Rheumatology International

, Volume 39, Issue 1, pp 59–65 | Cite as

The effects of 8-week water-running program on exercise capacity in children with juvenile idiopathic arthritis: a controlled trial

  • Deniz BayraktarEmail author
  • Sema Savci
  • Ozge Altug-Gucenmez
  • Egemen Manci
  • Balahan Makay
  • Nursen Ilcin
  • Erbil Unsal
Clinical Trials


Exercise capacity has been reported to be lower in children with Juvenile Idiopathic Arthritis (JIA). Therefore, the aim was to investigate the effects of an 8-week water-based exercise program on exercise capacity in children with JIA. Forty-two children with JIA were divided into two groups as: exercise group [n = 21, water-running, moderate-intensity exercise (60–70%), two times/week], and control group (n = 21, no additional treatment other than the prescribed medication). All children were assessed at baseline and post-intervention in terms of physical and disease-related characteristics, pain at rest and in activity (visual analog scale), range of motion (Escola Paulista de Medicina Range of Motion Scale), aerobic exercise capacity (cycle ergometer), and anaerobic exercise capacity (Wingate Test). Anaerobic exercise capacity was found to be improved in the exercise group [baseline: 5.54 W/kg (IQR 25/75: 4.07/6.88 W/kg) vs. post-intervention: 6.0 W/kg (IQR 25/75: 4.8/7.4 W/kg), p = 0.002], while no improvements were observed in the control group [baseline: 5.29 W/kg (IQR 25/75: 4.75/5.85 W/kg) vs. post-intervention: 5.5 watts/kg (IQR 25/75: 5.0/6.1 W/kg), p = 0.076]. The amount of the changes related to anaerobic exercise capacity were higher in the exercise group [exercise group: 0.6 W/kg (IQR 25/75: 0.3/1.3 W/kg) vs. control group: 0.2 W/kg (IQR 25/75: − 0.1/0.5 W/kg), p = 0.024]. No changes were detected related to aerobic exercise capacity in any of the groups (p > 0.05). An 8-week water-running program might be beneficial to improve anaerobic exercise capacity, but it is not enough to improve the aerobic exercise capacity in children with JIA.


Arthritis Child Exercise 


Author contributions

DB: study design, data management, analysis, interpretation, and writing. SS: study design, interpretation, and writing. OA-G: data management. EM: data management. BM: data management, and writing. NI: study design and interpretation. EU: study design, data management, and writing.


The present study was supported by The Scientific and Technological Research Council of Turkey (TUBITAK) within the scope of 2211-A General National Scholarship Program for PhD Students.

Compliance with ethical standards

Ethical approval

Children and the families were informed, and their informed consents were obtained prior to the study. The ethical approval was obtained at 30.06.2016 under the protocol number of 1958-GOA, with the decision number of 2016/18–32 from Dokuz Eylul University Noninvasive Research Ethics Board.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Physiotherapy and Rehabilitation, Faculty of Health SciencesIzmir Katip Celebi UniversityIzmirTurkey
  2. 2.School of Physical Therapy and RehabilitationDokuz Eylul UniversityIzmirTurkey
  3. 3.Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of MedicineDokuz Eylul UniversityIzmirTurkey
  4. 4.Division of Exercise Physiology, Department of Physiology, Institute of Health SciencesDokuz Eylul UniversityIzmirTurkey

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