Effects of Telemonitoring-supported Game-based Home Exercises in Juvenile Idiopathic Arthritis

Not Applicable

Completed

• Conditions: Exercise Therapy; Juvenile Idiopathic Arthritis

• Registration Number: NCT05837247
• Lead Sponsor: Istanbul University - Cerrahpasa (IUC)

Brief Summary

In order to cope with pain, improve quality of life and prevent kinesiophobia in children with juvenile idiopathic arthritis, most of the physiotherapy approaches used so far are standard.

However, nowadays, it has been observed that participation in treatment has increased with game-based exercises instead of standard physiotherapy. In addition, remote monitoring applications made it possible to perform physiotherapy programs, which are an integral part of the treatment in children with JIA, who is difficult to reach the clinic due to reasons such school schedule and living area, through remote monitoring. This project aimed to investigate the effects of telemonitoring-supported game-based home exercise programs on pain, kinesiophobia and quality of life.

The original aspect of our project is to include telemonitoring-supported game-based home exercise programs as an alternative physiotherapy program in children with JIA. Its contribution to clinical practice is to change the perspective of physiotherapists and children on standard physiotherapy practices, to increase their motivation, and to ensure children's participation in treatment.

Detailed Description

Juvenile rheumatic diseases are chronic diseases with a prognosis ranging from complete recovery to long-term disability. Juvenile idiopathic arthritis (JIA) is the most common rheumatologic disease in children. Pain is one of the main clinical symptoms in JIA. Due to pain, these children with rheumatic diseases avoid moving. The fear of moving because of this pain is defined as kinesiophobia. Kinesiophobia (fear of movement); It is defined as an excessive and unreasonable fear of physical action to avoid harm or re-injury. Its prevalence in chronic pain varies between 50-70%. Regular physical activity and fitness exercises can prevent kinesiophobia; Treatment includes therapeutic exercises and cognitive behavioral therapy.

In order to cope with pain, improve quality of life and prevent kinesiophobia in children with juvenile idiopathic arthritis, most of the physiotherapy approaches used so far are standard.

However, nowadays, it has been observed that participation in treatment has increased with game-based exercises instead of standard physiotherapy. In addition, remote monitoring applications made it possible to perform physiotherapy programs, which are an integral part of the treatment in children with JIA, who is difficult to reach the clinic due to reasons such school schedule and living area, through remote monitoring. This project aimed to investigate the effects of telemonitoring-supported game-based home exercise programs on pain, kinesiophobia and quality of life.

In this study, the participants will be evaluated and training game-based exercises at the baseline examination. Then, the participants will be followed the online synchronous communication application-based telemonitoring method After the game-based home exercises intervention, the participants will be re-evaluated again and the results will be compared.

Study Timeline

• Study First Submitted: 2023-03-29
• Study Start: 2023-03-30
• Study First Submitted QC: 2023-04-28
• Study First Posted: 2023-05-01
• Primary Completion: 2023-12-31
• Study Completion: 2024-03-01
• Status Verified: 2024-11
• Last Update Submitted: 2024-11-13
• Last Update Posted: 2024-11-15

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

1. Whose are diagnosed with JIA at least 1 year ago
2. Whose are aged 6-16 years
3. Whose are having pain in lower extremity joints for more than the last 6 months
4. Whose have stable medical treatment
5. Whose are at a level to understand the games and perform the activities mentally

Exclusion Criteria

1. Patients with neurological problems in addition to rheumatic diagnosis
2. Individuals who are contraindicated to exercise

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
The Tampa Scale for Kinesiophobia	immediately After intervention	It is a 17-item scale developed to measure the fear of movement/re-injury. The scale includes parameters of injury/re-injury and fear-avoidance in work-related activities. A 4-point Likert scoring (1 = I strongly disagree, 4 = I totally agree) is used in the scale. After reversing items 4, 8, 12 and 16, a total score is calculated. The person gets a total score between 17-68. A high score on the scale indicates a high level of kinesiophobia. It is recommended to use the total score in studies. In our study, the fear of avoiding movement will be evaluated with TSK. The unit of this outcome is a score.
Ankle dorsi-plantar flexion range of motion	immediately After intervention	The pre-study and post-study ankle dorsi-plantar flexion passive ranges of motion (ROM) were measured by goniometric measurement.
Hip flexion-extension range of motion	immediately After intervention	The pre-study and post-study hip flexion/extension passive ranges of motion (ROM) were measured by goniometric measurement.
Hip abduction/adduction range of motion	immediately After intervention	The pre-study and post-study hip abduction/adduction passive ranges of motion (ROM) were measured by goniometric measurement.
Knee flexion and extension range of motion	immediately After intervention	The pre-study and post-study knee flexion and extension passive ranges of motion (ROM) were measured by goniometric measurement.
Hip internal-external rotation range of motion	immediately After intervention	The pre-study and post-study hip internal-external rotation passive ranges of motion (ROM) were measured by goniometric measurement.
The Wong-Baker Faces Pain Rating Scale	immediately After intervention	A self-report tool called The Wong-Baker Faces Pain Rating Scale is used to assess how much pain kids are experiencing. It is widely acknowledged that measuring children's pain is challenging for medical professionals.; This is because children express pain differently than adults due to differences in their language, communication, and developmental stages.; The Wong-Baker Pain Scale has 6 faces. The first face represents a pain score of 0 and indicates "not hurt". The second face is a 2 represents the pain score and means "it hurts a little". The third face represents a pain score of 4 and "it hurts a little more" shows. The fourth face represents a pain score of 6 and indicates "it hurts more". The fifth face represents a pain score of 8.; and shows that "it hurts a lot"; the sixth face represents a pain score of 10 and indicates "worst pain". The unit of this outcome is a score.
Pediatric Quality of Life Inventory (PedsQL) 3.0 Arthritis Module	immediately After intervention	Patients with JIA have the Pediatric Quality of Life Inventory (PedsQL) 3.0 arthritis module. This criterion has been translated into Turkish and its validity has been demonstrated. 44 Evaluations are made about pain and suffering (four questions), daily activities (five questions), treatment (seven questions), anxiety (three questions), communication (three questions), and parent and child modules are evaluated separately. The unit of this outcome is a score. Every item is 5-point Likert scale type. Scores are transformed on a scale from 0 to 100. Items are reverse scored and linearly transformed to a 0-100 scale as follows: 0=100, 1=75, 2=50, 3=25, 4=0. Higher scores mean better quality of life and fewer problems or symptoms

Trial Locations

Locations (1)

İstanbul University-Cerrahpasa; 🇹🇷 Istanbul, Turkey