Clinical and Psychosocial Stress Factors Contributing to Decline in Physical Activity in Children With Juvenile Idiopathic Arthritis

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Qaisar Farooq
Aflak Rasheed
Hussain Shakeel
Muhammad Shiraz Niaz
Shujaat Hassan
Aftab Alam


Background: Juvenile Idiopathic Arthritis (JIA) significantly affects the physical activity levels of children, compounded by both clinical symptoms such as pain and stiffness and psychosocial stressors including emotional and social challenges. These elements collectively contribute to a decreased motivation for physical engagement among affected children.

Objective: This study aimed to evaluate the relative impacts of clinical and psychosocial stress factors on the decline in physical activity among children diagnosed with JIA.

Methods: This cross-sectional study included 150 participants aged 6 to 18 years with confirmed JIA diagnoses. Clinical assessments involved measuring disease activity using the Juvenile Arthritis Disease Activity Score (JADAS-27) and physical activity levels using the International Physical Activity Questionnaire (IPAQ) short form. Psychosocial stress was evaluated using the Pediatric Perceived Stress Scale (PPSS) and the Child Behavior Checklist (CBCL). Anthropometric measurements such as height and weight were recorded to calculate body mass index (BMI). Data analysis was performed using SPSS version 25.0. Descriptive statistics, Pearson correlation coefficients, and multiple regression analyses were conducted to assess the relationships between disease severity, psychosocial stress, and physical activity levels. Ethical approval was obtained from the institutional review board, and informed consent was provided by parents or guardians.

Results: The study found a significant inverse relationship between disease activity and physical activity levels (r = -0.99, p < 0.01). The average disease-specific activity score was 5.62 (SD = 2.52), and the mean IPAQ score was 132.60 (SD = 82.40). Higher disease activity scores correlated with increased psychological stress, as indicated by PPSS (mean = 21.53, SD = 9.88) and CBCL total scores (mean = 21.17, SD = 7.44). Regression analysis demonstrated that psychological stress significantly predicted physical activity levels (R² = 0.980, p < 0.001).

Conclusion: The study confirms that both clinical and psychosocial factors significantly contribute to the decline in physical activity in children with JIA. It emphasizes the need for integrated care approaches that address the physical, psychological, and social dimensions of health to improve overall patient outcomes.

Keywords: Juvenile Idiopathic Arthritis, Physical Activity, Psychosocial Stress, Integrated Care, Child Health, Chronic Disease Management

Article Details

How to Cite
Qaisar Farooq, Aflak Rasheed, Hussain Shakeel, Muhammad Shiraz Niaz, Shujaat Hassan, & Aftab Alam. (2024). Clinical and Psychosocial Stress Factors Contributing to Decline in Physical Activity in Children With Juvenile Idiopathic Arthritis. Journal of Health and Rehabilitation Research, 4(2), 1228–1233. Retrieved from


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