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Background: Body posture is defined as relative biomechanical alignmentof body’s head, trunk, and extremities as well as position of the body inthe space. Body posture might be altered due to different musculoskeletalpathologies. Juvenile Idiopathic Arthritis (JIA) is a chronic inflammatory diseasecharacterized by musculoskeletal problems including bone and musclegeometry alterations which may lead a deteriorated posture. However, it isnot known whether trunk muscle endurance is associated with body posturein children with JIA.Objectives: To investigate the relationship between postural changes and trunkmuscle endurance in children with JIA.Methods: Thirty-four children (eighteen female, sixteen male) were included inthe study. Postural changes were assessed by a three-dimensional evaluationsystem (PosturePrint System, Biotonix, Canada). The system provides PostureIndex (PI) score which is a composite score from three postural regions includinghead, ribcage, and pelvis. Higher PI scores indicate a more deterioratedposture. Biering–Sørensen Test (BST), Flexor Endurance Test (FET), LateralEndurance Test (LET) were used to assess trunk muscle endurance, and StaticScapular Endurance Test (SSET) were used to assess scapular muscle endurance.Spearman Rank Correlation test was employed to determine the possiblerelationships.Results: Enthesitis related arthritis was the most common JIA subtype in thestudy (38.2%) followed by oligoarthritis (26.5%), polyarthritis (20.6%), and systemicarthritis (14.7%). Significant negative correlations were detected betweenSSET and PI-head score (rho= -0.467, p=0.005), SSET and PI-ribcage score(rho= -0.381, p=0.026); FET and PI-head score (rho= -0.469, p=0.005); LET andPI-head score (rho= -0.441, p=0.009).Conclusion: These results indicated that postural displacements of head andribcage are linked with decreased trunk and scapular muscle endurance in childrenwith JIA. Exercise and physical activity programs targeting muscle endurancemay result improvements in posture in these children.

Background: Distal stabilization is an essential component for high qualityproximal movement. In this regard, scapular stabilization is important for upperextremity and hand functions. Moreover, scapular stabilization might have a roleas a support point for hand functions in patients with joint problems. However,the relationships between scapular stabilization and hand functions were notinvestigated in children with juvenile idiopathic arthritis (JIA).Objectives: To investigate the relationship between scapular stabilization andhand function in children with JIA with wrist arthritis history (JIAWrist+), and childrenwith JIA without wrist arthritis history (JIAWrist-).Methods: A total of forty children (20 children for each group) were included inthe study. Scapular stabilization was measured by using scapular muscle endurancetest. General functional status, subjective hand functions, and objectivehand functions were assessed by using Childhood Health Assessment Questionnaire(CHAQ), Duruoz Hand Index, and Purdue Pegboard Test, respectively.Results: JIAWrist+ patients reported poorer hand functions compared to JIAWrist-patients. No significant differences were detected for other parameters. Scapularmuscle endurance was moderately related to CHAQ Disability Index score,Purdue Pegboard Test (single hand score and assembly score) in JIAWrist+patients, while there was only a significant relationship between scapular muscleendurance and Purdue Pegboard Test both hand score in JIAWrist- patients.Conclusion: According to our results, scapular endurance was found morerelated to hand functions in wrist involved JIA patients. It seems that scapularstabilization contributes to hand functions differently related to joint involvementin JIA patients. It might be a beneficial strategy to work on scapular muscles inJIA patients with wrist involvement and poor hand functions.

Background: Joint position sense is a marker of proprioception and is definedas being aware of the body position and individual body parts in the space. Positionsense in the wrist joint is especially important for the manual dexterity. A possible damage due to arthritis may lead a decrease in joint position sense.However, the status of joint position sense was not investigated in children withjuvenile idiopathic arthritis (JIA).Objectives: To compare the wrist position sense and a motor performancetest related to manual dexterity among children with JIA with wrist arthritis history(JIAWrist+), children with JIA without wrist arthritis history (JIAWrist-), andhealthy controls.Methods: A total of sixty children (20 children for each group) were includedin the study. Wrist joint position sense was evaluated by measuring joint re-positionerror. The wrist was passively placed in a pre-determined position (30ofor flexion, 30o for extension, 10o for radial deviation, and 15o for ulnar deviation).Then passively was returned to baseline position. The patient was askedto reposition their wrist into the target degree actively. The absolute error indegrees between each position and reposition was calculated. Manual dexteritywas evaluated by using Purdue Pegboard Test. The test was repeatedthree times and the average number of the correctly placed pines was usedin the analysis.Results: Joint position sense (in all directions except radial deviation) andmanual dexterity (except assembly) was found negatively affected in JIAWrist+patients compared to healthy controls. No differences (except radial deviation)were observed between JIAWrist- patients and healthy controls.Conclusion: Joint position sense and related manual dexterity is diminishedin JIA patients with wrist involvement. The results of this study suggested thatchildren with wrist arthritis should be followed with special attention focusingon manual abilities. Hand therapy programs might help improving joint positionsense acuity.