Juvenile idiopathic arthritis Musculoskeletal Diseases Juvenile idiopathic arthritis
Conditions
Interventions
The intervention is an internet based education, physical activity and cognitive behavioral training program implemented over 14 weeks. During the intervention the child receives the normal standard t
Sponsors
University Medical Center Groningen (Netherlands)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Diagnosis: all subtypes of JIA according to the ILAR classification without active arthritis 1. Ages 8 up to13 years old 2. Command of Dutch language (patient and at least one of the parents) 3. Have internet connection and computer at home
Exclusion criteria
Exclusion criteria: 1. Active arthritis; visual analogue scale scored by the children's rheumatologist >20 mm on a 1-100 scale 2. Other diagnosis influencing exercise capacity 3. Co-morbidity influencing physical or psychological development 4. No command of Dutch language 5. No free access to internet 6. No computer at home 7. Participating in a cognitive behavioral program aimed at physical activity
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The main outcome measures are the Physical Activity Level (PAL) and Physical Activity Pattern (PAP). The amount of physical activity can be expressed as PAL. The basis for PAL was formulated in 1985 by the FAO/WHO/UNU expert committee on energy requirements. Energy needs are expressed as multiples of Basal Metabolic Rates (BMR) and PAL is defined as Total Energy Expenditure (TEE) divided by BMR. BMR for boys and girls of a given age and weight are predicted with the mathematical equation derived by Schofield. In terms of age and sex, Schofield's equations coincided with measured BMR in boys and girls 7- 16 years old in The Netherlands, the UK and the USA. PAL and PAP are measured with a 7-day activity diary. A 7-day activity diary provides a close estimate of PAL as validated by the doubly labelled water method. Reliability is high from the age of 10 years and onwards. 7-day diaries measure frequency, duration and intensity of daily activities and are therefore suitable instruments to describe PAP. PAL and PAP are also measured with an accelerometer. Accelerometers objectively monitor physical activity levels for weeks at a time. Data can be expressed as Activity Counts, Active Energy Expenditure (AEE), METs (metabolic equivalents), and also as time spent within various levels of activity (cut points - for sedentary, light, moderate and vigorous activity levels). It is evident that no single motion sensor will provide an accurate estimate of energy expenditure across all activities. The combined use of an accelerometer plus questionnaire or diary is advocated. PAL and PAP are measured at baseline, after completion, at 3 months and at 1 year follow-up. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. JIA disease activity is determined at maximal one month before the intervention, at the end, 3 months after and finally one year after completion of the internet based program. Disease activity is defined according to a validated set of criteria called JIA core set criteria and they consist of: 1.1 Functional ability measurement by the Childhood Health Assessment Questionnaire (CHAQ38)73-75. The CHAQ38 consist of two components: disability and discomfort. Disability is assessed using 38 questions in 9 domains covering major aspects of daily living: dressing, grooming, arising, eating, walking, hygiene, reach grip, activities and extra-curriculum activities. Each question is rated on a 4 point scale (no difficulty, some difficulty, and much difficulty, unable to do). The disability index is calculated as the mean of the 9 domains and yields a score between 0 (no disability)-3(most severe disability). Discomfort is measured by a 100-mm visual analogue scale (VAS) anchored at either end by 'no pain' and 'severe pain'. A similar 100-mm VAS assesses overall disease severity and disease impact 1.2 Number of active joints (pain/swelling) is assessed by the children's rheumatologist. 1.3 Assessment of joint mobility is performed by the children's rheumatologist. 1.4 Physician's global assessment of disease activity on a 100mm VAS 1.5 ESR and CRP 2. Disease flare is scored according to the known criteria 3. Quality of life is measured by PedsQL (Pediatric Quality of Life Inventory) (Children's Hospital and Health Center, San Diego, California), a modular instrument for measuring health-related quality of life (HRQOL) in children and adolescents ages 2 to 18. The PedsQL 4.0 Generic Core Scales consist of 23 items applicable for healthy school and community populations, as well as pediatric populations with acute and chronic health conditions. The questionnaire consists of 4 subscales; physical, emotional, social and school functioning. Cronbach's alpha 0.88 4. Fatique i | — |
Countries
Netherlands
Outcome results
None listed