Stretching and strengthening exercises for juvenile rheumatoid arthritis

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Stretching and strengthening exercises for juvenile rheumatoid arthritis

Stretching and strengthening exercises can help a child who has juvenile rheumatoid arthritis (JRA) control pain and stiffness and maintain mobility. A physical therapist can help determine how much exercise is appropriate for each child.

Stretching exercises are those in which the joints are moved through bent and straight positions without working the muscles against any resistance or weights, and the muscles are gently stretched. This type of exercise is designed to maintain the normal range of motion of a joint and can be done by a physical therapist or parent for infants or toddlers. Older children can do these exercises themselves. This type of exercise should be done even when a child has acute inflammation and pain, as it is essential to help prevent joint contractures.

Strengthening exercises are designed to maintain or improve strength. Strength is important for preventing osteoporosis (loss of bone mass and strength) and for promoting good joint health. Muscle strength is an important part of your child's ability to exercise effectively.¹ Children must do these exercises themselves. There are two types of strengthening exercises:

• Isometric exercises tighten the muscles without moving the joint. During an acute flare of arthritis, mild isometric exercises are helpful to attempt to maintain muscle strength.
• Isotonic exercises are those in which the child moves the joint through bent and straight positions. Isotonic exercises can be done with or without weights. When arthritis is less active, isotonic exercises can help regain or improve muscle strength.

When children with JRA have less active disease, they should be encouraged to maintain aerobic conditioning through swimming, bicycling, low-impact aerobics, walking, or dancing. Conditioning or aerobic exercises involve a level of intensity and duration to increase endurance and provide cardiovascular fitness.

References

Citations

1. Takken T, et al. (2002). Aerobic exercise testing in juvenile rheumatoid arthritis patients. Clinical Exercise Physiology, 4(1): 38–43.

Credits

Last updated:	June 25, 2008
Author:	Shannon Erstad, MBA/MPH
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Stanford M. Shoor, MD - Rheumatology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC