All posts by Teresa Stockton

solar eclipse

2017 Solar Eclipse Celebration

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The 2017 Solar Eclipse is Monday August 21st, so be sure to view this once in a lifetime event by visiting one of our many PT & Me physical therapy clinics. Some of our PT & Me clinics (in or nearest to the solar eclipse path) will be hosting viewings during this time and distributing solar eclipse viewing glasses. Find out if physical therapy can help you and join in on the solar eclipse fun! Be sure to check with your local PT & Me provider (based on the total eclipse path) by viewing the map shown below.

For more information on physical therapy clinics near the solar eclipse path or near you click here.

For NASA information on the 2017 Solar Eclipse click here.

PREHAB Knee Replacement

PREHAB Move to Improve Your Goals: Total Knee Replacement

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PREHAB Home Preparation
Before total knee replacement surgery there are a few simple things you can do in your home to make it safer and more comfortable during recovery.

  • Consider keeping a cordless phone near you or carry your cell phone in your pocket.
  • Move furniture to keep a clear wide path to your kitchen, bathroom and bedroom.
  • Remove throw rugs that may cause you to slip or trip. Tape down any loose edges of large area rugs that cannot be removed. Make sure extension cords are out of traffic areas or tape them down if needed.
  • Wear rubber sole shoes to prevent slipping.
  • Keep commonly used items in your home at waist level within easy reach. This will prevent you from bending over to reach items. Use a reacher to grab objects and avoid excessive bending at the knee.
  • Make sure there is adequate lighting in the house. Add night lights in hallways, bedrooms, and bathrooms.
  • It may be helpful to have temporary living space on the same floor if your bedroom/bathroom is located on the second floor of your home. Walking up/down stairs will be more difficult immediately following surgery and could increase your risk for falls.
  • Arrange for someone to collect your mail and take care of pets or loved ones if necessary.
  • Prepare frozen meals in advance to assist you with cooking.
  • Stock up on groceries, toiletries, and any needed medications you might need.
  • A shower chair or a tub bench will make bathing much easier. Do not take soak baths until your physician allows you to do so.
  • An elevated toilet seat will be helpful with toilet transfers and with following post surgical precautions or guidelines.
  • Assistive devices for dressing such as a reacher, extended shoe horn and / or sock aid may be necessary during your post operative recovery.

While it’s important to prepare your home before surgery, PREHAB should also include physical therapy. Physical therapists will work with patients to create an exercise program before surgery that can help improve performance and decrease recovery times after a total knee replacement. Talk to a PT near you and learn about the benefits of PREHAB before total joint replacements.

Industrial Rehab Physical Therapy PTandMe

Health Aging for a Sustainable Workforce

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What Can Employers Do to Protect an Aging Workforce?

Employers can start by revisiting job descriptions and knowing every detail each work task entails in order to help prevent costly and unnecessary workers’ compensation claims. Meanwhile, they should continue to promote health and wellness programs for all employees. Because older workers bring many benefits, from their experience and knowledge to their motivation and good work ethic, the advantages of employing older workers will outweigh the possible worker’s compensation claims, with preparation and planning.

Companies must utilize and implement preventative safety efforts. Specifically, companies should develop slip-and-fall prevention tactics, considering that slips and falls account for 33 percent of all injuries sustained by workers 65 and older, according to the National Safety Council. Safety training should consist of more than just scripted lectures, distributed
pamphlets and orientation videos. Employees should be taken through the physical movements and tasks that are specific to their job description–a hands-on learning experience. Because younger workers account for the majority of accidents while older workers have longer recovery periods, safety training benefi ts all employees and the employer. Bring in external experts such as physical therapists from the community to teach proper techniques and protocols.

  • Modification of work environment
  • Ergonomics and wellness programs
  • Industrial Athlete approach to exercise
  • Return to work accommodations

AGING WORKFORCE SERVICES:

Education:
A full battery of educational programs are available for both the professional staff of an employer to that of the general employee population such as slip and fall or back injury prevention.

Preventative Maintenance Testing:

A brief test – approx. 15 minutes that looks at the essential and critical factors of the job – usually body part specific and set up as a repeated test – every three to four months on a high risk job position – looking for trends or patterns of degradation of range of motion or strength of employees.

Fitness Programs for the Industrial Athlete:
Detailed stretching programs are customized per high risk job based upon historical injury determinations. The program is set up for employee participation prior to work, returning from lunch and at the end of the workday.

Physical Ability Maintenance:
A custom built strengthening program designed to maintain the physical abilities necessary to perform everyday work.

For more information about staying healthy and injury free in the workplace – try the links below:


       

Adapted from Fit2wrk Article 1.10   For more information on Fit2wrk click here.

postural hypotension PTandMe

Postural Hypotension: What It Is and How to Manage It

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Postural hypotension (or orthostatic hypotension) is when your blood pressure drops when you go from lying down to sitting up or from sitting to standing. When your blood pressure drops, less blood can go to your organs and muscles. This can make you likely to fall.

What are the symptoms?
Although many people with postural hypotension have no symptoms, others do. These symptoms can differ from person to person and may include:

  • Dizziness or lightheadedness
  • Feeling about to faint, passing out or falling
  • Headaches, blurry or tunnel vision
  • Feeling vague or muddled
  • Feeling pressure across the back of your shoulders or neck
  • Feeling nauseous or hot and clammy
  • Weakness or fatigue

When do symptoms tend to happen?
When standing or sitting up suddenly

  •  In the morning when blood pressure is naturally lower
  • After a large meal or alcohol
  • During exercise
  • When straining on the toilet
  • When you are ill
  • If you become anxious or panicky

What causes postural hypotension?
Postural hypotension may be caused by or linked to:

  • High blood pressure
  • Diabetes, heart failure, atherosclerosis or hardening of the arteries
  • Taking some diuretics, antidepressants or medicines to lower blood pressure
  • Neurological conditions like Parkinson’s disease and some types of dementia
  • Dehydration
  • Vitamin B12 deficiency or anemia
  • Alcoholism
  • Prolonged bed rest

What can I do to manage my postural hypotension?

  • Tell your healthcare provider about any symptoms
  • Ask if any of your medicines should be reduced or stopped
  • Get out of bed slowly. First sit up, then sit on the side of the bed, then stand up
  • Take your time when changing position, such as when getting up from a chair
  • Try to sit down when washing, showering, dressing or working in the kitchen
  • Exercise gently before getting up (move your feet up and down and clench and unclench your hands) or after standing (march in place)
  • Make sure you have something to hold onto when you stand up
  • Do not walk if you feel dizzy
  • Drink 6-8 glasses of water or low-calorie drinks each day, unless you have been told to limit your fluid intake
  • Avoid taking very hot baths or showers
  • Try sleeping with extra pillows to raise your head

This information was written by Proactive Physical Therapy, an outpatient physical therapy clinic in Sioux Falls, South Dakota. At ProActive Physical Therapy, their number one priority is the patient. They strive to provide individualized treatment with hands-on, compassionate care. They do not rush their patients or their clinicians. Rather, they perform comprehensive evaluations and encourage patient input for treatment planning and goal setting. For more information click here.

Healthy Recipes 101

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Healthy Recipes 101 features fit and lean recipes from online health resources!

HEALTHY MULTIGRAIN MUFFINS
This recipe makes delicious, healthy and versatile muffins. I have tried cranberries, apple pieces, almonds and macadamias as well. You can use any fruit or nut that you especially like. Read More

Written by contributor to Food.com

PT News

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This Month in PT News. Featuring articles from PTandMe partnering clinics!

1. No Equipment Outdoor Workouts
Written by the Therapy Team at Momentum Physical Therapy – San Antonio, TX

We have an idea you might not hear often- take a break from the gym. How? Well, instead of being inside, take your work out ‘out’ and sweat outdoors without any equipment at all. Read more

2. Sensitive Pain
Written by the Ryan Beck, MPT at Oregon Spine and Physical Therapy – Eugene, OR

One of my favorite analogies!! I have used this on several patients and I’ll never forget a few years ago working with a particular patient when this analogy popped into my mind and I’ve used it so many times to help people who are having a lot of pain. Read more

3. Certified Hand Therapists: Helping People Live Their Lives
Written by Jan Taylor, OT Fellowship Director and OT Resource Coordinator at ARC Physical Therapy Plus – Overland Park, KS

The hand is so critical to every minute of our daily lives that when you lose function of it your world is turned upside down. Read more

physical therapy cancer

How Physical Therapy Can Benefit Cancer Patients

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Mesothelioma can be one of the most difficult forms of cancer to treat. It is an aggressive illness that starts in the interior lung lining after exposure to asbestos fibers and it quickly spreads to the chest and lungs. As such, an equally intensive form of chemotherapy is often employed as a way to combat the spreading cells. However, this can leave the patient feeling fatigued and distressed. In order to deal with such side effects, many medical professionals recommend alternative treatments, such as physical therapy cancer related fatigue programs as a way for patients to begin feeling better during the recovery process.

Improved Mobility

One of the biggest benefits that physical therapy cancer programs can have for individuals is providing them with a way to improve their mobility. This can be invaluable in improving the patient’s mood as well. With more mobility, the patient will be able to exercise more efficiently, which can lead to a greater degree of independence. Patients can enjoy other activities that they used to engage in as well, such as drawing or walking, and the greater degree of mobility can also be invaluable in reducing long-term pains from staying in bed. As such, physical therapy is often recommended early for those who feel as though they have been cooped up in bed for too long as they recover.

Improved Overall Fitness

Because physical therapy cancer programs are designed to fight against muscular dystrophy, it can be one of the best methods to keep patients healthy. Because so much of the early chemotherapy process requires for individuals to stay relatively stationary to recover, it is not uncommon for many to begin losing muscle mass and feel weaker overall. Physical therapy helps exercise muscles, bringing necessary strength back to the patient as they continue to recover. As the body becomes stronger, the patient will be able to fight against the mesothelioma more efficiently, reducing potential issues in the future of the recovery.

cancer_patient

Improved Respiratory Health

Because of how dangerous the growths are, they can severely impact the way the individual breathes. With poor respiratory health, the patient may feel distressed, and the recovery process may be more difficult that it needs to be. Through physical therapy, the patient is able to improve their ability to breathe, reducing their risk of running into future respiratory issues. Improving breathing function also provides the patient with more support on a cellular level. As lung function improves, the mesothelioma begins to slowly lose ground, resulting in a smoother and more enjoyable healing process for the patient.

Those who are interested in learning more about their physical therapy options should be sure to contact their medical professionals as soon as possible. Through the right basic exercise system, it can be easy for individuals to start to feel better and get their strength back. Like any other such recovery process, however, it is vital for patients to take the recovery slow to build up their strength and improve their outlook in the future.

For more information on cancer related physical therapy programs click here:

    
Athletic Injuries PTandMe

3 Types of Athletic Injuries

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Did you know that most athletic injuries can be boiled down into three main categories?  Acute, Overuse and Chronic.  Physical therapists that specialize in sports medicine, help athletes experiencing pain get back in their sport.  From the time of the injury through recovery and performance, the licensed physical therapists that partner with PTandMe have the know-how and experience to get rid of your pain.

1.) ACUTE: Usually a result of a single traumatic event within the last five days. Examples: fractures, sprains, dislocations, muscle strains.

2.) OVERUSE: Subtle and occur over time, making them challenging to diagnose and treat. Examples: swimmer’s shoulder, runner/jumpers knee, Achilles tendonitis, shin splints.

3.) CHRONIC: Usually has lasted at least three months or more.

COMMON CAUSES OF INJURIES:

  • Improper training and technique
  • Incorrect equipment fitting and support
  • Anatomic or biomechanical issues of athlete
  • Catastrophic event on or off the field

football injury

OVERUSE INJURIES AND BURNOUT
Overuse/overtraining injuries and burnout are a major problem for adolescent athletes. Both can occur when students participate in sports year-round with no “off season”, or have insufficient recovery time between practices and games.

WATCH for typical burnout signs:

  • Pain during or after activity, or while at rest
  • Lack of enthusiasm for practices or games
  • Dip in grades

PREVENT overuse injuries and burnout with these simple tips:

  • Allow enough time for proper warm-up and cool down routines
  • Rest 1-2 days per week or engage in another activity
  • Focus on strength, conditioning or cross training during the “off season”

Did you know that 50% of all sports injuries to student athletes are a result of overuse?

SPRAIN
Sprains result from overstretching or tearing of the joint capsule or ligament which attaches a bone to another bone.

STRAIN
Strains, also referred to as pulls, result from over-stretching or tearing a muscle or tendon, which attaches a muscle region to a bone.

CONTUSIONS
Contusions or bruises are an injury to tissue or bone in which the capillaries are broken and local bleeding occurs.

TEARS
Tears are a complete separation of the tissue fibers.

Physical therapy and athletics go hand in hand. In many cases, your PT may be a former athlete that experienced an injury in their youth, and as a result found a passion for rehabilitating others. If you are experiencing pain, or have already had an injury, don’t wait to talk to your physical therapist. The faster you ask for help the faster you can get back into your sport.

For more information about physical therapy and sports medicine – try the links below:


       

This article about athletic injuries was provided by PTandMe physical therapy partner: The Center for Physical Rehabilitation. More information about the Center and their locations throughout Grand Rapids, MI can be found on their website at www.pt-cpr.com

throwing injuries PTandMe

Guidelines to Prevent Throwing Injuries

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In this monthly series, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.


WRIST EXTENSION
Start with the arm supported on a table and your wrist facing toward the ground. Hold the weight off the edge of the table and bring the back of your hand toward the ceiling.


WRIST FLEXION
Start with the arm supported on a table and your wrist facing toward the ceiling. Hold the weight off the edge of the table and bring your palm toward the ceiling.

ASMI GUIDELINES TO HELP PROTECT PITCHERS FROM SHOULDER & ELBOW THROWING INJURIES:

Don’t throw too much:
Daily, weekly and annual overuse is the greatest risk to a pitcher’s arm health. Numerous studies have shown that pitchers who throw more pitches per game and those who do not adequately rest between appearances are at an elevated risk of injury. While medical research does not identify optimal pitch counts, pitch count programs have been shown to reduce the risk of shoulder and elbow injury in Little League Baseball by as much as 50% (Little League, 2011). The most important thing is to set limits for a pitcher and stick with them throughout the season.

Don’t pitch through arm fatigue:
Individuals are 36 times more likely to develop shoulder and elbow injuries when routinely pitching with arm fatigue.

Don’t pitch more than 100 innings per year:
If an athlete throws over 100 innings they are 3.5 times more likely to be injured than those who did not exceed 100 innings pitched.

Don’t throw more than 8 months per year:
Athletes who throw > 8 months per year are 5 times as likely to suffer an injury requiring surgery of the elbow or shoulder. Pitchers should refrain from throwing for at least 2-3 months per year and avoid competitive pitching for at least 4 months per year.

Don’t pitch on consecutive days:
Pitchers who pitch on consecutive days have more than 2.5 times greater risk of experiencing arm pain.

Don’t play catcher following pitching:
If the player catches following pitching they are 2.7 times more likely to suffer a major arm injury.

Don’t play on multiple teams at the same time:
There is increased risk of injury due to the difficulty in monitoring pitch limits and rest time. If the player is on multiple teams, make meticulous efforts to keep track of the amount of pitches thrown to allow adequate rest.

Don’t forget the shoulder in strength and conditioning programs:
Numerous studies have shown that deficits in upper extremity strength and mobility are strongly correlated to serious arm injuries. Shoulder and forearm strengthening exercises can build strength, endurance and motor control which can prevent injury.

Be cautious with throwing curve balls and sliders:
While existing research has not consistently shown a strong connection between the curveball and injuries, Yang et al., found that amateur pitchers who threw curveballs were 1.6 times more likely to experience arm pain while pitching and Lyman et al, found that youth pitchers who throw sliders are 86% more likely to experience elbow pain.

Be cautious with the radar gun:
Radar guns do not directly cause harm to a pitcher, however, the gun may cause the pitcher to over throw beyond their normal comfort level. This could possibly create arm strain.

Following these guidelines may keep the throwing athlete safe from the debilitating shoulder and elbow throwing injuries seen on a regular basis in physical therapy clinics.

Pitching Guidelines Chart

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. They specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Their staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

   Prevent Throwing Injuries

   prevent throwing injuries

throwing injuries PTandMe

Juvenile Rheumatoid Arthritis

Juvenile Rheumatoid Arthritis (JRA; Juvenile Chronic Polyarthritis; Stills Disease)

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DEFINITION
Juvenile rheumatoid arthritis (JRA), also known as juvenile idiopathic arthritis, is a disease of the joints in children. It can affect a child over a long period of time. JRA often starts before the child is 16 years old.

In JRA, the joint becomes swollen. It will make the joint painful and difficult to move. JRA can also lead to long term damage to the joint. For some, JRA can interfere with the child’s growth and development.

There are 5 major types of JRA:

  • Pauciarticular JRA—4 or less joints are affected in the first 6 months of illness
  • Polyarticular JRA—5 or more joints are affected in the first 6 months of illness
  • Enthesitis associated arthritis—swelling of the tendon at the bone
  • Psoriatic arthritis—associated with a skin disease called psoriasis
  • Systemic onset JRA (also called Stills disease)—affects the entire body, least common type of JRA

CAUSES
JRA is caused by a problem of the immune system. The normal job of the immune system is to find and destroy items that should not be in the body, like viruses. With JRA, the immune system attacks the healthy tissue in the joint. It is not clear why this happens. The immune system problems may be caused by genetics and/or factors in the environment.

RISK FACTORS

Girls are more likely to get JRA than boys.

There are no clear risk factors for JRA. Factors that may be associated with some types of JRA include:

  • Family history of:
  • Arthritis and a family history of psoriasis in a first-degree relative (for psoriatic arthritis)

SYMPTOMS
Symptoms may include:

  • Joint stiffness, especially in the morning or after periods of rest
  • Pain, swelling, tenderness, or weakness in the joints
  • Fever
  • Weight loss
  • Fatigue or irritability
  • Swelling in the eye—especially associated with eye pain, redness, or sensitivity to light
  • Swollen lymph nodes
  • Growth problems, such as:
    • Growth that is too fast or too slow in one joint (may cause one leg or arm to be longer than the other)
    • Joints grow unevenly, off to one side
    • Overall growth may be slowed

Some symptoms are specific to each type of JRA. For example:

  • Symptoms common with polyarticular JRA include:
    • Problems found most often in small joints of the fingers and hands. May also affect weight-bearing joints like the knees, hips, ankles, and feet.
    • Joints on both sides of the body are affected. For example, if the left hand is affected, then the right hand will also be affected.
    • May also have a blood disorder called anemia. This is an abnormally low number of red blood cells.
    • One type of polyarticular JRA may occur with:
      • A low-grade fever
      • Nodules—bumps on parts of body that receive a lot of pressure such as elbows
  • Symptoms common with pauciarticular JRA include:
    • Problems most often found in large joints. These joints include knees, ankles, wrists, and elbows.
    •  If the left-side joint is affected, then the right-side similar joint will not be affected. For example, if the right knee is affected, then the left knee will be healthy.
    •  May also have swelling and pain at on the tendons and ligaments attached to the bon
  • Symptoms common with systemic onset JRA include:
    • Some of the first signs may be a high fever, chills, and a rash on the thighs and chest. May appear on and off for weeks or months
    • May have swelling in the heart, lungs, and surrounding tissues
    • The lymph nodes, liver, and/or spleen may become enlarged
  • Children with enthesitis arthritis often have tenderness over the joint where the pelvis and spine meet.
  • Children with psoriatic arthritis often have finger or toe swelling. There may also be damage on fingernails.

Often, there are remissions and flare-ups. Remission is a time when the symptoms improve or disappear. Flare-ups are times when symptoms become worse.

arthritis_card_dealt

DIAGNOSIS
You will be asked about your child’s symptoms. You will also be asked about your family medical history. A physical exam will be done. An eye examination may also be done to check for swelling in the eye. Your child may be referred to a specialist if Juvenile rheumatoid arthritis is suspected. The specialist is a doctor that focuses on diseases of the joints.

Images may be taken of your child’s bodily structures. This can be done with x-rays.

Your child’s bodily fluids may be tested. This can be done with:

  • Blood tests
  • Urine tests
  • Tests of joint fluid

JUVENILE RHEUMATOID ARTHRITIS TREATMENT
Talk with your doctor about the best plan for your child. The plan will work to control swelling, relieve pain, and control joint damage. The goal is to keep a high level of physical and social function. This will help keep a good quality of life.

PHYSICAL THERAPY FOR JUVENILE RHEUMATOID ARTHRITIS
Exercise is done to strengthen muscles and to help manage pain. Strong nearby muscles will support the joint. It also helps to recover the range of motion of the joints. Normal daily activities are encouraged. Non-contact sports and recreational activities may be good options. Physical activities can also help boost a child’s confidence in their physical abilities.

Physical therapy may be needed. This will help to make the muscles strong and keep the joints moving well.

JUVENILE RHEUMATOID ARTHRITIS MAINTENANCE DEVICES
Splints and other devices may be recommended. They may be worn to keep bone and joint growth normal. Some joints may get stuck in a bent position. These devices can help prevent this.

PREVENTION
There is no known way to prevent Juvenile rheumatoid arthritis.

by Jacquelyn Rudis

RESOURCES:
American College of Rheumatology
http://www.rheumatology.org

Arthritis Foundation
http://www.arthritis.org

CANADIAN RESOURCES:
The Arthritis Society
http://www.arthritis.ca

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:
Hofer MF, Mouy R, et al. Juvenile idiopathic arthritides evaluated prospectively in a single center according to the Durban criteria. J Rheumatol. 2001. 28:1083.

Juvenile idiopathic arthritis (JIA) enthesitis related. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T506592/Juvenile-idiopathic-arthritis-JIA-enthesitis-related. Updated July 15, 2016. Accessed September 29, 2016.

Juvenile idiopathic arthritis (JIA) oligoarticular. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114122/Juvenile-idiopathic-arthritis-JIA-oligoarticular. Updated July 16, 2016. Accessed September 29, 2016.

Juvenile idiopathic arthritis (JIA) polyarticular. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116580/Juvenile-idiopathic-arthritis-JIA-polyarticular. Updated July 15, 2016. Accessed September 29, 2016.

Juvenile idiopathic arthritis (JIA) systemic-onset. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115968/Juvenile-idiopathic-arthritis-JIA-systemic-onset. Updated July 15, 2016. Accessed September 29, 2016.

JAMA Patient Page. Juvenile idiopathic arthritis. JAMA. 2005;294:1722.

Petty RE, Southwood TR, et al. Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol.1998; 25:1991.

2/5/2013 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115968/Juvenile-idiopathic-arthritis-JIA-systemic-onset: De Benedetti F, Brunner HI, Ruperto N, et al. Randomized trial of tocilizumab in systemic juvenile idiopathic arthritis. N Eng J Med. 2012;367(25):2385-95.

2/24/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115968/Juvenile-idiopathic-arthritis-JIA-systemic-onset: Limenis E, Grosbein HA, et al. The relationship between physical activity levels and pain in children with juvenile idiopathic arthritis. J Rheumatol. 2014 Feb;41(2):345-351.

9/2/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115968/Juvenile-idiopathic-arthritis-JIA-systemic-onset: Guzman J, Oen K, et al. The outcomes of juvenile idiopathic arthritis in children managed with contemporary treatments: results from the ReACCh-Out cohort. Ann Rheum Dis. 2014 May 19.

Last reviewed December 2015 by Kari Kassir, MD Last Updated: 12/20/2014

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.