Leisure in Children and Adolescents with Juvenile Idiopathic Arthritis: A Systematic Review

The aim of this systematic review is to describe participation in social and physical leisure activities among children and adolescents with JIA, as well as identify potential determinants of leisure participation.MethodsElectronic databases were systematically searched for articles published up until June 2013 pertaining to participation in leisure activities among youth with JIA and other rheumatic diseases. Studies were included if they measured involvement in either social or physical leisure activities. Selection and quality appraisal of articles were completed independently by two authors.ResultsEight hundred and ninety-three articles were found through electronic and reference search. One hundred and nine full articles were reviewed to assess for eligibility. Twelve articles met inclusion criteria and findings were reviewed. Most focused on describing participation in physical rather than social activities. Results suggest that youth with JIA participated less in both social and physical leisure activities as compared to healthy peers, and those with JIA did not meet national recommendations for physical activity. Potential determinants of leisure participation were socio-demographic (age, sex), anthropometric (height, weight) and disease-related (JIA subtype, disease duration, pain, number of swollen or painful joints, stiffness, fatigue, well-being) factors.ConclusionCharacterization of leisure activity remains limited and mostly focused on physical activity in JIA. Assessment of more comprehensive outcome measures is warranted to obtain a better description of leisure in this population. Evidence of the influence of contextual factors as potential determinants of involvement in leisure among children with pediatric rheumatologic diseases is needed.

本系统综述旨在描述幼年特发性关节炎（JIA, Juvenile Idiopathic Arthritis）患儿及青少年的社交与体力休闲活动参与现状，并识别影响其休闲参与的潜在决定因素。
方法：系统性检索截至2013年6月发表的电子数据库，筛选与JIA患儿及青少年、其他风湿性疾病患者的休闲活动参与相关的文献。纳入标准为研究测量了社交或体力休闲活动的参与情况。两名研究者独立完成文献筛选与质量评价工作。
结果：通过电子数据库与参考文献检索，共检出893篇文献。对109篇全文文献进行入选资格审查后，最终有12篇符合纳入标准的研究被纳入分析。现有研究大多聚焦于体力休闲活动而非社交活动的参与特征。研究结果显示，与健康同龄人相比，JIA患儿及青少年的社交与体力休闲活动参与度均显著更低，且未达到国家推荐的体力活动标准。潜在的休闲参与影响因素包括社会人口学因素（年龄、性别）、人体测量学因素（身高、体重）以及疾病相关因素（JIA亚型、病程、疼痛程度、肿胀或压痛关节数量、僵硬程度、疲劳状态、健康状况）。
结论：目前针对JIA人群休闲活动特征的研究仍较为有限，且大多聚焦于体力活动维度。未来应采用更全面的结局评估指标，以更精准地描述该人群的休闲活动现状。同时，尚需更多研究证据阐明背景因素对儿科风湿性疾病儿童休闲活动参与的影响。