Juvenile Idiopathic Arthritis (JIA) is children's most common inflammatory rheumatic disease. The International League of Associations for Rheumatology (ILAR) defines it as a chronic arthritis condition that begins before the age of 16 lasts for six weeks or more, and has an unknown cause. Despite the gains made in the management of the disease of individuals with JIA with modern medical treatment methods, the physical and psychosocial problems caused by chronic inflammation negatively affect the daily living activities of individuals with JIA. On the other hand, in the JIA Core Set created by Outcome Measures in Rheumatology (OMERACT) in 2018, activities of daily living were included as a "mandatory area that should be evaluated in all studies." Therefore, to ensure that individuals with JIA reach a state of complete well-being, multi-interdisciplinary health professionals are expected to address the activities of daily living, identify the factors that limit these activities, and create intervention plans for the factors to be determined. The literature shows that the daily living activities of patients with JIA are addressed with a limited number of subjective measurement tools. However, these methods have disadvantages due to their subjectivity. In this case, objective measurement methods are needed to quantify the physical performance of patients with JIA in terms of their daily living activities. The Glittre Activities of Daily Living Test, initially developed by selecting activities similar to daily living activities to evaluate functional capacity in pulmonary diseases, has the potential to address this gap. Since the activities in the test require using both the lower and upper extremities, it has the advantage of reflecting functional capacity and providing information about performance in daily life activities. Although it has potential, the Glittre Activities of Daily Living Test needs appropriate psychometric properties for clinical settings and research for JIA patients. To our knowledge, no studies have been conducted in the current literature on the validity and reliability of the Glittre Activities of Daily Living Test in JIA patients. Therefore, this study aimed to evaluate the test-retest reliability, construct validity, and minimum detectable change of the Glittre Activities of Daily Living Test in assessing activities of daily living in children and adolescents with JIA.
Being diagnosed with Juvenile Idiopathic Arthritis (JIA) according to The International League of Associations for Rheumatology (ILAR) classification
Being between the ages of 8-18
Volunteering to participate in research
Advanced heart/lung/liver/kidney disease, neurological disease and malignancies
Having undergone major orthopedic surgery
Not volunteering to participate in the study
The study population will consist of individuals with JIA who meet the inclusion criteria at the Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine.
Other
Cross-sectional
Not listed
The Glittre Activities of Daily Living Test
The Glittre Activities of Daily Living Test is widely used in the literature to evaluate activities of daily living based on performance. The test consists of a cycle of standardized activities such as walking, weight-bearing, climbing stairs, and moving objects on shelves. It is a test that takes place over a total distance of 10 m divided into two parts by a ladder. The person completes the test cycle in 5 laps at this distance range. The time it takes for individuals to complete the test and their pre-and post-test heart rate, blood pressure, respiratory frequency, SpO2, and modified Borg Scale, as well as their dyspnea and fatigue levels during exertion, are evaluated. In our study, the Pediatric Glittre Activities of Daily Living Test will be used for individuals diagnosed with JIA between the ages of 8 and 14, and the standard version of the test will be used for JIA patients between the ages of 15 and 18.
Functional Reach Test
The Functional Reach Test is a test that evaluates dynamic balance. The person is asked to stand with their arm at 90̊ flexion and close to the wall without touching it; then, they are instructed to reach forward as far as they can without taking a step. The difference between the start and finish is measured with a tape measure and recorded in centimeters. Three trials are performed; the average is the Functional Reach Test score.
Six Minute Walk Test (6MWT)
For the 6MWT, individuals are asked to walk in a 30-meter corridor at the maximal speed they can walk without running. During the test, individuals are encouraged with standard expressions. At the end of the test, the distance covered will be recorded in meters. The individuals' pre-test and post-test heart rate, blood pressure, respiratory frequency, SpO2, and modified Borg Scale, as well as dyspnea and fatigue levels during exertion, will be evaluated.
Childhood Health Assessment Questionnaire (CHAQ)
The CHAQ assesses the functional abilities of children with JIA in activities of daily living. It comprises eight sections (dressing and grooming, arising, eating, walking, hygiene, reaching, griping, and activities) and evaluates pain (0: no pain and 10: extreme pain) and general well-being (0: no problem and 10: extreme problem) using a Visual Analog Scale. The total CHAQ score ranges from 0 to 3 (higher scores reflect low functionality).
Juvenile Arthritis Biopsychosocial Questionnaire (JAB-Q)
JAB-Q evaluates the problems experienced by both the child and the parent from a biopsychosocial perspective. The scale was developed initially in Turkish. It includes two separate forms for the child (patient) and parent (family) to complete. The child form consists of questions evaluating parameters such as pain intensity, disease activity, joint status, functional assessment, psychosocial status assessment, school status and fatigue, and is scored between 0 and 52 points. The family form includes parameters such as the parent's perception of health and psychosocial status and scores between 0 and 38. Forms can give both total scores and separate scores for subparameters. Higher scores indicate worse results.
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