Dos Santos WR. Assessing joint damage in juvenile idiopathic arthritis: Guide for prescribing physical exercise with the juvenile arthritis damage index. World J Clin Pediatr 2026; 15(1): 113152 [DOI: 10.5409/wjcp.v15.i1.113152]
Corresponding Author of This Article
Wlaldemir Roberto Dos Santos, Adjunct Professor, School of Physical Education, University of Pernambuco, School of Physical Education, University of Pernambuco, 310 Arnóbio Marques St, Santo Amaro, Recife 50100-130, Brazil. wlaldemir.santos@upe.br
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Rheumatology
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Letter to the Editor
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Mar 9, 2026 (publication date) through Mar 9, 2026
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World Journal of Clinical Pediatrics
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2219-2808
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Dos Santos WR. Assessing joint damage in juvenile idiopathic arthritis: Guide for prescribing physical exercise with the juvenile arthritis damage index. World J Clin Pediatr 2026; 15(1): 113152 [DOI: 10.5409/wjcp.v15.i1.113152]
World J Clin Pediatr. Mar 9, 2026; 15(1): 113152 Published online Mar 9, 2026. doi: 10.5409/wjcp.v15.i1.113152
Assessing joint damage in juvenile idiopathic arthritis: Guide for prescribing physical exercise with the juvenile arthritis damage index
Wlaldemir Roberto Dos Santos
Wlaldemir Roberto Dos Santos, School of Physical Education, University of Pernambuco, Recife 50100-130, Brazil
Author contributions: Dos Santos WR was responsible for the conception, preparation, literature review, and finalization of this manuscript.
Conflict-of-interest statement: The author declares that he has no conflicts of interest relevant to this manuscript.
Corresponding author: Wlaldemir Roberto Dos Santos, Adjunct Professor, School of Physical Education, University of Pernambuco, School of Physical Education, University of Pernambuco, 310 Arnóbio Marques St, Santo Amaro, Recife 50100-130, Brazil. wlaldemir.santos@upe.br
Received: August 18, 2025 Revised: September 11, 2025 Accepted: December 24, 2025 Published online: March 9, 2026 Processing time: 202 Days and 12.8 Hours
Abstract
Juvenile idiopathic arthritis (JIA) is a chronic disease capable of causing significant structural and functional damage. The study by Kolkhidova et al demonstrated that baseline structural damage, assessed by the juvenile arthritis damage index (JADI), is a strong predictor of poor response to biological treatment. While promising, these findings require validation in larger and more diverse cohorts to enhance external applicability. In addition to reinforcing early pharmacological decision-making, these results highlight the importance of integrating a precise damage assessment into rehabilitation planning, as it can support individualized exercise prescriptions and targeted physiotherapy. JADI can identify patients with established lesions, such as contractures, who may benefit from personalized physical exercise and physiotherapy programs. A more explicit emphasis on how damage assessment guides functional planning can improve the clinical applicability of these findings. Early integration of rehabilitation alongside medication therapy can help not only restore function but also prevent further deterioration, improve adherence, and foster long-term self-management. Incorporating JADI assessment into clinical practice can optimize exercise prescription, improve mobility and strength, and ultimately enhance quality of life in patients with JIA.
Core Tip: Juvenile idiopathic arthritis (JIA) can lead to irreversible structural and functional damage. The juvenile arthritis damage index (JADI) emerges as a valuable tool for assessing long-term joint involvement and guiding therapeutic strategies. In addition to predicting pharmacological response, JADI offers specific advantages over disease activity scores-such as juvenile arthritis disease activity score-because it reflects irreversible damage rather than active inflammation, making it particularly relevant for long-term rehabilitation planning. Beyond predicting pharmacological response, JADI enables the identification of patients with established lesions who require tailored rehabilitation. Early integration of individualized physical exercise and physiotherapy with medical treatment may restore function, prevent further deterioration, and enhance adherence. Incorporating JADI into clinical practice optimizes exercise prescription, mobility, and quality of life in patients with JIA.
