Home-based exercise program for adolescents with juvenile dermatomyositis quarantined during COVID-19 pandemic: a mixed methods study

Author(s):Show less -

Astley, Camilla ^{[1, 2]} ; Sieczkowska, Sofia Mendes ^{[1, 2]} ; Marques, Isabela Gouveia ^{[1, 2]} ; Ihara, Bianca Pires ^[3] ; Lindoso, Livia ^[3] ; Martins Lavorato, Sofia Simao ^[3] ; Arruda Campos, Lucia Maria ^[3] ; Rodrigues Pereira, Rosa Maria ^[2] ; Elias, Adriana Maluf ^[3] ; Aikawa, Nadia Emi ^{[2, 3]} ; Kozu, Katia ^[3] ; Iraha, Amanda Yuri ^{[1, 2]} ; Franco, Tathiane Christine ^{[1, 2]} ; Roschel, Hamilton ^{[1, 2]} ; Queiroz, Ligia Bruni ^[3] ; Polanczyk, Guilherme Vanoni ^[4] ; Silva, Clovis Artur ^{[2, 3]} ; Gualano, Bruno ^{[5, 1, 2]}

Affiliation

^[1] Univ Sao Paulo, Sch Phys Educ & Sport, Appl Physiol & Nutr Res Grp, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Hosp Clin, Fac Med, Rheumatol Div, HC FMUSP, Av Dr Arnaldo, 455, 3 Andar, BR-01246903 Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Hosp Clin, Inst Crianca & Adolescente ICr, HC FMUSP, Fac Med, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Fac Med, Dept Psychiat, Sao Paulo, SP - Brazil

^[5] Univ Sao Paulo, Food Res Ctr, Sao Paulo - Brazil

• Document type: Journal article
• Source: PEDIATRIC RHEUMATOLOGY; v. 19, n. 1 NOV 13 2021.
• Web of Science Citations: 0

Abstract

Background Exercise has been suggested to prevent deterioration of health-related quality of life (HRQL) and overall health in pediatric rheumatologic diseases during the COVID-19 pandemic. Herein we describe the effects of a 12-week, home-based, exercise program on overall health and quality of life among quarantined patients with juvenile dermatomyositis (JDM). Method This prospective, quasi-experimental, mixed methods (qualitative and quantitative) study was conducted between July and December 2020, during the most restricted period of COVID-19 pandemic in Brazil. The home-based exercise program consisted of a 12-week, three-times-a-week, aerobic and strengthening (bodyweight) training program. Qualitative data were systematically evaluated. Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory (PedsQOL) and Pittsburgh Sleep Quality Index (PSQI) evaluate symptoms of mental health disorder, HRQL, and quality of sleep. Findings 11 patients (out of 27) met the inclusion criteria (91% female; mean +/- SD age: 13.5 +/- 3.2 years). Adherence to the intervention was 72.6%. Barriers to exercise involved poor internet connectivity, excessive weekly sessions, and other commitments. Even though not statistically significant, Self-report SDQ subscales Total Difficulties Score, Emotional Problems Score, and PedsQOL School Functioning Score improved after intervention (- 2.4; 95%confidence interval {[}CI] -5.1; 0.2, p = 0.06; - 1.0; 95%CI -2.2; 0.2, p = 0.09 and; 11.7; 95%CI -2.5; 25.8, p = 0.09, respectively). Remaining SDQ subscales were not altered. Six themes emerged from patients' and parents' comments (qualitative results). Patients engaged in exercise reported other health-related benefits including increased motivation, concentration and strength. Interpretation A home-based exercise program was associated with qualitative perceptions of improvements in overall health and HRQL by quarantined adolescents with JDM during COVID-19 pandemic. Lessons from this trial may help developing interventions focused on tackling physical inactivity in JDM. (AU)

• FAPESP's process: 17/13552-2 - Reducing sedentary time in clinical populations: the take a stand for health study
• Grantee: Bruno Gualano
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 19/20814-9 - Reducing sedentary time in mild cognitive impairment patients: a randomized controlled trial
• Grantee: Isabela Gouveia Marques
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 15/03756-4 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy
• Grantee: Eloisa Silva Dutra de Oliveira Bonfá
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 19/15231-4 - Promotion of healthy lifestyle in patients with Systemic Erythematosus Lupus: effects on cardiometabolic risks factors the randomized and controlled clinical trial living well with Lupus
• Grantee: Sofia Mendes Sieczkowska
• Support Opportunities: Scholarships in Brazil - Doctorate