To investigate the reliability of an aerobic and an anaerobic exercise test in patients with juvenile dermatomyositis (JDM).
Sixteen patients with JDM (mean age 13.85 +/- 6.4 yrs, range 6.7-27.2) ...participated. Anaerobic exercise capacity was measured using the Wingate Anaerobic Exercise Test (WAnT). Aerobic exercise test was performed using a graded exercise test to volitional exhaustion on an electronically braked cycle ergometer. Patients were tested and retested within 12.8 +/- 5.7 days.
Correlation coefficients and other reliability statistics indicated that peak power and mean power on the WAnT and peak oxygen uptake (VO2peak) and maximal workload (Wmax) on the aerobic exercise test could be reliably assessed in patients with JDM. Pearson (R) and intraclass correlation coefficients (ICC) were > 0.85, and typical error was < 20% for the peak power and mean power on the WAnT. On the aerobic exercise test the R and ICC were > 0.95, and typical error was < 6% for the VO2peak and Wmax.
We found acceptable reliability for the WAnT and very good reliability for the aerobic exercise test. This indicated that these exercise tests could be performed reliably in patients with JDM.
Currently there are no evidence-based recommendations regarding fitness and strength tests for patients with childhood or adult idiopathic inflammatory myopathies (IIM). This hinders clinicians and ...researchers in choosing the appropriate fitness- or muscle strength-related outcome measures for these patients. Through a Delphi survey, we aimed to identify a candidate core set of fitness and strength tests for children and adults with IIM.
Fifteen experts participated in a Delphi survey that consisted of 5 stages to achieve a consensus. Using an extensive search of published literature and through the work of experts, a candidate core set based on expert opinion and clinimetrics properties was developed. Members of the International Myositis Assessment and Clinical Studies Group were invited to review this candidate core set during the final stage, which led to a final candidate core set.
A core set of fitness- and strength-related outcome measures was identified for children and adults with IIM. For both children and adults, different tests were identified and selected for maximal aerobic fitness, submaximal aerobic fitness, anaerobic fitness, muscle strength tests, and muscle function tests.
The core set of fitness- and strength-related outcome measures provided by this expert consensus process will assist practitioners and researchers in deciding which tests to use in patients with IIM. This will improve the uniformity of fitness and strength tests across studies, thereby facilitating the comparison of study results and therapeutic exercise program outcomes among patients with IIM.
To examine the feasibility of maximum exercise testing in patients with juvenile dermatomyositis (JDM), characterize the maximum oxygen consumption (VO2peak) of these patients, and determine if ...exercise time could be used as an surrogate index for VO2peak.
Fifteen patients diagnosed with JDM (age 5-14) performed a graded, maximum exercise test using a motor driven treadmill and metabolic cart to volitional exhaustion conforming to the Bruce protocol.
All patients were able to perform the exercise test. Ten of the 15 patients performed a maximal effort (heart rate > 180 beats/min or respiratory exchange ratio > 1.0). The patients who had a maximal exercise performance, the mean absolute VO2peak, relative VO2peak (related to body mass), and exercise time were respectively -1.82 (+/- 1.5), -2.83 (+/- 1.9), and -3.65 (+/- 1.9) standard deviations lower compared to age and sex matched reference values (p < 0.05). Z scores for exercise time were significantly lower compared to Z scores for absolute and relative VO2peak, an indication of reduced muscular economy. When exercise time was converted to VO2peak using the equation: VO2peak = 0.1583 (exercise time) + 0.0828, the VO2peak values were not significantly different from the measured VO2peak values.
Aerobic exercise testing on a treadmill was possible in patients with JDM and revealed an impairment in their maximal aerobic exercise capacity. Exercise time can be used as an indicator of VO2peak, when converted to VO2peak using a regression equation. VO2peak, measured or estimated, has the potential to be a good indicator of muscle function in patients with JDM.
Abstract Background One objective of a neonatal follow-up program is to examine and predict gross motor outcome of infants born preterm. Aims To assess the concurrent validity of the Test of Infant ...Motor Performance (TIMP) and the Alberta Infant Motor Scale (AIMS), the ability to predict gross motor outcome around 15 months corrected age (CA), and to explore factors associated with the age of independent walking. Methods 95 infants, born at a gestational age < 30 weeks, were assessed around 3, 6 and 15 months CA. At 3 months CA, correlations of raw-scores, Z-scores, and diagnostic agreement between TIMP and AIMS were determined. AIMS-score at 15 months CA and parental-reported walking age were outcome measures for regression analyses. Results The correlation between TIMP and AIMS raw-scores was 0.82, and between Z-scores 0.71. A cut-off Z-score of − 1.0 on the TIMP had 92% diagnostic agreement (κ = 0.67) with an AIMS-score < P10. Neither TIMP- nor AIMS-scores at 3 months CA were associated with the gross motor outcome at 15 months CA. The AIMS-scores at 6 months CA predicted the AIMS-scores at 15 months CA with an explained variance of 19%. Median walking age was 15.7 months CA, with which only the hazard ratio of the AIMS at 6 months CA and ethnicity were significantly associated. Conclusions Prediction of gross motor development at 15 months CA and independent walking was not possible prior to 6 months CA using the AIMS, with restricted predictive value. Cultural and infant factors seem to influence the onset of independent walking.
Background/Objectives: The purpose of this study was to develop an activity energy expenditure (AEE) prediction equation for the Actiheart activity monitor for use in children with chronic disease. ...Subjects/Methods: In total, 63 children, aged 8–18 years with different types of chronic disease (juvenile arthritis, hemophilia, dermatomyositis, neuromuscular disease, cystic fibrosis or congenital heart disease) participated in an activity testing session, which consisted of a resting protocol, working on the computer, sweeping, hallway walking, steps and treadmill walking at three different speeds. During all activities, actual AEE was measured with indirect calorimetry and the participants wore an Actiheart on the chest. Resting EE and resting heart rate were measured during the resting protocol and heart rate above sleep (HRaS) was calculated. Results: Mixed linear modeling produced the following prediction equation: Estimated AEE (J/kg/ min) = -93.7 + (4.8xHRaS) + (0.04xAccelerometer Counts) + (39.8xGender (girls = 0, boys = 1)). This equation results in a nonsignificant mean difference of 2.1 J/kg/min (limits of agreement: −144.2 to 148.4 J/kg/min) for the prediction of AEE from the Actiheart compared with actual AEE. Conclusions: The Actiheart is valid for the use of AEE determination when using the new prediction equation for groups of children with chronic disease. However, the prediction error limits the use of the equation in individual subjects.
Exercise therapy in juvenile idiopathic arthritis Takken, Tim; Van Brussel, Marco; Engelbert, Raoul H.H ...
Cochrane database of systematic reviews,
01/2008, Letnik:
2010, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Background
Exercise therapy is considered an important component of the treatment of arthritis. The efficacy of exercise therapy has been reviewed in adults with rheumatoid arthritis but not in ...children with juvenile idiopathic arthritis (JIA).
Objectives
To assess the effects of exercise therapy on functional ability, quality of life and aerobic capacity in children with JIA.
Search methods
The Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews (The Cochrane Library), MEDLINE (January 1966 to April 2007), CINAHL (January 1982 to April 2007), EMBASE (January 1966 to October 2007), PEDro (January 1966 to October 2007), SportDiscus (January 1966 to October 2007), Google Scholar (to October 2007), AMED (Allied and Alternative Medicine) (January 1985 to October 2007), Health Technologies Assessment database (January 1988 to October 2007), ISI Web Science Index to Scientific and Technical Proceedings (January 1966 to October 2007) and the Chartered Society of Physiotherapy website (http://www.cps.uk.org) were searched and references tracked.
Selection criteria
Randomised controlled trials (RCTs) of exercise treatment in JIA.
Data collection and analysis
Potentially relevant references were evaluated and all data were extracted by two review authors working independently.
Main results
Three out of 16 identified studies met the inclusion criteria, with a total of 212 participants. All the included studies fulfilled at least seven of 10 methodological criteria. The outcome data of the following measures were homogenous and were pooled in a meta‐analysis: functional ability (n = 198; WMD ‐0.07, 95% CI ‐0.22 to 0.08), quality of life (CHQ‐PhS: n = 115; WMD ‐3.96, 95% CI ‐8.91 to 1.00) and aerobic capacity (n = 124; WMD 0.04, 95% CI ‐0.11 to 0.19). The results suggest that the outcome measures all favoured the exercise therapy but none were statistically significant. None of the studies reported negative effects of the exercise therapy.
Authors' conclusions
Overall, based on 'silver‐level' evidence (www.cochranemsk.org) there was no clinically important or statistically significant evidence that exercise therapy can improve functional ability, quality of life, aerobic capacity or pain. The low number of available RCTs limits the generalisability. The included and excluded studies were all consistent about the adverse effects of exercise therapy; no short‐term detrimental effects of exercise therapy were found in any study. Both included and excluded studies showed that exercise does not exacerbate arthritis. The large heterogeneity in outcome measures, as seen in this review, emphasises the need for a standardised assessment or a core set of functional and physical outcome measurements suited for health research to generate evidence about the possible benefits of exercise therapy for patients with JIA. Although the short‐term effects look promising, the long‐term effect of exercise therapy remains unclear.
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