FRI0636-HPR COMPARING THE EFFECTS OF YOGA AND HOME EXERCISE PROGRAMS ON FUNCTIONAL STATUS IN CHILDREN WITH ENTHESITIS RELATED ARTHRITIS

Abstract

Background:Enthesitis-Related Arthritis (ERA), also referred as the juvenile ankylosing spondylitis, is a subtype of Juvenile Idiopathic Arthritis (JIA). However, ERA patients were reported as having higher pain levels, lower functional status and lower quality of life level compared to other JIA subtypes. Yoga is used as an exercise method in adult patients with rheumatic diseases and positive effects on physical and psychosocial symptoms were reported. However, no study was conducted related to yoga in pediatric population with rheumatic diseases.Objectives:The aim of this study was to investigate effects of performing yoga or home exercises on functional status in children with ERA.Methods:Twenty-one children with ERA were allocated into two groups as yoga group (n=11) and home exercise group (n=10). Yoga group performed yoga exercises supervised by a physiotherapist for twice a week, for eight weeks, while the home exercise group performed video-based home exercises for the same period. Pain in rest and activity (Numeric Rating Pain Scale), functional status (Six-Minute Walk Distance, Stair Climb Test), and quality of life (PedsQL Children and Parent Form) were evaluated at baseline and following eight weeks.Results:The groups were similar regarding to physical characteristics, pain, functional status, and quality of life at baseline (p>0.05, Table 1). While, all the parameters (except PEDSQL Parent Form) in yoga group significantly improved at the end of the study (p<0.05, Table 2), only stair climb test results significantly improved in home exercise group (p<0.05, Table 2).Table 1.Comparison of the groups at baselineYoga Group(n:11)Median (IQR 25/75)Home Exercise Group (n:10)Median (IQR 25/75)p*Physical parametersAge (year)15.0 (13.0/15.5)16.0 (14.0/17.0)0.099BMI (kg/m2)20.7 (18.3/23.1)21.2 (19.9/22.0)0.756PainRest pain (score)0 (0/5.0)1.0 (0/3.0)0.705Activity pain (score)4.0 (1.0/6.5)2.0 (0/7.0)0.387Functional StatusSix-minute walk distance (m)600.0 (552.5/664.5)626.0 (556.0/650.0)1.000Stair climb test (sec)7.6 (6.8/8.3)7.4 (7.0/8.0)1.000Quality of LifePedsQL Children (score)13.0 (10.0/23.5)12.5 (6.0/20.0)0.654PedsQL Parent (score)21.0 (8.5/31.5)26,0 (15.0/39.0)0.387*: Mann-Whitney U test; IQR 25/75: Interquartile Range 25/75, PedsQL: Pediatric Quality of Life Inventory, p<0.05Table 2.Changes in the GroupsBeforeMedian(IQR 25/75)AfterMedian(IQR 25/75)p*Yoga GroupPainRest pain (score)0 (0/5.0)0 (0/2.5)0.039Activity pain (score)4.0 (1.0/6.5)0 (0/1.5)0.012Functional StatusSix-minute walk distance (m)600.0 (552.5/664.5)692.0 (595.0/705.5)0.011Stair climb test (sec)7.6 (6.8/8.3)6.2 (6.0/7.0)0.008Quality of LifePedsQL Children (score)13.0 (10.0/23.5)9.0 (4.0/17.0)0.021PedsQL Parent (score)21.0 (8.5/31.5)18.0 (8.0/22.0)0.169Home Exercise GroupPainRest pain (score)1.0 (0/3.0)0 (0/3.0)0.715Activity pain (score)2.0 (0/7.0)2.0 (0/7.0)0.892Functional StatusSix-minute walk distance (m)626.0 (556.0/650.0)601.5 (585.0/707.0)0.093Stair climb test (sec)7.4 (7.0/8.0)7.0 (6.5/7.8)0.028Quality of LifePedsQL Children (score)12.5 (6.0/20.0)8.5 (7.0/18.0)0.475PedsQL Parent (score)26.0 (15.0/39.0)22.5 (14.0/30.0)0.192*: Wilcoxon Signed Rank Test, IQR 25/75: Interquartile Range 25/75, PedsQL: Pediatric Quality of Life Inventory, p<0.05Conclusion:Yoga seems promising for improving functional status in children with ERA compared to a home-based exercise program. Therefore, yoga can be implemented as an exercise intervention in rehabilitation programs in children with ERA.Disclosure of Interests:None declared