Juvenile Idiopathic Arthritis, Spondylarthritis, Spondylarthropathies
Conditions
Brief summary
Core stabilization exercises developed by McGill have been shown to be one of the physiotherapy techniques aimed at reducing pain, increasing aerobic capacity, enhancing muscle strength, and thereby improving bone health in children with JIA. However, there is no study that has investigated core stabilization training for different types of JIA. In our study, we aim to compare the effectiveness of core stabilization training and a daily physical activity program in children with spondyloarthropathy, to help identify the most effective strategy for clinical practice. Additionally, highlighting the specific effects of core stabilization training on the treatment of juvenile spondyloarthropathy (pain, functional status, fatigue, and quality of life) will make a significant contribution to the literature. Taking into account the gaps in the literature, our study will investigate the effect of core stabilization training on pain, functional status, fatigue, and quality of life in patients with juvenile spondyloarthropathy.
Detailed description
Core stabilization exercises are one of the physiotherapy techniques aimed at reducing pain, increasing aerobic capacity, enhancing muscle strength, and thereby improving bone health in children with JIA (1). Spondyloarthropathy typically begins as asymmetric oligoarthritis in children, and enthesitis and axial skeleton involvement may develop over the course of the disease (4). Since juvenile spondyloarthropathies can lead to severe functional impairments and long-term sequelae, the primary goal in treatment should be to suppress inflammation as early as possible and to prevent sequelae (5). Physiotherapy is recommended for children and adolescents with enthesitis or sacroiliitis, or those with functional limitations (6). Yoga exercises focusing on the core region have shown significant effects on lower extremity functional status, pain levels, and quality of life in patients with enthesitis-related conditions (2). Studies have supported that core stabilization exercises, combined with traditional physical therapy aimed at improving bone health status and functional capacity, serve as an effective combination therapy for children with JIA involving multiple joint involvement (3). Therefore, this study aims to fill the knowledge gap regarding core stabilization training in children with spondyloarthropathy.
Interventions
OTHERcore stabilization exercises
The program consists of lumbo-pelvic/core strength and stability exercises. The program will be implemented individually under the supervision of a physiotherapist twice a week for 12 weeks.
OTHERdaily physical activity program
The program consists of a daily physical activity program established and monitored for participation through weekly exercise tracking chart. The program will be implemented through weekly physiotherapist's control of the exercise tracking chart for 12 weeks.
Sponsors
Istanbul University - Cerrahpasa
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
10 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* "According to the International League of Associations for Rheumatology criteria, individuals aged 10-18 diagnosed with spondyloarthritis within the JIA subgroup will be included. * Only cases with stable disease activity and without additional neurological or orthopedic conditions will be considered. * Participants must also possess the cognitive ability to engage in active rehabilitation.
Exclusion criteria
* Individuals with a cardiovascular disease that impedes exercise * those who have participated in a rehabilitation program within the last 6 months * cases with variable medical treatment will be excluded.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analogue Scale | immediately after intervention | Pain intensity assessment in the lower extremity regions of the sacroiliac joint, hip, knee, and ankle. It is frequently used to quantify the severity or frequency of different symptoms in epidemiologic and clinical research. From the standpoint of the patient, pain seems to be a continuous spectrum rather than discretely varying, as categories like none, mild, moderate, and severe would imply. To represent this concept of an underlying continuum, the VAS was developed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Six minute walk test | immediately after intervention | The general functional status of the lower extremities will be evaluated by measuring the six-minute walking distance. The assessment will be conducted along a 15-meter monitored corridor, and the children will be asked to walk as quickly as possible without running. Standard encouragement instructions such as 'keep going' or 'you are doing well' will be used. The children will be allowed to stop and rest during the test, but the countdown will not be paused in these instances. The distance covered over six minutes will be recorded. |
| Pediatric quality of life | immediately after intervention | To assess quality of life, the Turkish version of the Pediatric Quality of Life Inventory (PedsQL) 3.0 Arthritis (Rheumatology) Module will be used. The PedsQL 3.0 Arthritis Module includes a total of 22 questions across five different domains: pain and hurt (4 items), daily activities (5 items), treatment (7 items), worry (3 items), and communication (3 items). The questionnaire is available in two forms: a patient form and a parent form. Both the children and one of their parents will complete the PedsQL 3.0 Arthritis Module. |
| PedsQL-Multidimensional Fatigue Scale | immediately after intervention | General fatigue, sleep/rest fatigue, cognitive fatigue, and overall fatigue scores will be assessed. Scoring for all child, adolescent, young adult, and parent surveys is conducted on a five-point Likert scale (0 = Never; 1 = Almost Never; 2 = Sometimes; 3 = Often; 4 = Almost Always). A score of 0 indicates high fatigue, while a score of 100 indicates less fatigue on the PedsQL-MFS item scoring. |
| Timed Up and Down Stairs Test (TUDS) | immediately after intervention | The individual taking part is standing one foot from the bottom of a 14-step staircase. "Quickly, but safely, go up the stairs, turn around on the top step (landing), and come all the way down until both feet land on the bottom step," is the participant's instruction. The amount of time, measured in seconds, between the "go" signal and the second foot returning to the bottom landing was the TUDS score. Faster times correlated with higher functional proficiency. |
Countries
Turkey (Türkiye)
Outcome results
None listed