Pos1459-HPR Investigation of the Efficacy of Self-Management Supported Telerehabilitation in Children and Adolescents With Juvenile Idiopathic Arthritis: A Randomized Controlled Study

Background: Juvenile idiopathic arthritis (JIA) is the most common chronic pediatric rheumatic disease leading to joint inflammation, fatigue, muscular weakness, poor endurance, reduced function and quality of life. Considering the long-term nature of the disease, it is important for children to learn the management their well-being and coping with the symptoms 1,2. However, exercise capacity is impaired in JIA, and they spend less time on physical activities compared to their healthy peers 3. While telerehabilitation-based exercise programs represent a contemporary treatment approach that needs to be explored and developed in chronic diseases, studies on this in JIA are limited. Objectives: To investigate the effect of self-management-supported telerehabilitation-based exercise programs on pain, functional status, lower extremity muscle strength and performance, quality of life, self-efficacy and biopsychosocial status in children and adolesants with JIA and compare the synchronous and asynchronous methods. Methods: A total of 26 patients with JIA diagnosed according to ILAR criteria were included and randomized into synchronous (n=13, mean age=13.23±2.58 years, 5 male) or asynchronous groups (n=13, mean age=13.15±2.76 years, 5 male). Both group received the same self-management training sessions and exercise programs three times a week for 12 weeks. In the synchronous group, exercise programs will be implemented through video conferencing (Zoom) under the supervision of a physiotherapist, while in the asynchronous group, exercise videos will be shared, and participants will be instructed to perform the exercises by watching the videos. The exercise program consisted of functional exercises focusing on core stabilization with warm-up and cool-down periods. After demographic and disease-related data were recorded, pain (numeric rating scale-NRS), functional status (Childhood Health Assessment Questionnariaes-CHAQ), lower extremity muscle strength and performance (five times sit-to-stand test), quality of life (Pediatric Quality of Life Inventory 3.0 Arthritis Module-PedsQL), self-efficacy (Self-Efficacy For Managing Chronic Disease 6-item Scale-SE) and biopsychosocial status (The Juvenile Arthritis Biopsychosocial and Clinical Questionnaire-JAB-Q) were assessed at baseline and after the intervention. Wilcoxon and Mann-Whitney U test were used to analyze the data. Results: The groups were similar at baseline. After treatment, five times sit-to-stand test (p=0.03) and SE (p=0.041) improved significantly in the synchronous group, while only five times sit-to-stand test (p=0.016) improved significantly in the asynchronous group. When the delta data were compared, there was a significant difference in favor of the synchronous group in five-time sit-to-stand test and SE, while there was a significant difference in favor of the asynchronous group in NRS (pConclusion: Self management education supported telerehabilitation-based exercise program seems benefical on pain, self-efficacy and lower extremity muscle strength and performance in children and adolesants with JIA. REFERENCES: 1 Palman J, Shoop-Worrall S, Hyrich K, McDonagh JE. Update on the epidemiology, risk factors and disease outcomes of Juvenile idiopathic arthritis. Best Pract Res Clin Rheumatol. 2018 Apr;32(2):206–22. doi: 10.1016/j.berh.2018.10.004.S1521-6942(18)30067-6. 2 Armbrust W, Bos JJ, Cappon J, van Rossum MA, Sauer PJ, Wulffraat N, van Wijnen VK, Lelieveld OT. Design and acceptance of Rheumates@Work, a combined internet-based and in person instruction model, an interactive, educational, and cognitive behavioral program for children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J. 2015 Jul 23;13:31. 3 Tarakci E, Kisa EP, Arman N, Albayrak A. Physical activity and exercise in patients with pediatric rheumatic disease: A systematic search and review. Turk Arch Pediatr. 2021 May 1;56(3):179-186. Acknowledgements: NIL. Disclosure of Interests: None declared.