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

NCT05837247 | Completed

• 1 other identifier: IstanbulUC_ccrpts
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

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.

Conditions

Exercise Therapy; Juvenile Idiopathic Arthritis

Keywords

telemonitoring; physiotherapy; juvenile idiopathic arthritis; game-based exercises; telerehabilitation; remote methods

Outcome Measures

Primary Outcomes (8)

• The Wong-Baker Faces Pain Rating Scale

  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.

  immediately After intervention

• Pediatric Quality of Life Inventory (PedsQL) 3.0 Arthritis Module

  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

  immediately After intervention

• The Tampa Scale for Kinesiophobia

  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.

  immediately After intervention

• Hip flexion-extension range of motion

  The pre-study and post-study hip flexion/extension passive ranges of motion (ROM) were measured by goniometric measurement.

  immediately After intervention

• Hip internal-external rotation range of motion

  The pre-study and post-study hip internal-external rotation passive ranges of motion (ROM) were measured by goniometric measurement.

  immediately After intervention

• Hip abduction/adduction range of motion

  The pre-study and post-study hip abduction/adduction passive ranges of motion (ROM) were measured by goniometric measurement.

  immediately After intervention

• Knee flexion and extension range of motion

  The pre-study and post-study knee flexion and extension passive ranges of motion (ROM) were measured by goniometric measurement.

  immediately After intervention

• Ankle dorsi-plantar flexion range of motion

  The pre-study and post-study ankle dorsi-plantar flexion passive ranges of motion (ROM) were measured by goniometric measurement.

  immediately After intervention

Study Arms (2)

Game-based telerehabilitation exercises

EXPERIMENTAL

The telemonitoring-supported program will be conducted with a smartphone application synchronously. The participants will be monitored by the investigators using an online communication application during exercise sessions.The sessions will be conducted to patients' individual calender via a smartphone application and a reminder from this smartphone application will send notifications to the patients.

Other: Game-based telerehabilitation exercises

Control group

ACTIVE COMPARATOR

The control group will be evaluated and followed with home exercise program.

Other: Home exercises

Interventions

Game-based telerehabilitation exercises OTHER

online Game-based home exercises are physiotherapy programs that include exercises transformed into game activities to increase the child's participation in the rehabilitation process. The exercises were planned such as; the dwarf camel game as squat exercises; the flamingo balance game as single leg balance exercises and weight-bearing activities etc. The exercise program will be conducted for 6 weeks and 3 sessions in a week.

Game-based telerehabilitation exercises

Home exercises OTHER

The physiotherapist will evaluate the control group patients and monitor them using only a home exercise program.

Control group

Eligibility Criteria

• Age: 6 Years - 16 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

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

You may not qualify if:

• Patients with neurological problems in addition to rheumatic diagnosis
• Individuals who are contraindicated to exercise

Sponsors & Collaborators

• Istanbul University - Cerrahpasa: lead

Study Sites (1)

İstanbul University-Cerrahpasa

Istanbul, 34000, Turkey (Türkiye)

Location

Related Publications (8)

• Crayne CB, Beukelman T. Juvenile Idiopathic Arthritis: Oligoarthritis and Polyarthritis. Pediatr Clin North Am. 2018 Aug;65(4):657-674. doi: 10.1016/j.pcl.2018.03.005.

  PMID: 30031492 BACKGROUND

• Arman N, Tarakci E, Tarakci D, Kasapcopur O. Effects of Video Games-Based Task-Oriented Activity Training (Xbox 360 Kinect) on Activity Performance and Participation in Patients With Juvenile Idiopathic Arthritis: A Randomized Clinical Trial. Am J Phys Med Rehabil. 2019 Mar;98(3):174-181. doi: 10.1097/PHM.0000000000001001.

  PMID: 30020092 BACKGROUND

• Minden K, Niewerth M. [Juvenile idiopathic arthritis--clinical subgroups and classification]. Z Rheumatol. 2008 Mar;67(2):100, 102-6, 108-10. doi: 10.1007/s00393-007-0246-5. German.

  PMID: 18299857 BACKGROUND

• Weermeijer JD, Meulders A. Clinimetrics: Tampa Scale for Kinesiophobia. J Physiother. 2018 Apr;64(2):126. doi: 10.1016/j.jphys.2018.01.001. Epub 2018 Mar 19. No abstract available.

  PMID: 29567379 BACKGROUND

• Zaripova LN, Midgley A, Christmas SE, Beresford MW, Baildam EM, Oldershaw RA. Juvenile idiopathic arthritis: from aetiopathogenesis to therapeutic approaches. Pediatr Rheumatol Online J. 2021 Aug 23;19(1):135. doi: 10.1186/s12969-021-00629-8.

  PMID: 34425842 BACKGROUND

• Grassini S. Virtual Reality Assisted Non-Pharmacological Treatments in Chronic Pain Management: A Systematic Review and Quantitative Meta-Analysis. Int J Environ Res Public Health. 2022 Mar 29;19(7):4071. doi: 10.3390/ijerph19074071.

  PMID: 35409751 BACKGROUND

• Hadjiat Y, Marchand S. Virtual Reality and the Mediation of Acute and Chronic Pain in Adult and Pediatric Populations: Research Developments. Front Pain Res (Lausanne). 2022 May 6;3:840921. doi: 10.3389/fpain.2022.840921. eCollection 2022.

  PMID: 35599969 BACKGROUND

• Leblebici G, Kisa EP, Tarakci E, Gunhan I, Yenici EN, Kasapcopur O. Gamified Telerehabilitation in Oligoarticular Juvenile Idiopathic Arthritis: A Randomized Controlled, Single-Blind Trial. Int J Rheum Dis. 2025 Jul;28(7):e70342. doi: 10.1111/1756-185X.70342.

  PMID: 40631545 DERIVED

MeSH Terms

Conditions

Arthritis, Juvenile

Condition Hierarchy (Ancestors)

Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Connective Tissue Diseases; Skin and Connective Tissue Diseases; Autoimmune Diseases; Immune System Diseases

Study Officials

• Gökçe Leblebici, Phd, Pt

  Istanbul Medeniyet University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Asssistant professor

Study Record Dates

• First Submitted: March 29, 2023
• First Posted: May 1, 2023
• Study Start: March 30, 2023
• Primary Completion: December 31, 2023
• Study Completion: March 1, 2024
• Last Updated: November 15, 2024

Record last verified: 2024-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)