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Nat. Rev. Rheumatol. doi:10.1038/nrrheum.2017.75
Figure 1 A vicious cycle of physical inactivity and/or sedentary lifestyle and systemic dysfunction Figure 1 | A vicious cycle of physical inactivity and/or sedentary lifestyle and systemic dysfunction. Physical inactivity and sedentary behaviour (possibly independently) lead to systemic dysfunction and the aggravation of symptoms in paediatric rheumatic diseases; some symptoms, in turn, can either directly (for example, in the case of joint pain that directly affects physical function) or indirectly (for example, dyslipidaemia, which does not directly affect physical function) predispose the patient to a more sedentary lifestyle. Therefore, a sedentary lifestyle can either be inherent to the disease (for example, in the case of a sedentary patient with marked physical disabilities) or simply incidental to the disease (as in the case of a sedentary patient without any debilitating physical impairments). Social self-isolation and overprotection, fear and/or ignorance on the part of parents, teachers and health care practitioners are also factors that might stimulate inactivity and sedentary behaviours, thereby fuelling this vicious cycle. Gualano, B. et al. (2017) Physical activity for paediatric rheumatic diseases: standing up against old paradigms Nat. Rev. Rheumatol. doi: /nrrheum
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