exercise: to rest is to rust

Juvenile Arthritis Conference 2011

Exercise: To Rest Is To Rust

Jennifer Horonjeff, MS, PhD Candidate jhoronjeff@gmail.com

Program of Ergonomics and Biomechanics Occupational & Industrial Orthopaedic Center

New York University

A little bit of history….

Bone

Responds to physical demand

Bone mineral density improves with exercise

Muscle

Significantly reduced muscle mass and strength!

Cartilage

Cyclical loading shown to have anti-inflammatory properties and may dampen cartilage destruction.

Motor Control

Delays in development

•  Reaction Time

•  Muscle activation strategies

•  Proprioception

•  Postural stability

People with JIA who exercise regularly, complain of fatigue less!

Energy and Endurance

A different way of movin’

Atypical gross motor function WHY??

Gait pattern differences

Energy expenditure vs. PAIN!

Need for Exercise

Remediate these deficiencies

Kids with JIA are significantly under the recommended levels!

Psychosocial

Exercise not just for the body!

Without Exercise

Goals

During a flare: PRESERVE!

When under control: Improve fitness and participation in activities

What does the child want to do?

What are the physical demands?

Does the child have the “resources” to meet these demands? If not—can they be remediated?

Are coaches, teachers, etc aware of child’s condition and willing to allow “self-limit” participation?

How to choose the right activities

Types of Exercise

Strength-conditioning Alone not able to bolster bone mineral density

Dynamic high-intensity exercise Reduction of disease activity greater than usual care

Non-weight bearing exercises Best when baseline radiologic damage exists

Hydrotherapy Some people have experienced feeling better than did with land exercises

Increased disease activity and radiologic damage NOT caused by long-term high-

intensity weight-bearing exercise

Actually less pronounced in this form of exercise than those who received physical

therapy!!

Is it safe?

Video Games

Not all bad!!

Thank You!

So, get up…

…and get moving!