Physical conditioning in children with arthritis. Assessment and guidelines for exercise prescription

Objective. To review the literature in the area of physical fitness and conditioning programs for individuals with chronic illnesses, and increase the awareness of the need to include fitness testing and conditioning programs in the therapeutic management of children and adolescents with chronic arthritis. Methods. This article provides a review of original research reports, information from principal texts, and review articles related to physical fitness testing and training in children. Results. Several factors limit the exercise capacity of children with chronic arthritis, and studies report that these children have lower aerobic endurance and muscle performance than their peers. Preliminary studies suggest that fitness testing is safe for most children with arthritis, and physical conditioning programs, which appear to benefit adults with arthritis and children with other chronic illnesses, may also benefit children with arthritis. Easily administered, inexpensive field tests of fitness are available. Guidelines for prescribing physical conditioning programs are provided. The risks and benefits of increased exercise are discussed. Conclusions. Assessment of exercise capacity and muscle function and individualized prescription of physical conditioning programs are indicated for children with chronic arthritis, soon after diagnosis.