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Fatigue in children with ESR-JIA is associated with lower muscle mass, weaker ankle plantarflexor strength, higher pain intensity, depression-related cognitive changes, and poorer sleep efficiency.

In a cross-sectional study of 77 children with enthesitis/spondylitis-related juvenile idiopathic arthritis (ESR-JIA), fatigue severity was independently associated with pain intensity, depression-related cognitive changes, ankle plantarflexion strength, and sleep efficiency. These factors collectively explained 33.6% of the variance in fatigue scores measured by the PedsQL-MFS.

Last updated: Jul 23, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★☆☆
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Factors associated with fatigue in children with enthesitis/spondylitis-related juvenile idiopathic arthritis: an exploratory cross-sectional study.

observational

Zhang M, Xing Y, He X, Guo G, Chen N · Pediatric rheumatology online journal (2026)

Participants: N/A
Duration: Cross-sectional (single time point)
Intervention: Observational study; no intervention tested.
Outcome: Fatigue severity measured by Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL-MFS) total score.
Effect Size: R² = 0.336 (33.6% of variance explained by final model)
Population: 77 children diagnosed with enthesitis/spondylitis-related juvenile idiopathic arthritis (ESR-JIA).

Result:

PubMed: 42469797DOI: 10.1186/s12969-026-01247-y

Mechanism Graph

Higher pain intensity and depression-related cognitive changes increase fatigue perception
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Lower ankle plantarflexion strength and poorer sleep efficiency contribute to physical and restorative deficits
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These factors collectively worsen fatigue severity in children with ESR-JIA

Limitations

  • ⚠Cross-sectional design prevents causal inference
  • ⚠Small sample size (n=77) limits generalizability
  • ⚠Exploratory analysis with multiple comparisons may inflate type I error

Frequently Asked Questions

What is the PedsQL-MFS and how is it scored?▼

The Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL-MFS) is a validated questionnaire assessing fatigue in children. Higher scores indicate less fatigue.

Which factors were independently associated with fatigue in ESR-JIA?▼

Pain intensity, depression-related cognitive changes, ankle plantarflexion strength, and sleep efficiency were independently associated with fatigue in the stepwise multivariable regression model.

How much variance in fatigue did the final model explain?▼

The final model explained 33.6% of the variance in PedsQL-MFS total scores.

What are the clinical implications of this study?▼

The findings highlight the multidimensional nature of fatigue in ESR-JIA, suggesting that management should address pain, depression, muscle strength, and sleep quality.

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References

  1. 1.Zhang M, Xing Y, He X, Guo G, Chen N. "Factors associated with fatigue in children with enthesitis/spondylitis-related juvenile idiopathic arthritis: an exploratory cross-sectional study.." Pediatric rheumatology online journal, 2026. PMID: 42469797 DOI: 10.1186/s12969-026-01247-y
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.