Juvenile Idiopathic Arthritis: Exploring Patient, Parent, and Physical Therapist Perspectives on Physical Activity, Kinesiophobia and Physical Therapy Intervention

Abstract

Juvenile Idiopathic Arthritis (JIA) is the most common rheumatic condition with an unknown etiology affecting children and adolescents under the age of 16. It can lead to short-term and long-term disabilities. Despite having a low disease activity score, children with JIA often exhibit low levels of physical activity, and pain. This is a significant concern for these children. While physical therapy is well-documented to improve physical activity and function in adults with arthritis, there is insufficient evidence to support its benefits specifically for JIA. To explore physical activity, kinesiophobia and physical therapy intervention two survey-based studies were conducted: one focusing on the perspectives of parents and children, and the other on the perspectives of physical therapists. In the first study, parents reported that their children had reduced levels of physical activity, and only a few children received physical therapy. These findings confirm previous research reporting reduced physical activity in children with JIA. The parents expressed varying degrees of willingness—neutral, likely, or very likely—to consider physical therapy as a treatment option for their child. Additionally, this study is one of the few that explored kinesiophobia in these children; however, the results were inconclusive. The positive response from parents regarding the potential of physical therapy highlights their openness to non-pharmacological management and their recognition of the potential value of physical therapy in improving their childs physical activity levels. When parents are actively involved and supportive of physical therapy, children are more likely to adhere to treatment plans and engage consistently in physical activity leading to better outcomes and long-term benefits. In the second study, physical therapists noted that their knowledge of pediatric rheumatology is limited, which affects their ability to effectively treat the patients. To address pain-related questions, therapists utilized a combination approach, considering input from both the parents/guardians and the child. Parents/guardians will be referred to as “parents” from this point forward. The PTs and PTAs used various treatment strategies to improve physical function and quality of life, including manual therapy. Early referral to physical therapy may enhance physical activity, manage pain, and improve the overall quality of life for children with JIA.