Three-dimensional analysis of gait in children and adolescents with juvenile idiopathic arthritis

Purpose: The paper aimed to assess the gait pattern in children and adolescents with juvenile idiopathic arthritis (JIA) treated at the rehabilitation center and to assess changes in this pattern after the end of treatment and 9 months later. Methods: 50 children with JIA were enrolled into the study. 35 healthy volunteers were enrolled into the study for a comparison. Spatiotemporal and kinematic gait parameters were obtained using a movement analysis system. The Gait Deviation Index (GDI) was calculated. The assessment was performed three times: on the day of admission to the rehabilitation center, after the end of a 4-week treatment period and 9 months later. Results: With regard to the majority of spatiotemporal and kinematic parameters, differences in their distribution were highly statistically significant between the study group and the control group (p < 0.001). In two subsequent tests, differences were less significant when compared to the control group (p < 0.01). In the study group, ranges of motion in the sagittal plane in the hip (p < 0.01), knee (p < 0.001) and ankle joints (p < 0.01) increased significantly between tests 1 and 2, and 1 and 3. A significantly lower value of GDI was observed in the study group (right limb; p = 0.036). Conclusions: The gait pattern of children with JIA is significantly different from the one observed in healthy children. A rehabilitation program significantly improved gait in children with JIA, but differences compared to healthy children were still observed, and it indicates that the abnormal gait pattern became permanent in this group of subjects.

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Role and effectiveness of complex and supervised rehabilitation on overall and hand function in systemic sclerosis patients—one-year follow-up study

Scientific Reports ◽

10.1038/s41598-021-94549-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Michał Waszczykowski ◽

Bożena Dziankowska-Bartkowiak ◽

Michał Podgórski ◽

Jarosław Fabiś ◽

Arleta Waszczykowska

Keyword(s):

Systemic Sclerosis ◽

Hand Function ◽

Exercise Program ◽

Rehabilitation Program ◽

Long Term Results ◽

Home Exercise ◽

Control Group ◽

Study Group

AbstractThe aim of this study was to estimate the long-term results of complex and supervised rehabilitation of the hands in systemic sclerosis (SSc) patients. Fifty-one patients were enrolled in this study: 27 patients (study group) were treated with a 4-week complex, supervised rehabilitation protocol. The control group of 24 patients was prescribed a home exercise program alone. Both groups were evaluated at baseline and after 1-, 3-, 6-, and 12-months of follow-up with the Disability of the Arm, Shoulder and Hand Questionnaire (DAHS) as the primary outcome, pain (VAS—visual analog scale), Cochin Hand Function Scale (CHFS), Health Assessment Questionnaire Disability Index (HAQ-DI), Scleroderma-HAQ (SHAQ), range of motion (d-FTP—delta finger to palm, Kapandji finger opposition test) and hand grip and pinch as the secondary outcomes. Only the study group showed significant improvements in the DASH, VAS, CHFS and SHAQ after 1, 3 and 6 months of follow-up (P = 0.0001). Additionally, moderate correlations between the DASH, CHFS and SHAQ (R = 0.7203; R = 0.6788; P = 0.0001) were found. Complex, supervised rehabilitation improves hand and overall function in SSc patients up to 6 months after the treatment but not in the long term. The regular repetition of this rehabilitation program should be recommended every 3–6 months to maintain better hand and overall function.

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Seroprevalence of Antibodies against SARS-CoV-2 in Children with Juvenile Idiopathic Arthritis a Case-Control Study

Journal of Clinical Medicine ◽

10.3390/jcm10081771 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1771

Author(s):

Violetta Opoka-Winiarska ◽

Ewelina Grywalska ◽

Izabela Korona-Glowniak ◽

Katarzyna Matuska ◽

Anna Malm ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Disease Activity ◽

Disease Activity Score ◽

Juvenile Arthritis ◽

Activity Score ◽

Control Group ◽

Healthy Children ◽

Serum Samples ◽

History Of ◽

Novel Coronavirus

There is limited data on the effect of the novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) on pediatric rheumatology. We examined the prevalence of antibodies against SARS-CoV-2 in children with juvenile idiopathic arthritis (JIA) and a negative history of COVID-19 and the correlation of the presence of these antibodies with disease activity measured by juvenile arthritis disease activity score (JADAS). In total, 62 patients diagnosed with JIA, under treatment with various antirheumatic drugs, and 32 healthy children (control group) were included. Serum samples were analyzed for inflammatory markers and antibodies and their state evaluated with the juvenile arthritis disease activity score (JADAS). JIA patients do not have a higher seroprevalence of anti-SARS-CoV-2 antibodies than healthy subjects. We found anti-SARS-CoV-2 antibodies in JIA patients who did not have a history of COVID-19. The study showed no unequivocal correlation between the presence of SARS-CoV-2 antibodies and JIA activity; therefore, this relationship requires further observation. We also identified a possible link between patients’ humoral immune response and disease-modifying antirheumatic treatment, which will be confirmed in follow-up studies.

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Evaluation of depression and self-esteem in children with monosymptomatic nocturnal enuresis: A controlled trial

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2014.3.212 ◽

2014 ◽

Vol 86 (3) ◽

pp. 212 ◽

Cited By ~ 7

Author(s):

Orhan Koca ◽

Mehmet Akyüz ◽

Bilal Karaman ◽

Zeynep Yesim Özcan ◽

Metin Öztürk ◽

...

Keyword(s):

Children And Adolescents ◽

Nocturnal Enuresis ◽

Depression Scale ◽

Self Esteem ◽

Control Group ◽

Case Group ◽

Healthy Children ◽

Significant Difference ◽

Monosymptomatic Nocturnal Enuresis ◽

Age Range

Objectives: Nocturnal enuresis (NE) is very common and is one of the most common causes for patients to be admitted to urology, pediatrics, child psychiatry and child surgery departments. We aimed to investigate the effect on depression and self-esteem of this disorder that can cause problems on person's social development and human relations. Material and methods: 90 patients who were admitted to our clinic with complaints of nocturnal enuresis were enrolled. Investigations to rule out organic causes were performed in this group of patients. Out of them 38 children and adolescents (age range 8-18 years) with primary monosymptomatic nocturnal enuresis (PMNE) agreed to participate in the study In the same period 46 healthy children and adolescents with a similar age range without bed wetting complaint were included in the study as a control group. The age of the family, educational and socioeconomic level were questioned and Piers-Harris Children's Self-Concept Scale (PHCSCS) and Children's Depression Inventory (CDI) forms were filled out. Results: Mean age of the cases (18 females or 47.4% and 20 males or 52.6%) was 10.76 ± 3.82 years whereas mean age of controls (26 females or 56.5% and 20 males or 43.5%) was 10.89 ± 3.11 years. Depression scale was significantly higher (p = 0.001) in the case group than in the control group (10.42 ± 4.31 vs 7.09 ± 4.35). In both groups there was no statistically significant difference by age and sex in terms of depression scale (p > 0.05). Conclusion: NE is widely seen as in the community and is a source of stresses either for children and for their families. When patients were admitted to physicians for treatment, a multidisciplinary approach should be offered and the necessary psychological support should be provided jointly by child psychiatrists and psychologists.

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Analysis of Physiological Gait Pattern in Children Without the Influence of Footwear

Foot & Ankle Specialist ◽

10.1177/1938640016666914 ◽

2016 ◽

Vol 9 (6) ◽

pp. 506-512 ◽

Cited By ~ 1

Author(s):

David Pomarino ◽

Juliana Ramírez Llamas ◽

Andrea Pomarino

Keyword(s):

Children And Adolescents ◽

Case Series ◽

Gait Pattern ◽

Healthy Children ◽

Children And Adolescent ◽

Levels Of Evidence ◽

Normal Gait ◽

Spss Software

In the literature, there have been several studies that have analyzed and explained the characteristics of physiological gait in association with pathologies; however, finding information about normal gait pattern while barefoot is difficult. This study focuses on the differences in the barefoot gait between children and adolescents. A total of 320 healthy children and adolescent were recruited and divided into groups according to age: G1 (1-6 years), G2 (7-10 years), G3 (>11 years). Data were collected using a dynamometric platform and analyzed using SPSS software. This study’s findings indicate that there are differences in the swing, stance, load, and single support phases of gait. To our knowledge, this is the first study to present the values of standardized data on barefoot gait pattern in children aged from 2 to 10 years. Levels of Evidence: Diagnostic, Level IV: Case series

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Decreased Pain Threshold in Juvenile Idiopathic Arthritis: A Cross-sectional Study

The Journal of Rheumatology ◽

10.3899/jrheum.120793 ◽

2013 ◽

Vol 40 (7) ◽

pp. 1212-1217 ◽

Cited By ~ 30

Author(s):

Anne Leegaard ◽

Johanne Jeppesen Lomholt ◽

Mikael Thastum ◽

Troels Herlin

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Pain Threshold ◽

Pain Perception ◽

Negative Control ◽

Control Group ◽

Healthy Children ◽

Cross Sectional ◽

Age Related ◽

Digital Pressure ◽

Pressure Algometer

Objective.To examine the pain threshold in children with juvenile idiopathic arthritis (JIA) compared with healthy children by using a digital pressure algometer.Methods.Fifty-eight children with JIA born between 1995 and 2000 and 91 age-related healthy children participated in the study. We used a digital pressure algometer to measure the pain threshold on 17 symmetric, anatomically predefined joint-related or bone-related areas. All children were asked to rate their current pain on a Faces Pain Scale, and parents of children with JIA were asked to complete a parental revised version of the Child Health Assessment Questionnaire (CHAQ-R). Clinical data were registered on children with JIA.Results.The pain threshold was significantly lower among children with JIA (total mean PT = 1.33 ± 0.69 kg/cm2) when compared with the healthy control group (total mean PT = 1.77 ± 0.67 kg/cm2). The same pattern was found in all areas measured, including negative control areas that are normally unaffected in JIA (p = 0.0001 to 0.005). Overall, the pain threshold was 34% lower in females than in males in both groups (p < 0.0001). We found no correlation between pain threshold and age, current pain experience, disease duration, or disease activity.Conclusion.Children with JIA had a substantially lower pain threshold even in areas usually unaffected by arthritis. Our findings suggest that JIA alters the pain perception and causes decreased pain threshold.

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Low Level of Vitamin D is Correlated with High C-Reactive Protein (CRP) and Disease Activity in Indonesian Juvenile Idiopathic Arthritis (JIA) Patients

The Indonesian Biomedical Journal ◽

10.18585/inabj.v12i2.1143 ◽

2020 ◽

Vol 12 (2) ◽

pp. 149-56

Author(s):

Desy Wulandari ◽

Wisnu Barlianto ◽

Tita Luthfia Sari

Keyword(s):

Vitamin D ◽

Juvenile Idiopathic Arthritis ◽

Serum Level ◽

Disease Activity ◽

Vitamin D Deficiency ◽

Control Group ◽

Healthy Children ◽

C Reactive Protein ◽

Low Level ◽

Reactive Protein

BACKGROUND: Vitamin D plays essential role in the regulation of inflammation, such as in pathogenesis of Juvenile Idiopathic Arthritis (JIA). Vitamin D deficiency has been reported among JIA patients, but there were conflicting results regarding the correlation with disease activity. This study aimed to assess vitamin D serum level and its correlation with C-Reactive Protein (CRP) and disease activity in JIA patients.METHODS: Children who were diagnosed with JIA according to International League of Associations for Rheumatology (ILAR) criterias were enrolled as JIA group subjects, while age and sex-matched healthy children were enrolled as the control group subjects. Vitamin D and CRP serum level were measured. Disease activity of JIA patients was calculated by Juvenile Arthritis Disease ActivityScore-27 (JADAS-27).RESULTS: Vitamin D serum level was lower in the JIA group compared to the healthy control group (p=0.000). Among 26 JIA patients, 61.5% were deficient, 30.8% were insufficient, and 7.7% had normal vitamin D. No significant different in CRP level between vitamin D group (p=0.441), but there was significant different in JADAS-27 (p=0.001). The mean of CRP and JADAS-27 were found highest in vitamin D deficiency group. Vitamin D serum level was negatively correlate with CRP (p=0.021, r=-0.452) and JADAS-27 (p=0.001 r=-0.595).CONCLUSION: Low level of vitamin D in JIA patients was inversely related to higher CRP and disease activity,suggesting that vitamin D supplementation could be havepotential role in JIA treatment.KEYWORDS: vitamin D, CRP, disease activity,JADAS-27, JIA

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An ultrasound protocol for temporomandibular joint in juvenile idiopathic arthritis: a pilot study

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20200399 ◽

2021 ◽

pp. 20200399

Author(s):

Ingrid Tonni ◽

Andrea Borghesi ◽

Silvia Tonesi ◽

Giulia Fossati ◽

Francesca Ricci ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Temporomandibular Joint ◽

Joint Effusion ◽

Control Group ◽

Ultrasound Images ◽

Healthy Children ◽

Mr Images ◽

Group A ◽

Group B ◽

Spearman Test

Objectives: As it is well known, the diagnosis of temporomandibular joint (TMJ) involvement in patients affected by Juvenile Idiopathic Arthritis (JIA) is important to avoid the impairment of mandibular growth. In this context, Magnetic Resonance Imaging (MRI) is the gold-standard for detection of TMJ involvement, however it is expensive and requires patients’ collaboration. The aim of this study was to evaluate if ultrasound may be used as an alternative tool to investigate the acute signs of TMJ involvement in JIA patients. Methods: Lateral periarticular space (LPAS) and joint effusion were evaluated by ultrasound in a study Group A of 8 JIA children (11.6±3.5 years old) with 14 TMJs involved, as confirmed by MRI, and in a control Group B of 7 healthy children (9.3±1.2 years old) without temporomandibular disorders (TMD). The LPAS width values were compared between the two groups using the Mann–Whitney test. The ultrasound images of the JIA group were then matched with the corresponding MR images; the Spearman Rank Correlation test and the Bland–Altman test were used to evaluate the differences. Results: The LPAS values in Group A were statistically significantly higher than those in Group B (p < 0.001). There was no overlap of the LPAS values confidence intervals (CIs) between the two groups. No signs of joint effusion were identified in groups A and B. The Spearman test applied to the values of LPAS measured in ultrasound and the corresponding MR images showed a proportional positive correlation with a ρ of 0.623 and a p < 0.05. Conclusions: Ultrasound can detect differences in the TMJ features between JIA patients and healthy patients and it might be used as a follow-up tool in the assessment of TMJ involvement in subject affected by JIA.

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Impact of Physiotherapy on Physical Capacity of 7–11-Year-Old Children with Autism Disorder

Reabilitacijos mokslai slauga kineziterapija ergoterapija ◽

10.33607/rmske.v2i11.837 ◽

2020 ◽

Vol 2 (11) ◽

Author(s):

Indrė Labanauskaitė ◽

Agnė Lileikytė ◽

Aistė Vasilionytė ◽

Vilma Dudonienė ◽

Valdas Urbonavičius ◽

...

Keyword(s):

Physical Therapy ◽

Muscle Strength ◽

Children With Autism ◽

Physical Capacity ◽

Control Group ◽

Study Group ◽

Healthy Children ◽

Long Jump ◽

Hand Muscle ◽

Autism Disorder

Research background. Autism is one of the most difficult wide spectrum developmental disorders. Recently, striking increase in the number of autistic children is observed. Physical activation is important for the development and physical fitness of children with autism disorder. Research object – children’s balance, muscle strength and endurance. The aim was to evaluate physical capacity and impact of physiotherapy on balance, muscle strength and endurance in 7–11-yearold children with autism disorder. Methods. The study group consisted of 10 children with autism disorder (8 boys and 2 girls), the control group consisted of 18 healthy children (15 boys and 3 girls). The average age of the study group was 8.90 ± 1.4 years; in the control group 8.94 ± 1.0 years. Balance of children was assessed by Berg Balance Scale, hand grip – by dynamometry, leg muscle strength – by long jump test and squat test, and endurance of abdominal muscle – by sit up test. The results showed that physical condition of children with autism disorder was significantly poorer compared to healthy children: the balance – 43.9 ± 7.82 v. s. 55.4 ± 0.9 points; right hand muscle strength of 5.9 ± 2.06 kg v. s. 12.2 ± 3.43 kg; left – 5.3 ± 1.87 kg v. s 12.1 ± 3.43; long jump 43.0 ± 25.25 cm v. s 132.6 ± 31.87 cm; endurance of abdominal muscles 7.3 ± 2.01 v. s 19.6 ± 4.06 times per 30 s; squats 9.1 ± 4.36 v. s 27.6 ± 7.07 times per 30 s. After applying physical therapy results of all performed tests in children with autism improved significantly: balance to 49.9 ± by 5.45 points, right hand muscle strength to 7.9 ± 2.49 kg, left – 7.5 ± 2.31 kg, long jump to 79.2 ± 39.87 cm, crunches to 11.8 ± 4.54 times, squats to 14.8 ± 4.83 times, but they did not reach the results of healthy children. Conclusion. Balance, muscle strength and endurance of children with autism disorder were significantly lower than those in healthy children. Physical therapy significantly improved physical capacity of autistic children, but the level of healthy children was not reached.Keywords: autism, children, physiotherapy.

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Vitamin D levels in children and adolescents with autism

Journal of International Medical Research ◽

10.1177/0300060520934638 ◽

2020 ◽

Vol 48 (7) ◽

pp. 030006052093463

Author(s):

Esma Şengenç ◽

Ertuğrul Kıykım ◽

Sema Saltik

Keyword(s):

Vitamin D ◽

Alkaline Phosphatase ◽

Children And Adolescents ◽

Autism Spectrum ◽

Control Group ◽

Healthy Children ◽

Birth Season ◽

Hydroxyvitamin D ◽

Vitamin D Levels ◽

Calcium Phosphorus

Objective This study aimed to investigate the relationship between autism spectrum disorder (ASD) and vitamin D levels in children and adolescents. Methods We measured serum 25-hydroxyvitamin D (25-OHD) levels in 1529 patients with ASD aged 3 to 18 years, without any additional chronic diseases. Levels of 25-OHD were compared according to sex, age (<11 or ≥11 years), and birth season. Additionally, laboratory parameters (calcium, phosphorus, alkaline phosphatase, and 25-OHD) of 100 selected patients with ASD were compared with those of the healthy control group. Results Vitamin D deficiency or insufficiency was found in approximately 95% of all patients. Levels of 25-OHD in adolescent patients with ASD aged 11 to 18 years were significantly lower than those in patients aged younger than 11 years. In the 100 selected patients with ASD, mean serum 25-OHD levels were significantly lower and alkaline phosphatase levels were higher compared with those in healthy children. Conclusion Our study suggests a relationship between vitamin D and ASD in children. Monitoring vitamin D levels is crucial in autistic children, especially adolescents, to take protective measures and treat this condition early.

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Oxidative Status and Its Contribution to Extracellular Cytokine Secretion in Children with Acute Lymphoblastic Leukemia.

Blood ◽

10.1182/blood.v108.11.4471.4471 ◽

2006 ◽

Vol 108 (11) ◽

pp. 4471-4471

Author(s):

Katarzyna Drabko ◽

Agnieszka Bojarska-Junak ◽

Jerzy R. Kowalczyk

Keyword(s):

Vitamin E ◽

Acute Lymphoblastic Leukemia ◽

Lymphoblastic Leukemia ◽

Plasma Concentrations ◽

Oxidative Status ◽

Cytokine Secretion ◽

Tnf Alpha ◽

Control Group ◽

Study Group ◽

Healthy Children

Abstract Recent data suggest that oxidative-antioxidative imbalance may influence cytokine secretion in children with acute lymphoblastic leukemia (ALL). Plasma cytokines concentrations are reported to have an effect on clinical course of the patients with lymphoid malignancies. The aim of the study was analysis of oxidative status (Malonylodialdehyde, MDA) and antioxidant defense (Superoxide dismutase, SOD; glutathione peroxidase, GPX; total antioxidant status, TAS and vitamin E) in peripheral blood and evaluation of plasma concentration of IL-2, IL-4, IL-10 and TNF-alpha in children with acute lymphoblastic leukemia. Material and methods: Study group consisted of 23 newly diagnosed ALL children, including 13 boys and 10 girls, with median age 5 years (range, 0.5–16). Control group consisted of 21 healthy children (11 boys and 7 girls) with median age 7 years (range, 2–17). TAS, SOD, GPX status were estimated using commercially available Randox Laboratories Ltd kits. Vitamin E and MDA plasma concentrations were measured spectrofluorimetrically. Cytokine concentrations were measured by quantitative immunoassay tests: IL-2 and IL-4 plasma levels were assessed using Bender MedSystems test (Vienna, Austria), IL-10 and TNF-alpha by R&D system tests. All assays were performed twice: on diagnosis and 6 weeks thereafter. Results: GPX activity in study group was significantly higher before and during treatment than in control subjects (1.5-fold, p=0.02 and 2-fold, p=0.0007, respectively). MDA concentrations were higher in ALL group before treatment (1.4-fold, p=0.0001) and 6 weeks thereafter (1.2 fold, p=0.01) than in control group. SOD activity, TAS and vitamin E concentrations did not differ between the groups. IL-10 level was found to be significantly increased on ALL diagnosis, but not during therapy, when compared to control group (2-fold, p=0.02). TNF-alpha level was higher in patients before treatment then during treatment (3-fold, p=0.02) and as compare to the controls (2,5-fold, ns). IL-2 and IL-4 plasma concentrations were comparable in all groups in both time points. There was a correlation in children with ALL after 6 weeks therapy between MDA and IL-10 concentrations (r=0.59, p<0,05) as well as MDA and TNF-alpha concentrations (r=0,58, p<0,05). In control group MDA was correlated with IL-10(r=0.59, p<0.05). Median follow-up of the study group is 23 months, and at that time relapses occurred in 3 out of 23 patients. 2-fold decrease in median GPX were observed in patients, who relapsed afterward,. Median IL-10 plasma concentrations in children, who subsequently relapsed were 4-fold higher at diagnosis and 8-fold higher after 6 weeks of therapy then in patients who are still in remission (despite of achieving complete remission by all study group at 6th week of treatment). Conclusions: Oxidation process in plasma of children with ALL is significantly increased on diagnosis. Pro-oxidative status may contribute to IL-10 and TNF secretion and affect efficacy of treatment.

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