1 Cavallo, et al: Leisure in JIA Personal non-commercial use only. The Journal of Rheumatology Copyright © 2015. All rights reserved. Participation in Leisure Activities by Children and Adolescents with Juvenile Idiopathic Arthritis Sabrina Cavallo, Annette Majnemer, Ciarán M. Duffy, and Debbie Ehrmann Feldman ABSTRACT. Objective. To describe leisure activities of children and adolescents with juvenile idiopathic arthritis (JIA) in terms of diversity, intensity, and enjoyment, and to identify potential determinants. Methods. One hundred seven children and adolescents aged 8–17 years diagnosed with JIA and their families participated in this cross-sectional study. Participants answered the Children’s Assessment of Participation and Enjoyment, which measures involvement in leisure (recreation, active physical, social, skill-based, self-improvement). Disease characteristics and sociodemographic factors were abstracted from the child’s medical file. Results. In terms of intensity, individuals with JIA were more often engaged in informal rather than formal leisure activities [t(106) = 45.5, p < 0.0001]. When intensity scores were compared across activity type, results showed that participants with JIA were most often involved in social and recre- ational activities (p < 0.001). The level of enjoyment was highest for social activities and lowest for self-improvement activities (p < 0.001). Those with active arthritis displayed less diverse (p = 0.016) and less intense (p = 0.011) participation in active physical activities, and less frequent involvement in informal activities (p = 0.043) compared with those who were asymptomatic. Conclusion. Children and adolescents with JIA tend to participate more in sedentary types of activities. Greater disease activity may dissuade children and adolescents from participating in more active pursuits, which places them at greater risk for adopting sedentary lifestyles. The identification of determinants of leisure activities in children and adolescents with arthritis may allow healthcare profes- sionals to assess children’s health needs with more precision and promote a healthier lifestyle. (J Rheumatol First Release June 15 2015; doi:10.3899/jrheum.140844) Key Indexing Terms: JUVENILE IDIOPATHIC ARTHRITIS PARTICIPATION LEISURE ACTIVITIES From the Département de Médecine Sociale et Préventive, École de Santé Publique, and Institut de Recherche en Santé Publique, and École de Réadaptation, Faculté de Médecine, Université de Montréal; Montreal Children’s Hospital, McGill University Health Center; Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Institut de Réadaptation de Montréal; School of Physical and Occupational Therapy, McGill University; Public Health Department, Montréal, Québec; and Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada. Supported by the Canadian Initiative for Outcomes in Rheumatology Care. Graduate financial support for the first author Sabrina Cavallo was provided by l’École de Santé Publique de l’Université de Montréal, the Canadian Arthritis Network, the programme MENTOR of the Canadian Institutes in Health Research, and the Fonds de Recherche du Québec - Santé. S. Cavallo, MSc, BSc(OT), École de Santé Publique, and Institut de Recherche en Santé Publique, Université de Montréal, and Montreal Children’s Hospital, McGill University Health Center, and Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Institut de Réadaptation de Montréal; A. Majnemer, PhD, OT, Montreal Children’s Hospital, McGill University Health Center, and School of Physical and Occupational Therapy, McGill University; C.M. Duffy, MD, Children’s Hospital of Eastern Ontario; D. Ehrmann Feldman, PhD, PT, École de Santé Publique, and Institut de Recherche en Santé Publique, and École de Réadaptation, Faculté de Médecine, Université de Montréal, and Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Institut de Réadaptation de Montréal, and Montreal Children’s Hospital, and Public Health Department. Address correspondence to S. Cavallo, C.P. 6128, succursale Centre-ville, Montréal H3C 3J7, Québec, Canada. E-mail: sabrina.cavallo@umontreal.ca Accepted for publication March 3, 2015. Juvenile idiopathic arthritis (JIA), the most common chronic childhood autoimmune disease, is a heterogeneous inflam- matory condition with periods of unpredictable flare and remission, and no known cure 1 . During periods of joint inflammation (i.e., active disease) children experience increased pain, fatigue, tender joints, and morning stiffness, which may interfere with age-appropriate activities (physical, self-care, and leisure) both at home and at school 2,3 . Cardio- respiratory fitness, muscle strength, and participation in leisure physical activity may be limited in children with JIA in comparison with their healthy peers 4,5,6,7,8,9,10 . Involve- ment in leisure activities is of critical importance in childhood and adolescence to maintain a fit lifestyle, to form friend- ships, and to refine life skills needed throughout adulthood, as well as to develop social contacts 11 . Participation is defined by the World Health Organization (WHO) as the “involvement in life situations” 12 . During childhood and early adolescence, time spent outside of school is devoted to play and leisure, making participation in leisure activities a primary role of childhood 13 . Engaging in leisure activities offers the child and teenager ample opportunity to take part in challenging and focus-oriented activities, as well as to acquire cognitive and social skills important for development 14,15 that can contribute to better www.jrheum.org Downloaded on September 30, 2022 from