Juvenile rheumatoid arthritis (JRA) is an autoimmune disease where the body attacks the cartilage in joints in the form of inflammation. It can affect one or many joints, and it can even affect the child’s eyes.

It is characterized by warm, red, swollen, painful joints and will typically affect the child’s fine and gross motor skills. Other signs and symptoms include the inability to fully straighten the joints of the extremities or neck.

Because these symptoms can mimic other diagnoses, like infections or injuries, JRA is sometimes difficult to diagnose. It is the training of the pediatric rheumatologists that enables them to definitively diagnose this disease.

Occupational therapy can assist these children in the form of training for activities of daily living and fine motor skills (like tooth brushing, bathing, and dressing). Hand splints can be custom made and used to regain the full motion of the affected joints, as well as to protect and support painful joints of the arm and hand.  

Splinting of the legs is typically performed by physical therapy, along with education on positioning, strengthening, measuring of leg length discrepancies and recommendations for shoe lifts if necessary.

Children with JRA are seen in the outpatient pediatric rheumatology physicians’ clinic in the Duke Children’s Hospital & Health Center and are referred to screening physical and occupational therapists on an as-needed basis for:

Physical Therapy Treatment

• Joint range of motion (ROM)
• Muscle flexibility
• Strengthening
• Splinting
• Adaptive equipment for mobility
• Gait and gross motor functional training 

Occupational Therapy Treatment

• Joint range of motion (ROM)
• Muscle flexibility
• Strengthening
• Splinting
• Adaptive equipment for self-care and feeding
• Activity of daily living training