108
J Gandhara Med Dent Sci
October - December 2026
ORIGINAL ARTICLE
How to cite this article
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ASSESSMENT OF POSTURAL STABILITY IN PEDIATRIC POPULATION WITH JUVENILE
IDIOPATHIC ARTHRITIS: A CROSS-SECTIONAL STUDY
Amina Ashfaq
1
, Somia Faisal
1
, Sarfraz Ahmad
2
, Amina Liaquat
1
, Sajal Rehman Nawaz
1
, Fatima Ali
1
Ashfaq A, Faisal S, Ahmad S, Liaquat
A, Nawaz SR, Ali F. Assessment of
Postural Stability in Pediatric
Population With Juvenile Idiopathic
Arthritis: A Cross-Sectional Study. J
Gandhara Med Dent Sci.
2026;13(4):108-113.
Date of Submission:
28-04-2026
Date Revised:
14-09-2026
Date Acceptance:
14-09-2026
2
Associate Professor, Department of
Correspondence
1
Somia Faisal,
Physiotherapist,
Department of Physical Medicine &
Rehabilitation, The Children’s
Hospital, University of Child Health
Sciences, Lahore, Pakistan
+92-320-4996487
somia786faisal@gmail.com
Child Health Sciences, Lahore,
Pakistan
Physical Medicine & Rehabilitation,
The Children’s Hospital, University of
ABSTRACT
OBJECTIVES
The study aimed to determine the postural stability of children with Juvenile
Idiopathic Arthritis (JIA).
METHODOLOGY
A cross-sectional study was conducted from June 2024 to January 2025 at
Children's Hospital Lahore. Seventy children aged 6- 15 years with JIA and
active joint involvement were recruited through convenience sampling. The
Pediatric Balance Scale (PBS) was used to evaluate postural stability, and
the Childhood Health Assessment Questionnaire (CHAQ) was used to assess
functional status. We used SPSS version 26 to analyse the data. Chi-square
tests and descriptive statistics were applied.
RESULTS
The mean age was 11.6 (± 2.8) years, with 41 females (58.6%) and 29 males
(41.4%). PBS scores showed 42 children (60%) with poor balance (score 0
20),
16 (22.9%) with moderate balance (21- 40), and 12 (17.1%) with good
balance
(41-
56).
According
to
the
CHAQ,
50
children
(71.5%)
reported
much diculty or were unable to perform everyday activities, while a further
9
(12.9%)
reported
some
diculty.
A
signicant
association
was
found
between CHAQ functional level and PBS balance category (
χ
² = 15.42, p =
0.017), and a
moderate
negative
correlation
was
observed
between
CHAQ
and PBS total scores (r = -0.41, p < 0.001). No signicant association was
found between age and balance (p = 0.087).
CONCLUSION
A substantial proportion
of children with JIA scored in the lower ranges of
the
PBS,
and
poorer
balance
was
moderately
correlated
with
greater
functional disability. These ndings support integrating ba
lance assessment
into routine clinical evaluation in pediatric JIA.
KEYWORDS:
Juvenile
Idiopathic
Arthritis,
Postural
Stability,
Balance,
Pediatrics, Rheumatology,
Health Status Indicators
INTRODUCTION
Juvenile Idiopathic Arthritis (JIA) is the most prevalent
chronic rheumatic disease in children and is dened by
persistent
joint
inammation
of
unidentied
etiology
lasting six weeks or more in children under 16 years of
age.
1
The
nomenclature
and
classication
of
the
pediatric
rheumatoid
disorders
have
changed
significantly,
with
the
International
League
Against
Rheumatism
(ILAR)
now
identifying
seven
dierent
subtypes of JIA, which are determined
by the
clinical
presentation in the rst six weeks of the disease.
2
The
prevalence
of
JIA
in
dierent
parts
of
the
world
is
between
1.6
and
23
cases
per
100,000
children,
with
combined estimates showing an approximate 8.3 cases
per
100,000 in Caucasian populations.
JIA prevalence
rates
dier
substantially
worldwide
and
depend
on
genetic, environmental, and healthcare access
factors.
3
Females are often more often aected than males, with
the
estimated
ratio
of
males
to
females
being
0.57:1.
Sex distribution diers among JIA subtypes.
4
Although
the children with JIA have improved clinical remission
rates
in
most
cases,
they
still
suer
signicant
functional
limitations,
reduced
physical
activity,
and
poorer
quality
of
life
than
their
healthy
peers.
5
JIA
etiology
is
not
fully
understood
but
is
thought
to
involve
multifaceted
interactions
among
genetic
susceptibility,
immune
dysregulation,
and
environmental
triggers.
6
HLA
as
well
as
non-HLA
genetic
markers
can
help
to
increase
susceptibility
to
the disease, whereas socioeconomic factors like the lack
of
access
to
rheumatology
care
promptly
are
linked
with worse outcomes and higher disease severity.
7
One
of the most crucial but underestimated areas of JIA is
postural stability, or the ability to maintain or regulate
body
position
during
static
and
dynamic
activities.
Balance depends on coordinated activity of the sensory,
musculoskeletal,
and
neuromuscular
systems,
with
proprioception playing a signicant role. These systems
are
susceptible
to
disruption
in
JIA,
causing
quantiable
postural
control
impairments
due
to
chronic
synovitis,
pain,
joint
stiness,
muscle
http://doi.org/10.37762/jgmds.13-4.925
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J Gandhara Med Dent Sci
October - December 2026
weakness, and impaired proprioception.
8
Children with
JIA
often
have
gait
deviations,
decreased
range
of
motion,
compensatory
movement
patterns,
and
abnormal
biomechanics,
all
of
which
lead
to
balance
dysfunction. Such impairments can heighten the risk of
falls,
restrict
physical
activity,
and
worsen
functional
outcomes, as children with JIA may be less active and
more
sedentary
than
their
healthy
peers.
9
Although
biologic
therapies
have
increased
the
rates
of
clinical
remission,
children
with
JIA
usually
become
less
physically active and more sedentary, compared to their
healthy
peers.
10
This
physical
deconditioning
can
trigger
a
vicious
cycle
of
further
joint
pain,
lack
of
activity, and a further increase in disease activity, which
increases
the
likelihood
of
developing
comorbid
metabolic
and
mental
health
issues.
11
JIA
has
a
great
inuence on many aspects of the life of a child, such as
psychological
well-being,
social
participation,
functional
independence,
and
quality
of
life,
which
means
that
eective
management
should
be
a
holistic
process
that
includes education,
lifestyle
modication,
social support, pain management, and self-ecacy and
communication
improvement
strategies.
12
In
children
with
JIA,
physical
activity
is
necessary
to
maintain
functional
capacity
as
well
as
overall
health.
Nevertheless,
evidence-based
guidelines
for
exercise
prescription
remain
limited,
and
barriers
such
as
individual,
interpersonal,
and
program-related
factors
often
obstruct
long-term
involvement.
13
Despite
growing
recognition
of
balance
decits
in
JIA,
clinicians
rarely
evaluate
postural
stability,
potentially
leaving
trunk
control
and
gait
abnormalities
unidentified.
This
study
aimed
to
evaluate
postural
stability
in
children
with
JIA
using
standardised
measures to inform targeted rehabilitation interventions
and improve clinical monitoring of functional status in
this vulnerable population.
METHODOLOGY
This
cross-sectional
study
was
conducted
over
eight
months, from June 2024 to January 2025, at Children's
Hospital
Lahore.
A
non-probability
convenience
sampling
method
was
used
to
enrol
70
children
diagnosed
with
Juvenile
Idiopathic
Arthritis
by
a
pediatric
rheumatologist.
The
sample
size
was
calculated based on the primary objective of estimating
the correlation between PBS and CHAQ scores. Using
G*Power 3.1 (two-tailed,
α
= 0.05, power = 0.80) and
assuming
a
moderate
correlation
of
r
=
0.30
between
PBS
and
CHAQ,
a
minimum
of
67
participants
was
required. Allowing for approximately 5% missing data,
we aimed to recruit 70 children, and 70 completed the
study. Inclusion criteria included children aged 6 to 15
years with active joint involvement and at least 1 year
of
disease
duration
who
could
follow
verbal
instructions.
Exclusion
criteria
included
visual
or
hearing
impairments,
orthopedic
injuries
in
the
recent
past, or cognitive impairments that may aect balance
measurement.
The
two
standardised
assessment
tools
were
the
Pediatric
Balance
Scale
(PBS)
and
the
Childhood Health
Assessment Questionnaire (CHAQ).
PBS is a 14-item performance-based scale designed to
measure
functional
balance
in
children.
All
items
are
rated on an ordinal scale from 0 (unable to perform) to
4 (normal performance),
producing a
total score
of 0-
56, with higher scores reecting better balance. CHAQ
is
a
parent-reported
questionnaire
assessing
functional
ability in daily living. It comprises 30 items across eight
domains, scored from 0 (without diculty) to 3 (unable
to
do),
with an overall
score of 0
to
3.
Higher scores
indicate
greater
disability
(higher
score
=
more
disability).
After ethical approval and signed informed
consent
from
parents
or
guardians,
a
trained
physiotherapist conducted the PBS assessment for each
child,
while
parents
completed
the
CHAQ
independently. The study followed the principles of the
Declaration
of
Helsinki.
The
Institutional
Review
Board approved the Study (Approval No. 706/SAHS).
We obtained written informed consent from all parents
or
legal
guardians
before
participation.
The
data
were
analysed using SPSS version 26.
RESULTS
This
cross-sectional
study
included
70
children
with
Juvenile Idiopathic Arthritis (JIA). The
mean age
was
11.6 ( 2.8 years), with a higher proportion of females
(n
=
41,
58.6%)
than
males
(n
=
29,
41.4%).
The
distribution across age groups was as follows: 69 years
(n = 17, 24.3%), 1012 years (n = 21, 30.0%), and 13
15
years
(n
=
32,
45.7%).
Table
1
summarises
the
cohort's clinical characteristics. The most common JIA
subtype was oligoarticular (n = 28, 40.0%), followed by
polyarticular RF-negative (n = 22, 31.4%) and systemic
(n = 6, 8.6%).
The mean disease duration was 3.4 1.8
years,
and
the
mean
age
at
diagnosis
was
8.2
2.6
years. Children had a mean of 6.1 3.9 aected joints
and 3.2 2.1 active joints at assessment. Mean disease
activity scores were JADAS-27 12.6 5.4, ESR 18.3
9.7 mm/h, and CRP 8.1 6.2 mg/L. At assessment, 52
children
(74.3%)
were
receiving
conventional
DMARDs, 18 (25.7%) biologics, 41 (58.6%) NSAIDs,
and 12 (17.1%) corticosteroids. ANA was positive in 21
children
(30.0%),
and
7
(10.0%)
had
a
history
of
uveitis.
Assessment of Postural Stability in Pediatric Population with Juvenile
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J Gandhara Med Dent Sci
October - December 2026
Table 1: Clinical Characteristics of Children with JIA (N = 70)
Characteristic
n (%age)
JIA subtype, n (%)
Oligoarticular
28 (40.0%)
Polyarticular (RF-negative)
22 (31.4%)
Polyarticular (RF-positive)
4 (5.7%)
Systemic
6 (8.6%)
Enthesitis-related
5 (7.1%)
Psoriatic
3 (4.3%)
Undifferentiated
2 (2.9%)
Disease duration, years, mean SD
3.4 1.8
Age at diagnosis, years, mean SD
8.2 2.6
Number of affected joints, mean SD
6.1 3.9
Number of active joints, mean SD
3.2 2.1
Disease activity
JADAS-27 score, mean SD
12.6 5.4
ESR, mm/h, mean SD
18.3 9.7
CRP, mg/L, mean SD
8.1 6.2
Medication status, n (%)
NSAIDs
41 (58.6%)
Conventional DMARDs
52 (74.3%)
Biologics
18 (25.7%)
Corticosteroids
12 (17.1%)
No DMARD
9 (12.9%)
ANA positive, n (%)
21 (30.0%)
Uveitis, n (%)
7 (10.0%)
Functional
assessment
using
the
Childhood
Health
Assessment
Questionnaire
(CHAQ)
showed
that
only
11
children
(15.7%)
could
perform
activities
of
daily
living
without
diculty,
while
the
majority
reported
functional
limitations:
9
(12.9%)
had
some
diculty,
27 (38.6%) had much diculty, and 23 (32.9%) were
unable to perform tasks independently (Figure 1).
0
5
10
15
20
25
30
35
40
Without diculty
Some diculty
Much diiculty
Unable to do
11
9
27
23
15.7
12.9
38.6
32.9
Childhood Health Assessment Questionnaire Score in JIA
We used the Pediatric Balance Scale to assess postural
stability.
PBS
total
scores
were
analysed
as
a
continuous variable (mean 24.3 12.7). For descriptive
purposes, 42 children (60.0%) scored in the 020 band
(poor
balance),
16
(22.9%)
in
the
2140
band
(moderate balance), and 12 (17.1%) in the 4156 band
(good balance) Figure 2); these bands are not validated
cut-os. Performance on specic PBS tasks highlighted
functional
decits.
During the sitting-to-standing task,
21
children
(30.0%)
needed
moderate
to
max
assistance, while only 4 (5.7%) could stand without any
hand
assistance.
In
unsupported
standing,
13
(18.6%)
were
unable
to
maintain
the
position
for
10
seconds,
and
only
one
child
(1.4%)
could
stand
safely
for
30
seconds.
In the
single-leg
stance,
10 children (14.3%)
did
not
attempt
the
task,
and
only
5 (7.1%)
stayed
in
position for 10 seconds.
Figure 2: Pediatric Balance Scale (PBS) Total Score Distribution
in Children with JIA (N = 70).
We
observed
a
signicant
association
between
functional
disability
(CHAQ
score)
and
balance
category
(PBS
total
score)
(
χ
=
15.42,
df
=
6,
p
=
0.017).
Children
reporting
greater
diculty
in
daily
activities
were
more
likely
to
have
poor
balance.
For
example,
among
those
who
were
"unable
to
do"
activities
on
the
CHAQ,
52.2%
(n
=
12)
had
poor
balance on the PBS (Table 2).
*
χ
²
= 15.42, df = 6, p =
0.017*
No
signicant
association
was
found
between
age
group
and
balance
category
(
χ
=
8.124,
df
=
4,
p
=
0.087).
Table
4
presents
the
distribution
of
balance
0
10
20
30
40
50
60
Poor Balance
(020)
Moderate
Balance (21
40)
Good Balance
(4156)
[VALUE]
[VALUE]
[VALUE]
[VALUE]
[VALUE]
[VALUE]
Pediatric Balance Scale Category (Score Range)
Frequency
Percentage
Table 2: Association Between CHAQ Functional Level and PBS
Balance Category
CHAQ Functional
Level
Poor
Moderate
Good
(41-56)
Total
Balance
Without diculty
3
5
3
11
Some difculty
5
2
2
9
Much difficulty
22
4
1
27
Unable to do
12
5
6
23
Total
42
16
12
70
(21-40)
(0-20)
Assessment of Postural Stability in Pediatric Population with Juvenile
Figure 1: CHAQ Score Distribution in Children with JIA (N=70).
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J Gandhara Med Dent Sci
October - December 2026
categories across age groups. Similarly, Table 3 shows
no signicant association between gender and balance
category (
χ
= 0.82, df = 2, p = 0.664).
Table 3: Association Between Age Group and PBS Balance
Category
Age
Group
Poor
Balance(0-20)
Moderate
Balance(21-40)
Good
Balance(41-56)
Total
6-9 years
7
8
2
17
10-12 years
14
4
3
21
13-15 years
21
4
7
32
Total
42
16
12
70
*
χ
² = 8.124, df = 4, p = 0.087.
However,
we
found
a
moderate
negative
correlation
between CHAQ scores and PBS total scores (r = −0.41,
p
<
0.001),
indicating
that
children
with
greater
functional
disability
tended
to
have
poorer
postural
stability (Table 4).
Table 4: Correlation Between CHAQ Scores and PBS Total
Scores
Variable
Mean ±
SD
Correlation with PBS (r)
p-value
CHAQ Score 2.1 ( 0.9)
-0.41
< 0.001
PBS Total
Score
24.3
( 12.7)
*Note: CHAQ Score Range 0–3 (Higher = More Disability), PBS
Score Range 0–56 (Higher = Better Balance)*
We also observed a signicant association between age
group and CHAQ functional level (
χ
= 12.34, df = 6, p
=
0.039),
with
older
children
(13-15
years)
reporting
higher disability levels.
et al. (2022) observed that both active and inactive JIA
children
had
slower
walking
speed,
dierent
gait
kinematics, and impaired performance on load-bearing
functional
tasks,
which
indicated
that
children
have
continued
to
experience
balance
and
mobility
diculties even after clinical remission.
15
These results
are
consistent
with
our
ndings,
as
dynamic
balance
tasks
(transfers,
turning,
and
reaching)
demonstrated
stronger
correlations
with
functional
disability
compared
to
the
results
of
a
static
task.
This
could
suggest that dynamic stability is more vulnerable to the
functional restrictions that children with JIA experience
and can be the goal of rehabilitative intervention. One
major
result
was
a
signicant
association
between
functional
disability
(CHAQ
score)
and
balance
category, supporting the importance of postural control
as
an
inseparable
component
of
daily
activity
performance.
This
connection
is
also
highlighted
in
recent
studies;
for
example,
Woolnough
et
al.
(2021)
found
gait
abnormalities
and
postural
deviations
in
children
with
JIA related to low
physical
activity
and
participation.
9
Additionally, Elnaggar et al. (2021) also
confirmed that core stability exercises not only have a
benecial eect on balance
but also
on the functional
capacity of the
children
with
polyarticular JIA,
which
supports the idea that balance-based interventions may
have
a
signicant
impact
on
a
functional
outcome
of
JIA
patients.
16
The
fact
that
this
study
found
that
dynamic
balance
decits
correlated
more
with
functional disability than static balance decits. Hence,
task-based
and
functional
balance
training
could
be
especially
advantageous.
However,
balance
performance
did
not
signicantly
correlate
with
age,
contrary
to
our
hypothesis.
This
observation
is
consistent
with
Sinem
Yenil
et
al.
(2024),
who
found
that motor impairments among children with JIA were
not
age-dependent
but
were
uniformly
evident
during
both
active
and
inactive
disease.
13
Nevertheless,
this
study
reported
a
significant
association
between
age
and
functional
disability,
and
older
children
reported
higher
limitations.
This
can
be
a
manifestation
of
the
accumulated eect of chronic illness, of long-standing
physical deconditioning, or of psychosocial adaptations
that
are
acquired
over
the
years
as
a
recent
study
by
Lupini et al. (2023) identified the process according to
which
adolescents
with
JIA
tend
to
have
identity
difculties,
social
inclusion,
and
physical
insecurity.
17,18
However,
in
a
systematic
review
of
physical
activity
interventions
in
JIA,
Iversen
et
al.
(2022)
found
no
gender
moderation
of
functional
outcomes
and
suggested
that
disease-related
factors
might
override
sex-based
disparities
in
balance
and
function in this clinical population.
19
In this cohort, no
gender-based balance dierence was assessed.
This cross-sectional study evaluated postural stability in
children with Juvenile Idiopathic Arthritis (JIA) and its
association with functional status, age, and sex. In this
cohort,
a
substantial
proportion
of
children
with
JIA
scored
in
the
lower
ranges
of
the
PBS,
and
balance
performance was moderately associated with functional
disability.
Additionally,
the
association
between
functional
disability
and
balance
performance,
as
measured
by
the
Childhood
Health
Assessment
Questionnaire
(CHAQ),
was
strong
and
signicant,
supporting the clinical importance of postural decits in
children. The high prevalence of balance impairment in
this study is consistent with recent research highlighting
motor
and
functional
decits
in
children
with
JIA.
According
to
Yenil
et
al.
(2024),
children
with
JIA
scored
much
lower
on
motor
prociency
assessment
tests
than
healthy
children,
with
dierences
in
both
gross
and
ne
motor
movements.
14
Similarly,
Vincent
DISCUSSION
Assessment of Postural Stability in Pediatric Population with Juvenile
112
J Gandhara Med Dent Sci
October - December 2026
LIMITATIONS
This study's
ndings are subject to several limitations
that
should
be
considered.
The
cross-sectional
design
could
not
support
causal
inferences
about
the
relationship between balance and functional disability.
Due
to convenience sampling, the study
ndings
may
lack generalizability. In this study, participants were not
stratied by JIA subtype or disease activity, which may
inuence balance outcomes. We excluded children with
cognitive,
visual,
or
orthopedic
comorbidities,
which
may
not
be
representative
of
the
general
JIA
population.
Lastly,
the
sample
size
was
sucient
for
the primary analyses but may have been underpowered
to
detect
less
pronounced
associations,
including
gender-related
ones.
The
PBS
bands
used
for
descriptive
purposes
in
this
study
are
not
validated
severity
categories,
and
the
primary analysis therefore
treated
PBS
as
a
continuous
variable.
Future
studies
should
establish
validated
PBS
cut-os
for
pediatric
JIA populations.
CONCLUSIONS
In
this
cohort
of
children
with
JIA,
a
substantial
proportion scored in
the
lower
ranges
of the Pediatric
Balance Scale, and lower PBS scores were moderately
correlated
with
greater
functional
disability
on
the
CHAQ.
These
ndings
suggest
that
clinicians
should
assess
balance
as
part
of
routine
pediatric
JIA
evaluation and that targeted balance training may be a
useful
component
of
rehabilitation.
However,
because
no
healthy
control
group
was
included,
these
results
cannot
establish
that
postural
stability
is
impaired
relative
to
typically
developing
children.
Future
controlled,
longitudinal
studies
are
needed
to
conrm
idiopathic
arthritis:
a
meta-analysis
of
randomised
controlled
trials.
Pediatr
Rheumatol
Online
J.
2024;22(1):33.
doi:10.1186/s12969-024-00967-3. PMID: 38438855.
14.
Yenil
S,
Gür
Kabul
E, Başakc
Çalk B,
Klbaş
G,
Yüksel
S.
Investigation of motor skill in patients with juvenile idiopathic
arthritis:
a
cross-sectional
study.
Rev
Colomb
Reumatol.
2025;32(1):36-42. doi:10.1016/j.rcreu.2023.11.005.
15.
Vincent
HK,
Sharifar
S,
Abdelmalik
B,
Lentini
L,
Chen
C,
Woolnough
LU.
Gait
parameters,
functional
performance
and
physical
activity
in
active
and
inactive
juvenile
idiopathic
arthritis.
Gait
Posture.
2022;98:226-232.
doi:10.1016/j.gaitpost.2022.09.080. PMID: 36191581.
16.
Elnaggar RK, Mahmoud WS, Moawd SA, Azab AR. Impact of
core
stability
exercises
on
bone
mineralisation
and
functional
capacity
in
children
with
polyarticular
juvenile
idiopathic
arthritis:
a
randomised
clinical
trial.
Clin
Rheumatol.
2021;40(1):245-253.
doi:10.1007/s10067-020-05219-9.
PMID:
32514677.
these
ndings
and
evaluate
the
eect
of
balance-
focused interventions on functional outcomes.
CONFLICT OF INTEREST:
None
FUNDING SOURCES:
None
REFERENCES
1.
Long AM, Marston B. Juvenile idiopathic arthritis. Pediatr Rev.
2023;44(10):565-577.
doi:10.1542/pir.2022-005623.
PMID:
37777651.
2.
Lee JJY, Eng SWM, Guzman J, Duy CM, Tucker LB, Oen K,
et al. A comparison of International League of Associations for
Rheumatology and Pediatric Rheumatology International Trials
Organization
classication
systems
for
juvenile
idiopathic
arthritis among children in a Canadian arthritis cohort. Arthritis
Rheumatol.
2022;74(8):1409-1419.
doi:10.1002/art.42113.
PMID: 35289119.
3.
Beesley
RP,
Hyrich
KL,
Humphreys
JH.
POS0745
The
incidence and prevalence of juvenile idiopathic arthritis diers
between
ethnic
groups
in
England.
Ann
Rheum
Dis.
2023;82(Suppl
1):663.
doi:10.1136/annrheumdis-2023-
eular.482.
4.
Zheng X, Liang Y, Cai J, Liu R. Childhood juvenile idiopathic
arthritis combined with Klinefelter syndrome: a case report and
literature
review.
Am
J
Transl
Res.
2025;17(9):7300-7307.
doi:10.62347/RAYG2315. PMID: 41113051.
5.
Ramos FO, Zinterl C, Fonseca JE. A lifelong journey: long-term
perspectives on juvenile idiopathic arthritis. Best Pract Res Clin
Rheumatol.
2024;38(3):101984.
doi:10.1016/j.berh.2024.101984. PMID: 39068102.
6.
Ventura
I,
Meira-Blanco
GC,
Legidos-García
ME,
Prez-
Bermejo M, Murillo-Llorente MT.
Is there a link between the
molecular basis of juvenile idiopathic arthritis and autoimmune
diseases?
Systematic
review.
Int
J
Mol
Sci.
2024;25(5):2803.
doi:10.3390/ijms25052803. PMID: 38474052.
7.
La Bella S, Rinaldi M, Di Ludovico A, Di Donato G, Di Donato
G,
Salpietro
V,
et
al.
Genetic
background
and
molecular
mechanisms
of
juvenile
idiopathic
arthritis.
Int
J
Mol
Sci.
2023;24(3):1846. doi:10.3390/ijms24031846. PMID: 36768167.
8.
Chickermane
PR,
Panjikaran
ND,
Balan
S.
Role
of
rehabilitation
in
comprehensive
management
of
juvenile
idiopathic
arthritis:
when
and
how?
Indian
J
Rheumatol.
2023;18(1 Suppl). doi:10.4103/injr.injr_55_22.
9.
Fazaa A, Sellami M, Ouenniche K, Miladi S, Kassab S, Chekili
S, et al. Physical activity assessment in children and adolescents
with juvenile idiopathic arthritis compared with controls. Arch
Pediatr.
2021;28(1):47-52.
doi:10.1016/j.arcped.2020.10.008.
PMID: 33250332.
10.
Nesbitt C, Kuntze G, Toomey C, Esau S, Brooks J, Mosher D,
et al. Secondary consequences of juvenile idiopathic arthritis in
children
and
adolescents
with
knee
involvement:
physical
activity,
adiposity,
tness,
and
functional
performance.
Rheumatol
Int.
2022;42(2):319-327.
doi:10.1007/s00296-021-
04920-5. PMID: 34132889.
11.
Rochette E, Saidi O, Merlin É, Duch P. Physical activity as a
promising alternative for young people with juvenile idiopathic
arthritis:
towards
an
evidence-based
prescription.
Front
Immunol. 2023;14:1119930. doi:10.3389/mmu.2023.1119930.
PMID: 36860845.
12.
Guerriero S, Palmieri R, Craig F, La Torre F, Albano V, Alessio
G, et al. Psychological eects and quality of life in parents and
children
with
JIA-associated
uveitis.
Children
(Basel).
2022;9(12):1864.
doi:10.3390/children9121864.
PMID:
36553308.
13.
Liu
WY,
Li
HM,
Jiang
H,
Zhang
WK.
Eect
of
exercise
training on heath, quality of
life,
exercise capacity in juvenile
Assessment of Postural Stability in Pediatric Population with Juvenile
113
J Gandhara Med Dent Sci
October - December 2026
17.
Di Ludovico A,
La Bella S, Di Donato G, Felt J, Chiarelli F,
Breda L. The benets of physical therapy in juvenile idiopathic
arthritis.
Rheumatol
Int.
2023;43(9):1563-1572.
doi:10.1007/s00296-023-05380-9. PMID: 37382676.
18.
Lupini F, Rubinstein TB, Mackey ER, Sule S. Behavioral health
outcomes
and
social
determinants
of
health
in
children
with
diabetes
and
juvenile
arthritis.
Res
Sq
[Preprint].
2023
Nov
28.3.rs-3610878.
doi:10.21203/rs.3.rs-3610878/v1.
PMID:
38076886.
19.
Iversen
MD,
Andre
M,
von
Heideken
J.
Physical
activity
interventions
in
children
with
juvenile
idiopathic
arthritis:
a
systematic
review
of
randomised
controlled
trials.
Pediatric
Health
Med
Ther.
2022;13:115-143.
doi:10.2147/PHMT.S282611. PMID: 35444485.
.
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Amina Ashfaq
-
Concept & Design; Data Acquisition;
Critical
Revision; Supervision;
Final Approval
Somia
Faisal
-
Concept
&
Design;
Data
Acquisition;
Data
Analysis/Interpretation; Critical Revision; Final Approval
Sarfaraz
Ahmad
-
Concept
&
Design;
Data
Acquisition;
Drafting
Manuscript;
Critical
Revision;
Supervision;
Final
Approval
Amina
Liaquat
-
Concept
&
Design;
Data
Acquisition;
Drafting
Manuscript;
Critical
Revision;
Supervision;
Final
Approval
Sajal Rehman Nawaz
-
Concept & Design; Data Acquisition;
Drafting
Manuscript;
Critical
Revision;
Supervision;
Final
Approval
Fatima
Ali
-
Concept
&
Design;
Data
Acquisition;
Drafting
Manuscript;
Critical
Revision;
Supervision;
Final
Approval
AUTHORS CONTRIBUTION
The authors accept responsibility for all aspects of the work
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Assessment of Postural Stability in Pediatric Population with Juvenile
