exercise: to rest is to rust
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Juvenile Arthritis Conference 2011
Exercise: To Rest Is To Rust
Jennifer Horonjeff, MS, PhD Candidate [email protected]
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!