Cognitive Exercise Therapy Approach (\*Bilişsel Egzersiz Terapi Yaklaşımı\*-BETY), an innovative method developed for adults with rheumatism, aims to promote behavioral change and prevent social isolation by focusing on exercises that provide pain management and functional gains. BETY also recognizes the importance of family education in achieving these goals. However, there is a need for studies on exercise approaches that fit the biopsychosocial model, such as BETY in childhood rheumatic diseases. BETY is an innovative exercise approach based on the biopsychosocial model that aims to change the patient's cognitions through exercise, specifically developed for patients with rheumatism. This approach includes function-oriented trunk stabilization exercises, chronic pain management, and authentic dance therapy training targeting positive cognitive displacement. It is carried out in a routinized structure that continues for years on a face-to-face basis in groups and individually. Interventions that provide physical and psychosocial support are needed in childhood rheumatic diseases. Learning to exercise the muscles surrounding the joints at the proper traction angle through exercise with BETY, gaining the ability to manage chronic pain during the day, gaining positive cognitive displacement skills, and having the opportunity to socialize through both individual and group exercises constitute the basis of the intervention.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
52
The cognitive Exercise Therapy Approach (Bilişsel Egzersiz Terapi Yaklaşımı-BETY) will be applied for 24 one-hour sessions, two days a week.
Control group will be followed up with a home exercise program, and notes will be taken.
Hacettepe University
Ankara, Altındağ, Turkey (Türkiye)
Juvenile Arthritis Biopsychosocial Questionnaire-JAB-Q-Patient
Developed in 2018 in Turkey, it is a patient/parent-centered measurement method that helps to evaluate the biopsychosocial aspects of the patient, such as disease activity, posture, functional and psychosocial status, fatigue, performance at school. The results obtained from a total of 33 questions are used to evaluate the functional status of children, while their psychosocial status is recorded according to their answers to 21 questions. Scored between 0-164. A high score indicates a poor psychosocial status.
Time frame: Three months
Juvenile Arthritis Biopsychosocial Questionnaire-JAB-Q-Family
JAB-Q is used to assess the biopsychosocial status of patients and their parents. JAB-Q is a multidimensional questionnaire with a parent (family) form. The questionnaire developed in Turkish is completed by one of the parents/persons responsible for the child. The family form assesses the biopsychosocial status of the parent from their perspective and scores between 0 and 38. Higher scores indicate worse biopsychosocial status.
Time frame: Three months
Pain Catastrophizing Scale - Parent Version (PCS-P)
It is assessed with a 5-point Likert scale ranging from 0 (never) to 4 (always) and consists of 13 items. Parallel to the child questionnaire, it assesses three domains: rumination, magnification, and helplessness. A total score between 0-52 is obtained; higher scores reflect a higher level of catastrophizing in parents.
Time frame: Three months
Child and Adolescent Scale of Participation (CASP):
It is a 20-question questionnaire that evaluates the community participation of children and adolescents in school, neighborhood, and close environments. The questionnaire includes four sub-sections: 6 questions about home participation, four about neighborhood and community participation, five about school participation, and five about home and community participation. The questionnaire rating is expected by age (full participation), somewhat limited, very limited, not applicable, and not applicable. The family of the child or primary carer completes the questionnaire. The person completing the questionnaire is asked to select the answer that best describes the participation of a child in their care. As a result, the assessment is based between 0-100 points, with higher scores describing a better level of involvement.
Time frame: Three months
Childhood Health Assessment Questionnaire (CHAQ)
The CHAQ assesses the functional abilities of children with JIA in activities of daily living. It consists of eight subsections (dressing and personal care, standing up, eating, walking, body care, reaching, holding, and activities). It also assesses pain and general well-being with a visual analog scale. Scores range between 0 and 3 points. A high score is an indicator of low functionality.
Time frame: Three months
Pain Catastrophising Scale-Child (PPS-C)
It consists of 13 items describing different thoughts and feelings that children may experience when they feel pain. The questionnaire measures three areas: rumination, magnification, and helplessness. All items are evaluated on a 5-point Likert scale ranging from 0 (never) to 4 (always). Higher scores indicate more catastrophic pain beliefs. The total score is scored between 0 and 52.
Time frame: Three months
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