YOGA FOR CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS

INVESTIGATING THE EFFECTIVENESS OF TELEREHABILITATION-BASED YOGA EXERCISES IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS

Juvenile Idiopathic Arthritis (JIA) is a chronic autoimmune condition starting before age 16, often leading to fatigue, joint stiffness, and decreased physical activity. While exercise is widely recommended to improve functional capacity in children with JIA, the effectiveness of specialized mind-body exercises like yoga is still being explored. This study aims to investigate the impact of an 8-week, telerehabilitation-based yoga program on children with JIA. Participants will engage in 45-minute individual yoga sessions twice a week via Zoom, led by certified physiotherapists. The sessions will progress in difficulty and focus on breathing techniques, physical postures, and meditation to improve the overall physical and mental well-being of the children.

Juvenile Idiopathic Arthritis (JIA) is characterized by chronic inflammation that manifests in symptoms such as pain, swelling, movement restriction, and growth retardation. Clinical evidence suggests that exercise interventions, including aerobic and strengthening programs, provide significant benefits for pain management, range of motion (ROM), and quality of life in this population.

Yoga is a traditional exercise discipline that integrates breathing techniques (Pranayama), physical postures (Asanas), and meditation (Dhyana). Due to its adaptable nature and minimal equipment requirements, it has gained popularity as a therapeutic intervention. This study utilizes a telerehabilitation-based approach to deliver yoga to children with JIA, ensuring accessibility and professional guidance at home.

The Intervention Protocol:

Participants will undergo a specialized yoga program twice a week for 8 weeks. Each session will last 45 minutes and will be conducted one-on-one by two physiotherapists certified in "Yoga for Children" via the Zoom platform. The protocol is based on established literature.

Each session follows a structured sequence:

Introduction: Diaphragmatic breathing exercises. Main Phase: Progressive yoga postures (moving from simple to complex). Postures will be held for 2-3 breaths initially, progressing up to 10 breaths as the child's tolerance increases.

Closing: Relaxation and meditation.

List of Yoga Postures to be Utilized:

Mountain Pose, Crescent Pose (Starting positions) Star Pose, Tree Pose, Eagle Pose Bumblebee and Camel Pose Warrior I, II, and III Poses Triangle Pose, Horse Pose Lunge Pose, Butterfly Pose Frog, Pigeon, Turtle, and Basket Poses Diamond and Candle Poses Tiger Pose, Boat Pose Cat-Cow Pose, Reversed Hedgehog Pose Bridge, Rabbit, Child's Pose, and Plank. During transitions, children will be allowed rest periods as needed. The focus will remain on the synchronization of breath and movement throughout the intervention.

Inclusion Criteria:

• Being between 8 and 12 years of age.
• Diagnosed with Juvenile Idiopathic Arthritis (JIA) by a pediatric rheumatologist.
• Having no major changes in pharmacological treatment within the last 3 months.
• Having reliable internet access and the necessary technological equipment to participate in online video sessions.
• Voluntary participation in the study.
• Providing written parental informed consent and child assent.

Exclusion Criteria:

• Being in an acute disease flare-up/attack period.
• Having undergone orthopedic surgery within the last 6 months.
• Presence of severe cardiopulmonary or neurological conditions that contraindicate participating in yoga exercises.
• Cognitive level or impairment that prevents the child from following instructions and verbal cues.
• Regular participation in another structured exercise or physical rehabilitation program.