FRI0636-HPR COMPARING THE EFFECTS OF YOGA AND HOME EXERCISE PROGRAMS ON FUNCTIONAL STATUS IN CHILDREN WITH ENTHESITIS RELATED ARTHRITIS
Authors: E. Yasar, E. Kavlak, S. Turkucar, D. Bayraktar, C. Acari, E. Unsal
Journal: Annals of the Rheumatic Diseases (2020)

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&gt;0.05, Table 1). While, all the parameters (except PEDSQL Parent Form) in yoga group significantly improved at the end of the study (p&lt;0.05, Table 2), only stair climb test results significantly improved in home exercise group (p&lt;0.05, Table 2). Table 1. Comparison of the groups at baseline Yoga Group (n:11 ) Median (IQR 25/75 ) Home Exercise Group (n:10 ) Median (IQR 25/75 ) p* Physical parameters Age (year) 15.0 (13.0/15.5) 16.0 (14.0/17.0) 0.099 BMI (kg/m 2 ) 20.7 (18.3/23.1) 21.2 (19.9/22.0) 0.756 Pain Rest pain (score) 0 (0/5.0) 1.0 (0/3.0) 0.705 Activity pain (score) 4.0 (1.0/6.5) 2.0 (0/7.0) 0.387 Functional Status Six-minute walk distance (m) 600.0 (552.5/664.5) 626.0 (556.0/650.0) 1.000 Stair climb test (sec) 7.6 (6.8/8.3) 7.4 (7.0/8.0) 1.000 Quality of Life PedsQL Children (score) 13.0 (10.0/23.5) 12.5 (6.0/20.0) 0.654 PedsQL 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&lt;0.05 Table 2. Changes in the Groups Before Median (IQR 25/75) After Median (IQR 25/75) p* Yoga Group Pain Rest pain (score) 0 (0/5.0) 0 (0/2.5) 0.039 Activity pain (score) 4.0 (1.0/6.5) 0 (0/1.5) 0.012 Functional Status Six-minute walk distance (m) 600.0 (552.5/664.5) 692.0 (595.0/705.5) 0.011 Stair climb test (sec) 7.6 (6.8/8.3) 6.2 (6.0/7.0) 0.008 Quality of Life PedsQL Children (score) 13.0 (10.0/23.5) 9.0 (4.0/17.0) 0.021 PedsQL Parent (score) 21.0 (8.5/31.5) 18.0 (8.0/22.0) 0.169 Home Exercise Group Pain Rest pain (score) 1.0 (0/3.0) 0 (0/3.0) 0.715 Activity pain (score) 2.0 (0/7.0) 2.0 (0/7.0) 0.892 Functional Status Six-minute walk distance (m) 626.0 (556.0/650.0) 601.5 (585.0/707.0) 0.093 Stair climb test (sec) 7.4 (7.0/8.0) 7.0 (6.5/7.8) 0.028 Quality of Life PedsQL Children (score) 12.5 (6.0/20.0) 8.5 (7.0/18.0) 0.475 PedsQL 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&lt;0.05 Conclusion: 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