Background Juvenile Idiopathic Arthritis (JIA) has reportedly been associated with decreased physical activity (PA) but accurate, objective measurements of PA related to potential factors limiting PA in children with JIA have been lacking. Joint pain is a primary symptom of JIA and pain has been shown to be a significant predictor of impaired physical and psychosocial function in these patients. It could therefore be anticipated that pain would explain the decreased PA in JIA. The use of pain-coping strategies and pain-specific health beliefs in children with JIA has previously been found to be associated with both clinical and experimental pain reports. Beliefs about a stressor such as pain are thought to influence an individual's coping responses. We have previously reported that cognitive health beliefs were significantly associated with pain in children with JIA even after controlling for disease related variables and pain coping.
Objectives To relate accelerometer-assessed PA to disease activity, report of pain intensity, the use of pain coping strategies and pain-related health beliefs in children with JIA.
Methods PA was assessed using the hip-worn GT1M Actigraph accelerometer during wakening hours for one week, providing at least 3 separate days of each 8 hours of valid recording accelerometer in JIA patients using 10 sec. count-time periods (epochs). Demographic, disease- and pain-related parameters, pain coping questionnaire (PCQ) and pain-specific health beliefs using the survey of pain attitudes for children (SOPA-C) were simultaneously obtained.
Results Accelerometer data of 61 JIA patients (60.7%) were available for analysis. Accelerometer values of mean counts per minute (c/min), minutes with moderate and high PA (>1000 c/min) and high PA (>2500 c/min) were significantly lower in patients than normative values. Disease activity, expressed as JADAS27, was negatively correlated to accelerometer counts. However, PA assessed by accelerometer was neither correlated to the patient's pain report nor to the pain coping strategies. Changes in accelerometer counts were significantly correlated to cognitive health beliefs measures reflecting beliefs that one is in control over pain (“Control”) but not to other pain-specific health beliefs. In a hierarchical regression analysis “Control” did not explain a significant unique part of the variance when controlling for JADAS27, whereas JADAS27 significantly explained 23-27% of the variance when controlling for the health belief “Control”.
Conclusions Accelerometer-assessed PA-levels of JIA-children were significantly lower than those of normative controls and were negatively correlated to JADAS27. Accelerometer-assessed PA-levels were not correlated to pain or pain coping strategies but significantly correlated to cognitive health beliefs that one is in control over pain (“Control”).
Disclosure of Interest None declared