Muscle function in Juvenile Idiopathic Arthritis A two-year follow-up
نویسندگان
چکیده
.......................................................................................................................................................... 5 ORIGINAL PUBLICATIONS............................................................................................................................. 7 CONTENTS........................................................................................................................................................... 9 INTRODUCTION............................................................................................................................................... 11 Rheumatoid arthritis.................................................................................................................................... 11 Rheumatoid arthritis in childhood............................................................................................................... 11 Muscles ........................................................................................................................................................ 12 Muscles during growth ................................................................................................................................ 14 Strength measurement ................................................................................................................................. 14 Strength measurement in children ............................................................................................................... 16 Muscle function in joint disorders ............................................................................................................... 16 Muscle function in rheumatoid arthritis ...................................................................................................... 17 Muscle function in juvenile idiopathic arthritis........................................................................................... 17 Immunology and muscle .............................................................................................................................. 18 AIMS OF THE STUDY...................................................................................................................................... 19 MATERIAL......................................................................................................................................................... 21 PATIENTS .......................................................................................................................................................... 21 CONTROL AND REFERENCE GROUPS .................................................................................................................. 24 Reference groups ......................................................................................................................................... 24 Controls ....................................................................................................................................................... 24 METHODS .......................................................................................................................................................... 27 MUSCLE STRENGTH........................................................................................................................................... 27 Isometric muscle strength............................................................................................................................ 27 Isokinetic muscle strength ........................................................................................................................... 27 Handgrip strength ....................................................................................................................................... 27 Non-voluntary strength................................................................................................................................ 28 MUSCLE THICKNESS.......................................................................................................................................... 29 MUSCLE BIOPSY ................................................................................................................................................ 30 Muscle biopsy .............................................................................................................................................. 30 Staining........................................................................................................................................................ 30 Immunohistochemistry................................................................................................................................. 30 Fibre types and areas .................................................................................................................................. 31 NERVE CONDUCTION STUDY ............................................................................................................................. 31 JOINT EVALUATION ........................................................................................................................................... 31 DATA ANALYSIS................................................................................................................................................ 32 STATISTICAL ANALYSIS..................................................................................................................................... 32 STUDY DESIGN .................................................................................................................................................. 32 ETHICAL CONSIDERATION ................................................................................................................................. 32 RESULTS AND DISCUSSION.......................................................................................................................... 33 PAPER I ............................................................................................................................................................. 33 PAPER II ............................................................................................................................................................ 51 PAPER III........................................................................................................................................................... 70 PAPER IV .......................................................................................................................................................... 74 SUMMARY OF RESULTS................................................................................................................................ 81 GENERAL CONSIDERATIONS...................................................................................................................... 83 MAIN CONCLUSIONS ..................................................................................................................................... 87
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