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Juvenile Arthritis Conference 2011
Exercise: 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
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
Energy and Endurance



       People with JIA who exercise regularly,
       complain of fatigue less!
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
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?
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
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!!
Video Games


Not all bad!!
Thank You!
So, get up…




…and get moving!

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Exercise: To Rest is To Rust

  • 1. Juvenile Arthritis Conference 2011 Exercise: 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. A little bit of history….
  • 3.
  • 4. Bone Responds to physical demand Bone mineral density improves with exercise
  • 6. Cartilage Cyclical loading shown to have anti-inflammatory properties and may dampen cartilage destruction.
  • 7. Motor Control Delays in development •  Reaction Time •  Muscle activation strategies •  Proprioception •  Postural stability
  • 8. Energy and Endurance People with JIA who exercise regularly, complain of fatigue less!
  • 9. A different way of movin’ Atypical gross motor function WHY?? Gait pattern differences Energy expenditure vs. PAIN!
  • 10. Need for Exercise Remediate these deficiencies Kids with JIA are significantly under the recommended levels!
  • 13. Goals During a flare: PRESERVE! When under control: Improve fitness and participation in activities
  • 14.
  • 15. 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?
  • 16. 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
  • 17. 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!!
  • 19.
  • 20.
  • 21.
  • 22.
  • 24. So, get up… …and get moving!