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Hand strength in juvenile chronic arthritis: a two-year follow-up
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.
2003 (English)In: Acta Paediatrica, ISSN 0001-656X, Vol. 92, no 11, 1291-1296 p.Article in journal (Refereed) Published
Abstract [en]

AIM: To describe changes in muscle strength in the hands of children with juvenile chronic arthritis (JCA) and to examine the relationship between muscle strength, presence of local arthritis and disease subtype.

METHODS: Twenty children (10 girls and 10 boys) with JCA aged 7 to 18 y were followed for two years. Isometric muscle strength in wrist dorsiflexors and handgrip strength were measured repeatedly. The results were compared with reference values for the same methods. Arthritis severity in the hand was scored every third month. Nerve conduction velocities were measured twice.

RESULTS: Seven out of 20 patients had initially low or decreasing strength in one or both of the two tests. Five out of 20 children had reduced strength (more than two standard deviations below the mean of the reference group) in at least one test. Four children showed a significant reduction in muscle strength in at least one test during the observation time. The greatest reduction in strength was measured in four children with polyarticular disease. These children also had local arthritis in the hand. A greater proportion of children with polyarthritis had low or decreasing strength compared with children with oligoarthritis. The same was true for children with active arthritis in the hand. Nerve conduction velocities were normal in all cases and did not change.

CONCLUSION: The majority of children with JCA have normal strength in the hand. Some children, especially those with polyarthritis and hand arthritis, have reduced muscle strength in the hand. Risk factors for low or decreasing strength are polyarthritis and/or active arthritis in the hand.

Place, publisher, year, edition, pages
2003. Vol. 92, no 11, 1291-1296 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-13646DOI: 10.1080/08035250310006340OAI: diva2:21106
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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