Exercise: To Rest is To Rust

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Exercise: To Rest is To Rust

  1. 1. Juvenile Arthritis Conference 2011Exercise: 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
  2. 2. A little bit of history….
  3. 3. BoneResponds to physical demandBone mineral density improves with exercise
  4. 4. MuscleSignificantly reduced muscle mass and strength!
  5. 5. CartilageCyclical loading shown to have anti-inflammatoryproperties and may dampen cartilage destruction.
  6. 6. Motor ControlDelays in development•  Reaction Time•  Muscle activation strategies•  Proprioception•  Postural stability
  7. 7. Energy and Endurance People with JIA who exercise regularly, complain of fatigue less!
  8. 8. A different way of movin’ Atypical gross motor function WHY?? Gait pattern differences Energy expenditure vs. PAIN!
  9. 9. Need for ExerciseRemediate these deficienciesKids with JIA are significantly under the recommended levels!
  10. 10. PsychosocialExercise not just for the body!
  11. 11. Without Exercise
  12. 12. GoalsDuring a flare: PRESERVE!When under control: Improve fitness and participation in activities
  13. 13. How to choose the right 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?
  14. 14. 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 HydrotherapySome people have experienced feeling better than did with land exercises
  15. 15. Is it safe? 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!!
  16. 16. Video GamesNot all bad!!
  17. 17. Thank You!
  18. 18. So, get up……and get moving!

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