For patients with juvenile idiopathic arthritis (JIA), lower extremity involvement, including hip and knee arthritis, is an important determinant of walking endurance, function, and quality of life (QOL), according to study results published in Advances in Rheumatology.

The aim of the study was to evaluate the effect of lower extremity involvement type on exercise, function, and QOL in peripheral predominant forms of JIA.

Patients with a history of peripheral arthritis were included in the study. Researchers collected data on patient demographics, JIA subtype, disease duration, arthritis and deformities of the lower extremities, disease activity score, as well as scores for the 6-minute walk test (6MWT), cycling exercise test (CYC-E), childhood health assessment questionnaire (CHAQ), and pediatric QOL inventory (PedsQOL).

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Mean age of patients was 12.91±2.37 years; 28.1% of patients had knee arthritis, 15.6% had foot/ankle arthritis, and 12.5% had hip arthritis. A total of 37.5% of patients were diagnosed with a lower extremity deformity.

In a regression analysis, the factors significantly associated with CHAQ and PedsQOL scores were hip and knee arthritis. Height and knee arthritis were also significantly associated with CYC-E, while the 6MWT was significantly associated with hip arthritis, knee arthritis, and demographic characteristics.

One of the study limitations included the lack of generalizabilility to patients with all types of JIA.

Researchers recommended, “Each patient should be evaluated especially in terms of these joints with clinical and, if necessary, subclinical examination.”


Kasman SA, Karaahmet ÖZ, Hastürk AB, et al. The importance of lower extremity involvement type on exercise performances, function, and quality of life in peripheral predominant forms of juvenile idiopathic arthritis. Adv Rheumatol. 2021;61(1):39. doi:10.1186/s42358-021-00195-3