10  times  in each 
session twice a day
● Contract-relax tehnique 
● the  primary  target 
should be the 
prevention of 
permanent 
deformities
 
 
Conclusion
● JIA is a disease that can be  managed by 
close  follow -up and timely application of 
appropriate treatment modalities, 
enabling children to reach adult ages 
without  development of disabilities . 
● Early diagnosis, appropriate treatment, 
education, and teamwork  of the family, 
patient, and physicians are factors that 
increase the chances of success.
 
 
Sources
●  http://www.medscape.com/viewarticle/500156_1
●  http://en.wikipedia.org/wiki/Juvenile_idiopathic_arthritis
 
 
 
 

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