THU0504 Quantifying physical education attendance and its relationship to pain severity and fatigue in adolescents with juvenile idiopathic arthritis – results from the german national paediatric rheumatological database

Abstract

Background: Regular physical education (PE) can help adolescents achieve the recommended amount of daily physical activity and provide immediate health benefits, by positively affecting musculo-skeletal development, mental health and social behavior. Adolescents with juvenile idiopathic arthritis (JIA) are less physically active and have lower fitness levels than their healthy peers [1]. Moreover, pain and fatigue are one of the most frequent complaints and identified as one of the causes behind impaired (social) functioning [2]. Objectives: To describe the participation rate in PE and to assess its relationship to pain and fatigue in adolescents with JIA. Methods: Cross-sectional data of adolescents with JIA recorded in the National Paediatric Rheumatological Database (NPRD) in the year 2015 were considered for the analyses. Disease characteristics were provided by rheumatologists along with patient-reported outcomes and participation in PE. Relationship to PE was assessed by using spearman's correlation. Results: In 2015, a total of 3,289 adolescents with JIA (females 66%, mean disease duration 5 years, persistent oligoarthritis 30%) aged 13 to 17 were recorded. About 60% of the patients reported to participate in PE "always" (56% of girls, 69% of boys), whereas about 18% stated to be fully exempt from participating in PE (20% of girls, 14% of boys). Significant differences were observed among JIA subtypes, whereby patients with enthesitis-related arthritis participated more frequently than patients with rheumatoid factor-positive polyarthritis (64% vs. 46%). The mean pain level was 2.1, the mean fatigue level 1.8. Participation in PE was negatively correlated with self-reported pain intensity (r=-0.43) and fatigue (r=-0.32). Significant associations were found between PE attendance and age, sex, disease duration, functional status as well as disease activity measured by CHAQ and JADAS3-10, respectively (p<0.05). Conclusions: 6 of 10 adolescents with JIA participate in PE always, whereby higher rates of self-reported attendance are associated with less severe pain and fatigue. Since exercise programs in JIA lead to significant improvements in quality of life, it is likely that physical education attendance plays an important role in pain reduction and social functioning improvement in JIA.