Examining the Relationship between Self-Perceived Health and Well-being and Physical Activity and Fitness in Children with a Chronic Condition

Abstract

Habitual physical activity and fitness are well-established as independent predictors of health in both children and adults. Chronic inflammatory conditions in children have been shown to negatively impact participation and maintenance of physical activity in childhood which can lead to a reduction in fitness. Juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are two of the most common childhood chronic conditions, both of which are characterized by inflammation. Alarmingly, even during remission, physical activity and fitness levels are reduced and sickness behaviours persist in these children. As such, it is thought that psychosocial measures, such as self-perceived health and well-being, may have a stronger association with decreased physical activity and fitness levels in this population as compared to healthy controls. The purpose of this project was to examine the relationship between self-perceived health and well-being and physical activity and fitness in children with JIA or IBD. In total, 58 children (32 girls, 26 boys) between the ages of 7 and 17 years with a single diagnosis of either JIA or IBD, and healthy controls were recruited. They completed measures of anthropometry, body composition, physical activity, as well as fitness (aerobic and muscle strength). Questionnaires regarding perceived health and well-being were also completed, and blood samples were obtained to measure specific markers of inflammation. Children with JIA or IBD were found to engage in significantly less moderate-to-vigorous physical activity (MVPA) relative to healthy controls (t = -1.977, p = 0.040). A linear regression established that MVPA, when expressed as an average of minutes per day, could statistically significantly predict self-perceived health, F(1,50) = 6.516, p = 0.014, where MVPA accounted for 11.5% of the explained variability in self-perceived health. This was no longer significant with the controls age, sex, and body fat percentage added into the model. Linear regression models showed that fitness was more predictive of self-perceived well-being, as seen with relative VO2 peak, F(1,38) = 6.683, p = 0.014, where relative VO2 peak accounted for 15% of the variability with self-perceived well-being. Furthermore, composite isometric strength expressed relative to body mass was able to significantly predict a composite blood inflammatory marker score, F(1,49) = 4.447, p = 0.040, where a relative composite isometric strength score accounted for 8.3% of the variability in a composite inflammatory blood marker score. Our findings indicate weak but significant predictive power for physical activity and fitness variables with regards to self-perceived health and well-being. Therefore, it may be important to explore ways to increase self-perceived health and well-being in children with JIA or IBD in order to improve physical activity participation and fitness.