PHYSIOTHERAPY IN CHILDREN WITH JUVENILE ARTHRITIS

Juvenilni idiopatski artritis (JIA) utječe na dijete u različitim aspektima i potrebno mu je višestruko liječenje. Karakterizira ga dugotrajna upala jednog ili više zglobova uz oticanje, bol i smanjenu pokretljivost. Bolest se u pravilu javlja u dječjoj dobi, prije navršene šesnaeste godine. U ovom radu donosim pregled etiologije, kliničke slike, danas dostupnog medikamentoznog liječenja, fizioterapijskih i kineziterapijskih intervencija. Bez pravovremenog i adekvatnog liječenja bolest napreduje i rezultira dugoročnim promjenama na zglobovima. Fizioterapijski modaliteti, hidroterapija i terapija vježbom može poboljšati funkciju, kvalitetu života i tjelesnu kondiciju te smanjiti bolnost. U akutnoj fazi fizioterapeutu je prioritet smanjiti bolnost i otok koristeći imobilizaciju zgloba, hladne obloge, te očuvati opseg pokreta. Nakon akutne faze terapija sad ai uključuje na vježbe jačanja zahvaćenih mišića, vježbe istezanja, propriocepcije, školu hoda itd. U remisiji bolesti dijete se motivira da se nastavi baviti sportom koji mu najviše odgovara. Cilj suvremenog liječenja reumatskih bolesti u dječjoj dobi, osim suzbijanja boli i upale jest spriječiti nastanak nepovratnih promjena tkiva i zgloba, trajne invalidnosti te postizanje remisije bolesti.Juvenile idiopathic arthritis (JIA) has an effect on a child in a variety of different aspects and it requires multiple treatments. It is characterized by long-term inflammation of one or more joints with swelling, pain and decreased mobility. Typically, this illness occurs in childhood before turning 16 years. In this piece of work I am providing the overview of etiology, clinical picture, currently available medical treatment, physiotherapy and kinesitherapy interventions. Without appropriate and promptly treatment the illness prospers and manifests with long-term changes of the joints. Physiotherapy treatments like hydrotherapy and physical therapy can improve the function, quality of life, physical condition and reduce the pain. During the acute phase, for a physiotherapist it is a priority to lower the pain and swelling using joint immobilization, cold compresses and maintaining the range of motion. After the acute phase, the therapy involves combination of strengthening and stretching exercises, proprioceptive exercises, learning how to walk, etc. During the remission, the child is motivated to continue to engage in sport that suits the child the best. The goal of the modern treatment of rheumatic diseases in the childhood, except pain control and inflammation, is to prevent the formation of irreversible changes of the tissue and the joints, permanent disability and accomplishing to achieve remission of the disease