Physical and Rehabilitation Medicine Modalities in Pediatric Immune-Mediated Rheumatic Diseases: A Narrative Review of Current Evidence and Future Directions
5 affiliations
- 1Department of Physical and Rehabilitation Medicine, Zabok General Hospital and the Croatian Veterans Hospital, 49210 Zabok, Croatia
- 2Department of Rheumatology, Physical and Rehabilitation Medicine, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
- 3Department of Physical Medicine and General Rehabilitation, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
- 4Department of Pediatrics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- 5Department of Pediatrics, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
Abstract
Even when inflammation is controlled, impairments in strength, mobility, physical capacity, and participation may persist in children with immune-mediated rheumatic diseases. This narrative review examines therapeutic interventions relevant to physical and rehabilitation medicine (PRM) in multidisciplinary care. Literature identified through a narrative PubMed/MEDLINE search and examination of reference lists was synthesized by modality. Evidence was most extensive for land-based therapeutic exercise, particularly in juvenile idiopathic arthritis, whereas studies in juvenile dermatomyositis, childhood-onset systemic lupus erythematosus, and childhood-onset Takayasu arteritis were fewer and smaller. Aquatic therapeutic exercise has improved selected measures of pain, fitness, strength, fatigue, or function but has not demonstrated consistent superiority over well-designed land-based therapy. Digital delivery methods have shown potential to support access, feedback, and engagement within goal-directed, appropriately dosed programs. A small number of trials suggest possible adjunctive benefits of photobiomodulation, high-intensity laser therapy, and electromyographic biofeedback, whereas TECAR/CRET should remain investigational because direct evidence in pediatric rheumatic diseases is lacking. Individualized land-based therapeutic exercise should remain the core PRM modality, while aquatic therapeutic exercise may serve as an alternative or transitional option. Future trials should clarify prescription, dose, therapist involvement, adherence, adverse events, growth-plate safety, and participation outcomes.
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BibTeX
@article{lamot2026physical,
title = {{Physical and Rehabilitation Medicine Modalities in Pediatric Immune-Mediated Rheumatic Diseases: A Narrative Review of Current Evidence and Future Directions}},
author = {Leonard Lamot and Frane Grubišić and Lovro Lamot},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218751},
url = {https://www.mdpi.com/2077-0383/15/21/8751},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Physical and Rehabilitation Medicine Modalities in Pediatric Immune-Mediated Rheumatic Diseases: A Narrative Review of Current Evidence and Future Directions
AU - Leonard Lamot
AU - Frane Grubišić
AU - Lovro Lamot
PY - 2026
DA - 2026/11/09
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218751
UR - https://www.mdpi.com/2077-0383/15/21/8751
AB - Even when inflammation is controlled, impairments in strength, mobility, physical capacity, and participation may persist in children with immune-mediated rheumatic diseases. This narrative review examines therapeutic interventions relevant to physical and rehabilitation medicine (PRM) in multidisciplinary care. Literature identified through a narrative PubMed/MEDLINE search and examination of reference lists was synthesized by modality. Evidence was most extensive for land-based therapeutic exercise, particularly in juvenile idiopathic arthritis, whereas studies in juvenile dermatomyositis, childhood-onset systemic lupus erythematosus, and childhood-onset Takayasu arteritis were fewer and smaller. Aquatic therapeutic exercise has improved selected measures of pain, fitness, strength, fatigue, or function but has not demonstrated consistent superiority over well-designed land-based therapy. Digital delivery methods have shown potential to support access, feedback, and engagement within goal-directed, appropriately dosed programs. A small number of trials suggest possible adjunctive benefits of photobiomodulation, high-intensity laser therapy, and electromyographic biofeedback, whereas TECAR/CRET should remain investigational because direct evidence in pediatric rheumatic diseases is lacking. Individualized land-based therapeutic exercise should remain the core PRM modality, while aquatic therapeutic exercise may serve as an alternative or transitional option. Future trials should clarify prescription, dose, therapist involvement, adherence, adverse events, growth-plate safety, and participation outcomes.
SN - 2077-0383
ER -