A PT evaluation measures and establishes a baseline for joint range of motion, muscle strength, muscle bulk, physical activity and fitness, coordination, and neuromuscular function. PTs look at activities children do or want to do, identify any physical limitations and try to address those deficits.

Adaptive equipment may be used both in PT and OT including splints which can help keep joints in correct position, relieve pain and help stretch muscles and other soft tissues that have been shortened due to the disease. Assistive devices can help a child with daily activities like eating, dressing, bathing or writing. Custom molded in-shoe orthoses may help to relieve a child’s foot and leg pain while walking.

There are always at home exercises to do with OT and PT and, depending on the child’s condition, regular or periodic direct therapy sessions. For instance Klepper’s home program for a child with moderately active disease and stiffness but good range of motion might include daily range of motion exercises at night during or after a bath and in the morning in bed to offset stiffness. She’d give two or three strengthening activities to do during the day. She’d give older kids straight strengthening exercises while for young kids she’d devise play activities to get the job done.

Range-of-motion exercises keep joints flexible. Strengthening exercises build muscle, strength and endurance plus can help support weak joints. Kids with JIA should also strive to meet health guidelines that recommend an hour of daily moderate physical activity.

Best of Both

The optimum situation occurs when medication and exercise therapy work together to provide the best outcome for the child. “Just as kids with JIA need very specific pharmacologic management, they need specific instruction in exercise to try to get them to a good level of function with the emphasis on leading as normal, healthy, and active a life as possible,” concludes Klepper.

10 Tips for Sticking With the Program

Though it’s clear that PT, OT and exercise are beneficial, getting kids to adhere to a program can be difficult. Klepper and Shahum offer some strategies:

  • Go to therapy appointments with your child so you know exactly what she's being asked to do. Request take home illustrations.
  • Consider setting up a reward system to build motivation. Perhaps make a sticker board where you give a prize once your child earns a certain number of stickers.
  • Have your child set a goal that is important to her with the therapist.
  • Make sure the entire family knows of the child’s exercise plan. Family should be the strongest support system.
  • Set aside time in your child’s schedule for exercise each day. This way it’s less likely to be pushed aside.
  • Have your child keep an exercise log or journal.
  • Encourage your child to have a training buddy, whether it’s a sibling, friend or you.
  • Change up exercise options to keep things fresh. Take a nature hike, play the Wii or similar game, swim, or walk the mall when it rains.
  • Even when your child is sore or achy, stretching is beneficial. Try not to let her completely skip a day.
  • If your child likes watching DVDs, ask your therapist to videotape your child doing her exercises. Most kids like watching themselves.