SAT0626-HPR EXPLORING THE RELATION BETWEEN PAIN AND ACTIVITY AND PARTICIPATION BASED ON ICF IN CHILDREN AND ADOLESCENTS WITH JUVENIL IDIOPATIK ARTRIT: A PILOT STUDY
Authors: E. Gur Kabul, B. Basakci Calik, B. Akar, M. Bali, Z. Ekici Tekin, G. Otar Yener, S. Yuksel
Journal: Annals of the Rheumatic Diseases (2020)

Background: Functional limitation and inactivation are the most important problems in children with Juvenil Idiopatik Artrit (JIA). Objectives: The aim of this study was to link and allocate items of Childhood Health Assessment Questionnaire (CHAQ) with activity and participation based on International Classification of Functioning, Disability and Health (ICF). The other aim was to examine the relationship between the pain and activity and participation determined on the basis of CHAQ with Juvenil Idiopatik Artrit (JIA). Methods: Thirty-seven children and adolescents (26 girls, 11 boys, mean age=11.75±4.04 years) were included. The mean BMI of the participants was 19.61±4.52 kg / cm 2 . Inclusion criteria: To be diagnosed with JIA according to ILAR classification. Being in the 6-18 age range. To be stable in drug use for at least 3 months or longer. Exclusion criteria:The presence of another disease. Intraarticularsteroid injection or surgery in any joint in last 3 months. Evaluations were made by the same pediatric rheumatologist and physiotherapist (PT) by face to face interview method. Pain was evaluated by use of Numeric Rating Scale (NRS) (0=no, 10=worst) and disability by CHAQ. As CHAQ score increases, disability increases. CHAQ has 8 categories. The highest score for any question determines the score for that category. The items of CHAQ were linked with ICF codes and allocated with the ICF components by three PT. Original scoring of CHAQ allocated to ICF components was used in order to calculate scores of activity and participation in accordance with clinical data for 37 JIA. The 20th item in the “Reach” category is not included in the calculation as it contains the body function component of ICF. The data was analyzed using Pearson’s correlation coefficient. Results: Mean score of NRS was 3.52±2.34. Mean activity and participation score of CHAQ was 0.51±0.58, 0.70±1.10, respectively. Based on expert distinction, activity and participation categories of ICF were covered 24 and 5 items of CHAQ, respectively. Pain had moderate correlation with activity (r=0.595; p=0.002) and participation (r=0.604; p=0.001) for CHAQ. Activity had high correlation with participation (r=0.702; p=0.000). Conclusion: Pain in children and adolescents with JIA is an important parameter affecting activity and participation. Pain should be evaluated in all aspects due to the limitation of both activity and participation. CHAQ largely contains the activity component of ICF. The development of new questionnaire is needed to assess the participation of JIA children and adolescents in more detail. References: [1]Schanberg LE. Widespread pain in children: when is it pathologic? Arthritis Rheum 2003;48:2402-2405. Table 1. Linking and allocating items of CHAQ Items ICF Code ICF Component DRESSING &amp; GROOMING Dress, including tying shoelaces and doing buttons? d5402 A Shampoo his/her hair? d5100 A Remove socks? d5403 A Cut fingernails? d520 A ARISING Stand up from a low chair or floor? d4103 A Get in and out of bed or stand up in crib? d4100 A EATING Cut his /her own meat? d550 A Lift a cup or glass to mouth? d4402 A Open a new cereal box? d440 A WALKING Walk outdoors on flat ground? d450 A Climb up five steps? d4551 A HYGIENE Wash and dry entire body? d510 A Take a tub bath? dd410 A Get on and off the toilet or potty chair? d4103 A Brush teeth? d5201 A Comb/brush hair? d5202 A REACH Reach and get down a heavy object from just above his/her head? d4452 A Bend down to pick up clothing or a piece of paper from the floor? d4105 A Pull on a sweater over his/her head? d5400 A Turn neck to look back over shoulder? b7101 Body Function GRIP Write or scribble with pen or pencil? d170 A Open car doors? d4450 A Open jars which have been previously opened? d4453 A Turn faucets on and off? d4402 A Push open a door when he/she to turn a door knob? d4453 A ACTIVITIES Run errands and shop? d6200 P Get in and out of car or toy car or school? d4702 P Ride bike or tricycle? d4750 P Do household chores d6402 P Run and play? d9201 P A:Activity, P:Participation Disclosure of Interests: None declared