Comprehensive Rehabilitation Approach in a Paediatric Case of Juvenile Rheumatoid Arthritis

Abstract

Background: Juvenile Rheumatoid Arthritis (JRA), also known as Juvenile Idiopathic Arthritis, is a chronic autoimmune inflammatory disorder affecting children under 16 years of age. It primarily involves synovial joints, leading to pain, stiffness, swelling, and functional limitations. Early diagnosis and multidisciplinary management, including physiotherapy, are vital for preventing deformities and improving functional outcomes.
Case Presentation: A 10-year-old female child diagnosed with polyarticular JRA presented with pain and stiffness in bilateral knees, wrists, and ankles, along with morning stiffness and difficulty in performing daily activities. Assessment revealed restricted joint range of motion, muscle weakness, and functional dependency. A six-week physiotherapy intervention program was designed, incorporating pain management modalities, range of motion and strengthening exercises, hydrotherapy, gait training, and caregiver education.
Results: After six weeks of structured physiotherapy, the patient demonstrated significant improvement in pain (VAS reduced from 6/10 to 2/10), knee flexion (increased from 90° to 120°), muscle strength (quadriceps improved from grade 3/5 to 4+/5), and walking tolerance (increased to 500 meters). Functional outcomes measured by the Childhood Health Assessment Questionnaire (CHAQ) improved from 1.8 to 0.8, indicating enhanced quality of life.
Conclusion: Early and individualized physiotherapy intervention plays a crucial role in managing Juvenile Rheumatoid Arthritis by reducing pain, maintaining joint function, improving mobility, and enhancing overall quality of life. Continuous follow-up and parent education are essential to ensure long-term functional independence and prevent disability progression.