Effect of Video assisted Physiotherapy on compliance and functional ability in patients with JIA: A randomized controlled trial

JIA patients typically have follow-ups every three months in the Pediatric Rheumatology Clinic (PRC), making it difficult to assess the compliance to exercise protocol more frequently. This limits direct observation and reinforcement of physiotherapy techniques. To address these challenges, this study explores the use of exercise videos that could mimic direct observation of physiotherapy. This study focuses on compliance to physiotherapy protocol using smartphone/mobile based exercise videos compared to compliance with standard home based exercise protocol. All patients visiting the outpatient department/Pediatric Rheumatology Clinic with diagnosis of JIA, fulfilling the inclusion criteria will be enrolled in the study after proper information and obtaining informed consent from the parents/legally authorized representative (LAR). Assent will be obtained from children >7 years of age. Patients will be divided into two groups: Intervention group (video assisted and routine physiotherapy) and Control group (routine physiotherapy).

Children randomized to intervention group will be taught routine physiotherapy for the affected joints along with which videos of the same will be provided to them. They will be asked to send videos of the exercises daily for the first 7 days. The videos will be assessed by an assessor.  If more than 80% steps are performed correctly according to the check-list, then it will be rated as correct. If the technique is found to be inappropriate it will be corrected on the same day by telephonic call or video call. In case the participant fails to send the videos for 2 consecutive days in the initial 7 days, he/she will be reminded telephonically for the same. After 7 days, participants will send the videos once a week for the next 3 weeks of the first month and then once a month for the remaining 8 months. The patient will be assessed by the two assessors (one of which being an independent assessor) after every 3 months, 6 months and 9 months for the correctness of the technique. They will be reviewed for the functional ability at the end of the study.

Children randomized to control group will continue physiotherapy as usual and be followed up in Pediatric Rheumatology clinic every 3 monthly for 9 months. They would be assessed for correctness of technique and functional ability.

Both the groups will be provided with a diary to record the number of times exercises performed and duration of their daily physiotherapy sessions.