Ottawa Panel evidence-based clinical practice guidelines for structured physical activity in the management of juvenile idiopathic arthritis

Publication date: Available online 6 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Sabrina Cavallo, Lucie Brosseau, Karine Toupin-April, George A. Wells, Christine A.M. Smith, Arlanna G. Pugh, Jennifer Stinson, Roanne Thomas, Sara Ahmed, Ciarán M. Duffy, Prinon Rahman, Inmaculada C. Àlvarez-Gallardo, Laurianne Loew, Gino De Angelis, Debbie Ehrmann Feldman, Annette Majnemer, Isabelle J. Gagnon, Désirée Maltais, Marie-Ève Mathieu, Glen P. Kenny, Susan Tupper, Kristi Whitney-Mahoney, Sarah Bigford
ObjectiveTo create guidelines focused on the use of structured physical activity (PA) in the management of juvenile idiopathic arthritis (JIA).Data SourcesA systematic literature search was conducted using the electronic databases Cochrane Central Register of Controlled Trials, Medline (Ovid), EMBASE (Ovid), and Physiotherapy Evidence Database (PEDro) for all studies related to PA programs for JIA from January 1966 until December 2014, and was updated in May 2015.Study SelectionStudy selection was completed independently by two reviewers. Studies were included if they involved individuals between the ages of 0 to ≤ 21 diagnosed with JIA taking part in therapeutic exercise or other physical activity interventions for which effects of various disease-related outcomes are compared to a control group (e.g. no physical activity program or activity of lower intensity).Data ExtractionTwo reviewers independently extracted information on interventions, comparators, outcomes, time period, and study design. The statistical analysis was reported using the Cochrane collaboration methods. The quality of the included studies was assessed according to the PEDro scale.Data SynthesisFive randomised controlled trials (RCTs) fit the selection criteria and, of these, 4 were high-quality RCTs. The following recommendations were developed: 1) Pilates for improving quality of life (QoL), pain, functional ability and range of motion (ROM) (grade A); 2) home exercise programme for improving QoL and functional ability (grade A); 3) aquatic aerobic fitness for decreasing the number of active joints (grade A); and 4) and cardio-karate aerobic exercise for improving ROM and number of active joints (grade C+).ConclusionsThe Ottawa Panel recommends the following structured exercises and physical activities for the management of JIA: Pilates, cardio-karate, home and aquatic exercises. Pilates showed improvement in a higher number of outcomes.



from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/2heWItL
via IFTTT