• Houghton, Kristin

    Titles

    Investigator, BC Children's Hospital
    Pediatrician, BC Children's Hospital
    Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia

    Degrees / Designations
    BA, MD, FRCPC
    Primary Area of Research
    Childhood Diseases
    Secondary Area(s) of Research
    Phone
    604-875-2437
    Fax
    604-875-3141
    Lab Phone
    Mailing Address

    BC Children's Hospital
    Room K4-123 
    4480 Oak Street
    Vancouver, BC V6H 3V4

    Affiliate Websites

    Exercise in children with chronic illness with a focus on exercise rehabilitation in children with chronic rheumatic diseases.

    Research Areas

     

    Summary
    Current Projects
    Evaluation of dynamic postural balance using the Biodex Balance System® in children with Juvenile Idiopathic Arthritis

    Children and adults with musculoskeletal lower limb injuries are known to lose postural balance. Balance training is now accepted by sports medicine physicians as a standard component of rehabilitation. Adults with arthritis are known to lose balance. It would seem reasonable, although it is not known, that children with arthritis affecting their lower limbs also lose balance. 

    In this pilot study we aim to evaluate and describe postural balance in a cohort of children with JIA and children without musculoskeletal disease or injury. This pilot will provide the framework for a randomized controlled trial to evaluate the role of balance training in rehabilitation of children with arthritis. 

    The pilot data will be sufficient to address the hypotheses that children with JIA have poor static and dynamic balance compared to healthy children and that lower extremity strength is positively correlated with static and dynamic balance. 

    The primary hypothesis of the ensuing intervention trial will be that children with JIA can improve their balance with postural balance training. We believe that balance training and assessment of children with JIA will allow counselling for increased and safe participation in physical activity, decrease the risks of injury and disability, and ultimately improve the quality of life of children with JIA for both the short and long term. 

    Balance training might also be valuable for children with other illnesses that cause interrupted optimal physical participation. 

    Aerobic and anaerobic exercise capacity in Juvenile Idiopathic Arthritis 
    Children with juvenile idiopathic arthritis (JIA) have lower physical fitness and lower peak oxygen consumption (VO2 peak) compared to healthy children. Suboptimal VO2 peak may be due to central limitations, characterized by suboptimal heart rate response, cardiac output (CO) or oxygen saturation; or peripheral limitations, characterized by high mixed venous oxygen content (low A-VO2). 

    In order to examine the cardiorespiratory response during aerobic exercise and the anaerobic to aerobic ratio (metabolic index), patients with JIA and age and sex matched controls are undergoing maximal aerobic and anaerobic exercise tests on a cycle ergometer. 

    During aerobic exercise we measure CO (litres/minute) with Doppler echocardiography. Arterial – mixed venous oxygen index (A-VO2) and systemic vascular resistance (SVR) are calculated. We hypothesize children with JIA will have lower VO2 peak and lower anaerobic fitness (peak power and total work) than their healthy age matched peers and that children with JIA will have a different cardiorespiratory response during maximal aerobic exercise tests compared to healthy age matched peers. 

    Children with JIA will have less efficient muscle oxygen utilization during maximal exercise, manifest by lower arterial – venous oxygen difference (A-VO2) (corresponding to higher mixed venous oxygen difference) at a given CO and higher systemic vascular resistance (SVR). We believe better understanding of the cardiorespiratory response during exercise will allow us to more effectively prescribe exercise in children with JIA.

    Selected Publications

    Shiff NJ, Abdwani R, Cabral DA, Houghton KM, Malleson PN, Petty RE, Espinosa VM, Tucker LB.: Access to pediatric rheumatology subspecialty care in British Columbia, Canada. J Rheumatol. 2009 Feb;36(2):410-5.

    Houghton, K.: Role of activity in health and its effect on morbidity and mortality in chronic rheumatic diseases of childhood. In: Kutcha G, Davidson I, eds.  Occupational and Physical Therapy for Children with Rheumatic Diseases: A Clinical Handbook. Radcliff Publishing. Oxford, 2008.

    Houghton KM, Potts JE, Sheel AW, Petty RE, McKenzie DC.: Aerobic and anaerobic capacity in Juvenile Idiopathic Arthritis: evaluation of the cardiorespiratory response. Internet Journal of Rheumatology. 2008 Oct. Vol 5 No 2. Internet Journal of Rheumatology. 2008 Oct. Vol 5 No 2.

    Abdwani R, Houghton K, Dobson S, O' Sullivan M, Malleson P.: An adolescent with both Wegener's Granulomatosis and chronic blastomycosis. Pediatric Rheumatology Online J. 2008 Aug, 6:13
     
    Houghton KM.: Review for the generalist: evaluation of pediatric foot and ankle pain. Pediatr Rheumatol Online J. 2008 Apr 9;6:6.

    Houghton KM, Tucker LB, Potts JE, McKenzie DC.: Fitness, fatigue, disease activity, and quality of life in pediatric lupus. Arthritis Rheum. 2008 Apr 15;59(4):537-45.

    De Souza A, Houghton K, Sanatani S, Duncan W, Sandor G, Potts J. Development of a hospital-based exercise prescription clinic for obese children. Med Sci Sports Exerc 2008;40(5 Suppl): Accepted for Presentation at the 55th Annual Meeting of the American College of Sports Medicine, Indianapolis, 2008. 

    De Souza A, Houghton K, Sanatani S, Duncan W, Sandor G, Potts J. Baseline fitness measures in a cohort of obese children. Med Sci Sports Exerc 2008;40(5 Suppl): Accepted for Presentation at the 55th Annual Meeting of the American College of Sports Medicine, Indianapolis, 2008. 

    Houghton KM. Review for the generalist: evaluation of anterior knee pain. Pediatric Rheumatology 2007,5:8. (Biomed central)

    Houghton KM, Cabral DA, Petty RE, Tucker LB. SLE in the pediatric North American Native population of British Columbia. Journal of Rheumatology 2006;33:161-163.

    Houghton KM, Malleson PN, Cabral DA, Petty RE, Tucker LB. Primary Sjogren’s syndrome in children and adolescents: Are current diagnostic criteria valid? Journal of Rheumatology 2005;32:2225-32. 

    Houghton K, Cabral D, Petty R, Tucker L. Primary Sjogren’s syndrome in dizygotic adolescent twins: one case presentation with lymphocytic interstitial pneumonia. Journal of Rheumatology 2005;32:1603-6. 

    Houghton K, Huber A, Ramsey S, Wren P and Lang B. Clinical trial of the sensitivity to tuberculin in children referred for evaluation of Kawasaki disease. Pediatric Rheumatology Online Journal. Volume 2 Number 6. February 2004. 

    Grants
    Honours & Awards

    Balance in children with Juvenile Idiopathic Arthritis. Equipment grant from the Abercrombie Foundation to purchase the Biodex Balance System® ($22,148.70).

    Comparing aerobic and anaerobic power during upper and lower body exercise in pediatric subjects. Pediatric Exercise Working Group. Grant from College-Wide Fund for Scholarly Activity, Douglas College ($3000.00) 

    Principal applicant Kathryn Duff PhD. Co-applicants: James E Potts PhD, William Sheel PhD, Bonnie Sawatzky PhD, Astrid DeSouza MSc. Clinical Investigator Program; Royal College of Physicians and Surgeons Fellowship Program. University of British Columbia. Funding for July 2005 to January 2007. Project title: Aerobic capacity in juvenile idiopathic arthritis: central versus peripheral limitations. 

    Research Group Members

    Pediatric Exercise Working Group (includes exercise scientists from UBC and Douglas College):

    • Kathryn Duff, PhD 
    • James E Potts, PhD 
    • William Sheel, PhD
    • Bonnie Sawatzky, PhD 
    • Astrid DeSouza, MSc