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Measurement of Quadriceps Muscle Strength and Bulk in Juvenile Chronic Arthritis: A Prospective, Longitudinal, 2 Year Survey
Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
1998 (English)In: Journal of Rheumatology, ISSN 0315-162X, Vol. 25, no 11, 2240-2248 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: In a prospective survey over a 2-year period we studied strength and bulk of the quadriceps muscle in the thighs of children with juvenile chronic arthritis (JCA). METHODS: Every third month for 2 years we measured isometric muscle strength in knee extensors with a hand-held dynamometer in 20 children with JCA. Ultrasound equipment was used to measure thigh muscle bulk. A joint evaluation was made using a standard severity score. The children had their ordinary medical treatment and physiotherapy during the observation period. RESULTS: Children with high severity scores in the knee or hip had least strength and muscle bulk. In the 4 children with the highest severity scores muscle strength was reduced to half of that expected. In 10 of the children there were clear variations in severity scores during the study period, for either better or worse. In these children an increase in the severity score correlated significantly with reduction in muscle strength and bulk (p < 0.05). The muscle strength and bulk changed in parallel in these children. Other factors, although not independent, such as polyarticular JCA, long duration of disease, and steroid treatment, also reduced muscle strength. CONCLUSION: The presence and intensity of local arthritis is one important factor affecting muscle function in JCA. Normal muscle strength and bulk is rapidly lost near an inflamed joint. It is difficult to maintain or achieve normal muscle function in the presence of active arthritis despite medical and physical treatment. We assume that the muscle weakness is in part caused by atrophy of the muscle, which is influenced by local arthritis.

Place, publisher, year, edition, pages
1998. Vol. 25, no 11, 2240-2248 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-13645OAI: diva2:21105
Available from: 2004-05-27 Created: 2004-05-27 Last updated: 2009-08-19
In thesis
1. Muscle function in Juvenile Idiopathic Arthritis: A two-year follow-up
Open this publication in new window or tab >>Muscle function in Juvenile Idiopathic Arthritis: A two-year follow-up
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This is a study of muscle function in Juvenile Idiopathic Arthritis (JIA). Rheumatoid arthritis (RA) is a disease that primarily affects the synovial membrane of joints. Muscle weakness, atrophy and pain occur in adult RA. This may be a consequence of joint pain, stiffness and immobility. Muscle inflammation and neuropathy occur as complications in adults. Muscle function in JIA has been much less studied.

The aim of the study was to examine whether muscle weakness and atrophy also occur in children with JIA.

This was a longitudinal study over a two-year period, where muscle strength and thickness were measured repeatedly in a group of 20 children and teenagers with JIA. Muscle strength was measured using different methods and in several muscle groups. Muscle biopsies were obtained and nerve conduction velocity studies performed.

The study concludes that, compared to healthy people, children and teenagers with JIA have as a group reduced muscle strength and muscle thickness. For most of these children and teenagers, muscle strength is only slightly lower than expected, but a few have marked muscle weakness. This is most apparent in patients with severe polyarthritis where the weakness seems to be widespread. Patients with isolated arthritis may also have greatly reduced strength and thickness of muscles near the inflamed joint.

There is a risk of decreasing strength in patients with polyarthritis and in muscles near an active arthritis.

Minor changes are common in muscle biopsies, and findings may indicate immunological activity in the muscles.

Atrophy of type II fibres, as in adult RA, was not found in JIA.

No patient had signs of neuropathy.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2004. 97 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 847
arthritis, juvenile rheumatoid, physiopathology, muscle, skeletal, pathology, physiopathology, Muscular atrophy, etiology, physiopathology, arthritis, juvenile rheumatoid, complications
National Category
Clinical Science
urn:nbn:se:liu:diva-5195 (URN)91-7373-819-0 (ISBN)
Public defence
2004-05-07, Viktoriasalen, Campus US, Linköpings universitet, Linköping, 13:00 (English)
On the day of the public defence the status of article IV was: Submitted.Available from: 2004-05-27 Created: 2004-05-27 Last updated: 2012-01-25Bibliographically approved

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Lindehammar, Hans
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Clinical Neurophysiology Faculty of Health SciencesDepartment of Neurophysiology UHL
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