Juvenile Rheumatoid Arthritis. Part 3

Recent findings indicate that exercise, especially with resistance, can improve JRA symptoms even more than previously believed.

Exercise

Prevents loss of joint movement.
Regains lost motion.
Encourages normal growth.
Improves endurance, making everyday activities easier.
Helps develop confidence.
Occupational and physiotherapy include a daily exercise routine. Sticking to this is critical for JRA sufferers, who should have all their joints moved each day to reduce tightness and allow healing. This can be difficult, especially when a child’s joints hurt. Persistence, encouragement and a positive attitude are essential.
Imagination and play can make exercise more fun. Allowing the child to set his own limits also helps. Remember: in children (unlike adults), cartilage and bone can still grow with exercise!

Splinting is another cornerstone of JRA treatment. There are two types of splints.

Resting splints:

Hold inflamed joints in the correct position during sleep.
Help prevent, and can gradually correct, deformity.

Working splints:
Support and assist during daytime activities.
Protect inflamed joints.
Provide pain relief.

If splints embarrass a child, it may help to have the teacher discuss the reasons for wearing them with the class.
Rest
Children need extra down time during a flare-up to prevent more serious complications. However, staying in bed all day promotes stiffness and loss of mobility, so even very ill children should be moved through as full a range of movement as possible.

Diet
Chronic disease puts increased demands on little bodies. Plenty of nutritious calories are vital, even when kids have no appetite, or painful joints and jaws make eating difficult.

Encourage your child to eat a well-balanced diet at regular intervals.
Make each bite count by offering highly nutritious foods.
Increase nutrient content by adding high-calcium cheese or milk to foods. (See sidebar)
Medication side effects and limited activity can cause weight gain (and extra stress on joints). Fight this by avoiding “empty,” fattening foods such as sweets and junk food.

There is no cure for juvenile arthritis yet. However, thanks to so many effective therapies, a child with JRA is no longer sentenced to a lifetime of pain and disability. He can now manage the disease well, limit its effects and grow up to live a healthy, productive life. It is not an easy road, but a child who has met this challenge grows up to be a strong and unique individual.

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