Cvičení při JIA — aktivita JE léčba (Klepper 2008), screening uveitidy povinný, sport kompatibilní v remisi

ILAR classification + ACR 2019 management + 2022 JADAS-CRP framework. Juvenile idiopathic arthritis is the most common pediatric rheumatologic disease, encompassing six subtypes: oligoarticular (most common, ANA+ subset has the highest uveitis risk), polyarticular RF+ and RF-, systemic-onset (Still's disease), psoriatic, enthesitis-related, and undifferentiated. Treatment combines methotrexate + biologics (anti-TNF, IL-6 inhibitors, JAK inhibitors). Uveitis screening per AAP/AAO is mandatory (slit-lamp Q3-12 months by ANA status + age + disease duration) — undiagnosed uveitis is the leading cause of vision loss in JIA. Klepper 2008 + Wakefield 2010 + 2021 systematic review established that graded aerobic + resistance training IMPROVES function + reduces flares — overturning the long-held 'avoid sports' advice that limited generations of JIA kids unnecessarily. Sports are compatible in remission; the recommendation now is REGULAR activity per pediatric rheum. During active arthritis, joint protection + heat + reduced load are appropriate; this is not the same as 'no exercise'.

Volya's catalogue carries the foundation moves: supported-glute-bridge for posterior chain low-intensity work, wall-push-up for scaled upper-body strength, scapular-retraction for posture, cat-cow for spinal mobility, supine-knee-to-chest for low-back release, diaphragmatic-breathing for parasympathetic regulation, standing-march for managed cardio, sit-to-stand for functional + bone-loading (steroid-induced bone effects + growth), ankle-pump for circulation + DVT prevention if immobile during flare. The AI coach also knows the nutrition side — growth + protein 1.0-1.5 g/kg/day pediatric-RDA-appropriate + leucine adequate (anabolic response differs in children), calcium 800-1300 mg + vitamin D 600-1000 IU/day for bone density during growth (steroid + JIA inflammation impair both), Mediterranean anti-inflammatory backbone (Berntson 2020/2022 reviews), omega-3 1-2 g/day pediatric-appropriate, MTX folate effects folic acid 1-5 mg/day per pediatric rheum, AVOID excessive caffeine + energy drinks (sleep + medication + bone Ca), iron + B12 + folate check, AVOID restrictive diets without pediatric dietitian (calorie + growth + medication tolerance), growing-pain non-specificity rule out anemia + vit D before assuming flare. CRITICAL: Arthritis Foundation + ACR + IL-CARRA + pediatric rheumatology + pediatric ophthalmology (uveitis screen Q3-12 months) + pediatric dentistry (TMJ involvement common) + pediatric dietitian + pediatric/family psych. This is NEVER a replacement for pediatric rheumatology care.