Eureka! Institutional Repository

Introduction: The Juvenile Idiopathic Arthritis (JIA) chronicity, combined with the disease management psychosocial effects on children and parents, often leads to non-compliance in physiotherapy. However, in the era of the economic crisis, it’s an incentive to seek new approaches in physiotherapy. Objectives: To investigate the applicability and the impact of a physiotherapy tele-rehabilitation program (TRP) on children with JIA and their family. Methods: Thirty JIA patients, who applied a home-exercise program (HEP), were selected and randomly divided in the tele-rehabilitation (TRG, n=15) and the control group (CG, n=15). The TRG participated, in a 30-minute tele-session under the supervision and guidance of a qualified pediatric physiotherapist, twice a week, for 12 weeks. Before and after the TRP (T1 and T2, respectively), TRG and CG patients and a parent/guardian completed the Juvenile Arthritis Multi-demensional Assessment Report questionnaire (JAMAR) and a questionnaire relevant to the HEP implementation and compliance. Residual disease was estimated at T1 and T2 from a physiotherapist, different from the one performing the tele-rehabilitation program. At T2, TRG patients and their parents completed a questionnaire, evaluating the tele-rehabilitation program. One month after T2, a reassessment of compliance with the home-exercise program was performed. Results: The patients’ median (range) age was 12.8 (8-16) years. Nineteen children (63%) had polyarticular JIA and 11 (37%) oligoarticular. At T2, the TRG children performed the HEP more frequently (p=0.023), for a longer time (p=0.034) and with less promoting (p=0.004), compared to T1. Moreover, there was increased compliance with HEP (p=0.001), functionality (p=0.008) and quality of life (p=0.007) and less pain (p=0.017) in contrast with CG. The residual disease was improved in both groups (TRG: p=0.002, CG: p=0.018), but more in TRG (p=0.045). The applicability of the TRP and its total benefit was rated as excellent by both patients and parents. Finally, one month after T2, the compliance with the HEP was still greater, compared to T1 (p=0.001). Conclusion: The implementation of an interactive physiotherapy TRP is applicable and effective in patients with JIA, providing an additional tool in their rehabilitation.