The coronavirus disease 2019 pandemic has yielded containment measures with detrimental effects on the physical and mental health of the general population. The impacts of lockdown on clinical features in Parkinson’s disease are not well known. We aimed to compare the physical activity, anxiety–depression levels between Parkinson’s disease patients and controls during lockdown. Forty-five Parkinson’s disease patients and 43 controls were evaluated with the Physical Activity Scale for the Elderly (PASE) and Hospital Anxiety and Depression Scale (HADS) via telephone interview. The patients’ disease-related symptoms were worsened during lockdown though regular Parkinson’s disease medication use. The PASE scores were low in both groups. The HADS scores of groups were below the cutoff point of anxiety–depression presence. Pandemic restrictions could lead to worsening of the motor and nonmotor symptoms in Parkinson’s disease.
BackgroundJuvenile idiopathic arthritis is a chronic rheumatological disease characterized by persistent joint inflammation [1, 2]. This disease, which we can consider to be relatively rare, causes pediatric patients to encounter health problems at an early age and therefore struggle with more questions and problems than their peers [3]. At this point, it is important that both children and their families have access to adequate and accurate information about health and that they can use this information [4]. Access to health-related information has brought the concept of “health literacy”, which has become more important in recent years, to the agenda [5].ObjectivesOur primary aim is to reveal the health literacy levels of children with JIA and their caregivers by using the Turkish Health Literacy-32 (THL-32), Adult Health Literacy Scale (AHLS) and Turkish version of the Health Literacy for School-Aged Children (HLSAC-T) the validity and reliability studies of which have been done before [6-8]. In addition, revealing the relationship between health literacy and the health status and quality of life of children with JIA is the secondary main aim of the study. Another secondary aim is to evaluate the physical limitations and functional capacity caused by JIA.MethodsThis cross-sectional study was conducted between September and December 2022 at Hacettepe University. Inclusion criteria were a confirmed JIA diagnosis according to the International League Against Rheumatism (ILAR) criteria, aged between 9–18 years. Children and one of their parents were invited to study. Demographic data, clinical findings, laboratory findings, and previous treatment information were recorded retrospectively from patient files and by asking the participants themselves.THL-32, AHLS, and HLSAC-T questionnaires were used to assess health literacy. Functional ability was assessed with the Turkish version of the Childhood Health Assessment Questionnaire (CHAQ) [9]. The Juvenile Arthritis Biopsychosocial Questionnaire (JAB-Q) was used to evaluate the problems experienced by both the child and the parent from a biopsychosocial perspective [10]. The 6-minute walk test (6MWT), 10-meter walking test (10-MWT) and 10-stair climbing test (10-SCT) were used to evaluate the physical and exercise capacity of children [11, 12].ResultsSeventy-nine patients with JIA and one of their parents were included in the study. The patients’ mean age was 13.67 ± 2.80 years, and 60.8% of them were female. The mean disease duration was 6.75 ± 4.28 years. The JIA subtypes were as follows: 39 (49.4%) had oligoarticular JIA; 15 (19.0%) had polyarticular JIA; 19 (24.1%) had enthesitis-related arthritis; and 6 (7%) had systemic JIA.Following the THL-32 scale scoring, level of parents’ health literacy resulted in the following percentages: inadequate, 3.8%; problematic, 22.8%; sufficient, 34.2%; and excellent, 39.2%. From a total of 79 patients with JIA, 16.5% had low HL, %55.7 had moderate HL, and 27.8% had high HL. The mean age of children with high health literacy was statistically older than the group with medium health literacy (p< 0.017). There was no statistically significant relationship between the children’s health literacy and parent health literacy.ConclusionAccording to the results of our study, children’s health literacy levels show a positive increase as they get older, and there is no significant relationship between parents’ health literacy levels. Parents’ health literacy levels and education levels are compatible with the AHLS, which includes objective questions. As the education level of the families increases, positive changes are observed in the CHAQ, JAB-Q parameters and 10-SCT test results. Our study shows that the education level of the families is positively related to the quality of life and physical condition of the children, but health literacy is not statistically related to other parameters other than the age of the children.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundMusculoskeletal involvements due to synovitis and tenosynovitis in the upper extremity joints of individuals with JIA negatively affect their daily living activities with the progression of the process [1-2].ObjectivesThe aim of this study is to compare the disease activity, inflammatory biomarker, functionality, participation and biopsychosocial status of individuals with JIA according to the presence of upper extremity involvement.MethodsForty individuals (21 girls, 19 boys) who were followed up with the diagnosis of JIA between March and December 2022 were included in our study. Individuals whose demographic information was obtained were divided into two groups as those with isolated upper extremity involvement (JIAUE+, n=11) and those without active and/or sequela joint involvement in the upper or lower extremities (JIAULE-, n=29). Disease activity (JADAS-71 and BASDAI), inflammatory biomarker (ESR and CRP), functionality (Childhood Health Assessment Questionaire (CHAQ)) [3], participation (The Child and Adolescent Scale of Participation (CASP)) [4] and biopsychosocial status (Juvenile Arthritis Biopsychosocial and Clinical Questionnaire (JAB-Q)) [5] was evaluated.ResultsWhile there was no difference between the two groups in terms of age, gender and BMI(p>0.05), in the JIAUE+ group, JADAS-71 (p=0.012), CRP (p=0.041), CHAQ-Pain (p=0.048), CHAQ-Overall Impact (p=0.003), JAB-Q Child Form functionality (p=0.033) and total score (p=0.009) were found to be significantly higher than the JIAULE- group. All sub-parameters (home (p=0.009), community (p<0.001), school (p=0.005), home and community living activities (p=0.044)) and total score of CASP (p=0.003) were found to be significantly lower in the JIAUE+ group.ConclusionDisease activity and inflammatory biomarker levels of JIAUE+ individuals were higher than JIAULE- individuals. In addition, pain, functionality, participation and biopsychosocial status of JIAUE+ individuals were worse than JIAULE- individuals. Our results were consistent with the literature, which revealed that functionality, school performance, and general quality of life were negatively affected in JIAUE+ individuals [6]. The data obtained from the study revealed that the upper extremity joint involvement of individuals with JIA showed more negative effects than those without involvement. With these results, the need for a rheumatologist-physiotherapist-occupational therapist interdisciplinary team understanding was emphasized in order to include individuals with JIA with upper extremity involvement in the exercise-physical activity and participation processes in daily life at the earliest stage, taking into account the disease activity.References[1]Vermaak, P V et al. “Wrist Arthroscopy in Juvenile Idiopathic Arthritis: A Review of Current Literature and Future Implications.” Journal of wrist surgery vol. 7,3 (2018): 186-190.[2]Leblebici, Gokce et al. “Validity and reliability of “Shriners Hospital for Children Upper Extremity Evaluation” in children with rheumatic diseases.” Clinical rheumatology vol. 40,12 (2021): 5033-5040.[3]Ozdogan, H et al. “The Turkish version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).” Clinical and experimental rheumatology vol. 19,4 Suppl 23 (2001): S158-62.[4]Atasavun, U et al. “Çocuk ve Adölesan Katilim Anketi’nin (CASP) Türkçe Geçerlilik Güvenilirlik Çalişmasi” (2018). [Poster].[5]Unal, Edibe et al. “A new biopsychosocial and clinical questionnaire to assess juvenile idiopathic arthritis: JAB-Q.” Rheumatology international vol. 38,8 (2018): 1557-1564.[6]Hoeksma, Agnes F et al. “High prevalence of hand- and wrist-related symptoms, impairments, activity limitations and participation restrictions in children with juvenile idiopathic arthritis.”Journal of rehabilitation medicinevol. 46,10 (2014): 991-6.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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