Adherence to exercise therapy among children and adolescents with Juvenile idiopathic arthritis: a scoping review

Abstract

Purpose

To identify parameters and measurement methods of exercise therapy adherence, as well as barriers and facilitators affecting adherence among children and adolescents with juvenile idiopathic arthritis (JIA).

Methods

Studies were eligible for inclusion if patients were 0–18 years of age, had JIA, and the focus of the research was on exercise therapy patterns, measurement/parameters of exercise adherence, and barriers/facilitators for exercise adherence. Two reviewers independently identified and categorized the barriers and facilitators to exercise therapy adherence using the International Classification of Functioning, Disability, and Health (ICF).

Results

Twenty articles were included in this review. Among patients with JIA, 29%–99% adhered to exercise therapy. The most commonly measured parameters of adherence were session completion and behavior component, with a self-report log serving as the most common means of assessment. Time pressure, symptoms related to JIA, lack of enjoyment, and insufficient motivation were the main barriers. Facilitators were commonly identified as adequate motivation, effective symptoms management, and social support.

Conclusions

Future interventions should consider the identified factors to promote exercise engagement in children and adolescents with JIA. Strategies for promoting exercise adherence in children and adolescents with JIA is needed.

Implications for Rehabilitation

• Despite its potential as an effective means of improving health and function in patients with juvenile idiopathic arthritis (JIA), the level of exercise participation in this population is not ideal.

• Future interventions should focus on improving personal factors associated with exercise therapy adherence, such as motivation.

• To facilitate the participation in the exercise of children and adolescents with JIA, supportive exercise environments should be provided.

Keywords:

• Juvenile idiopathic arthritis
• exercise therapy
• adherence
• facilitators
• barriers

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Shanghai Jiao Tong University Medical School Science and Technology Fund Project [Grant No. Jyh2106] and Science and Technology Project of Nantong City [Grant No. MSZ19191].