Self-Management Supported Telerehabilitation in Children and Adolescents With Juvenile Idiopathic Arthritis

The Efficacy of Telerehabilitation-Based Self-Management Supported Exercise in Children and Adolescents With Juvenile Idiopathic Arthritis: A Randomized Controlled Study

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of unknown etiology in childhood. JIA covers several different subgroups and is predominantly manifested by peripheral arthritis. Joint swelling, effusion, tenderness, pain in JIA; causes functional limitations, fatigue and quality of life disorders. Chronic inflammation limits the patient's daily activities and productivity. Self-management is defined as an individual's ability to manage their symptoms, treatment, lifestyle changes, and the psychosocial and cultural consequences of health conditions. Good self-efficacy and coping skills reduce the health and financial burden on the individual as well as on health care, benefiting society in general. Telerehabilitation is the dissemination of rehabilitation services through communication technologies. In the literature, it is seen that the studies on internet-based exercise applications are limited. In the studies, people were encouraged to physical activity with an internet-based application and the benefits of being active were given within the scope of patient education, and it was reported that the level of physical activity effectively improved as a result. It can also increase endurance, has been reported to be safe and feasible. In our study, unlike the literature, the self-management program and exercise applications will be integrated into the internet-based telerehabilitation method, based on the fact that the exercise practices in JIA are effective in disease management and improvement of symptoms. Therefore, in our study; the effectiveness of telerehabilitation-based exercise methods to be applied additionally synchronously and asynchronously to self-management education in children and adolescents with JIA on pain, disease activity, functional status, fatigue, quality of life, psychosocial status, self-efficacy and satisfaction will be examined and compared.

Inclusion Criteria:

• Having been diagnosed with Juvenile Idiopathic Arthritis according to ILAR diagnostic criteria
• 8-18 years old
• Agreeing to do the exercises throughout the study
• Stable symptoms and medications
• Internet and computer access

Exclusion Criteria:

• Be younger than 8 years old
• Surgical or arthroscopic operation in the last 1 year
• Having any musculoskeletal disease or orthopedic, neurological, psychological disease that may prevent participation in exercise
• Presence of active synovitis and arthritis
• Active vestibular disease
• Family and patient's inability to adapt to the assessment
• Having a psychiatric illness that affects cooperation
• Having heart failure and lung pathology at a level that will affect activities of daily living