G. Arın

AB1403-HPR Investigation of the validity of bety scale in patients with rheumatoid arthritis

Background The Cognitive Exercise Therapy Approach is a biopsychosocial model for the patients with rheumatic diseases.1 Cognitive Exercise Therapy Approach Scale (the authors request that the abbreviation stay as “BETY” as the original in Turkish) is a scale that evaluates the biopsychosocial status of the patients with rheumatic diseases. This scale needs validation studies in different rheumatic diseases.2 Objectives The aim of this study is to investigate the validation of the BETY scale in patients with Rheumatoid Arthritis (RA). Methods 120 RA patients were included in this study. To determine the functional status of the patient Health Assessment Questionnaire (HAQ) was used. Rheumatoid Arthritis Quality of Life Scale (RAQoL) and 36-Item Short Form Survey (SF-36) were used to measure quality of life. Hospital Anxiety and Depression Scale (HADS) was used to determine anxiety and depression levels. BETY scale was used to in addition to this questionaires for the validation. Results 120 RA patients including 13 men and 107 women were participated in the study. The average age of the participating patients was 28,47±11,39 years and the body mass index was 28.4±6,56. There was a very high correlation between the BETY scale and RAQoL (r=0,817, p<0,001). There was high correlation between the BETY scale and subscale of the HADS-Anxiety, HAQ and subscale of the SF-36 Pain (r=0,617, p<0.001; r=0,606, p<0.001; r= −0, 610, p<0.001, respectively). There was moderate correlation between the BETY scale and subscale of the HADS-Depression, subscales of the SF-36 form Physical Functioning, Role Limitations, Role Limitations Due to Emotioal and General Health Perception (r=-0,597, p<0,001; r=-0,576, p<0,001; r=-0,525, p<0,001; r=-0, 598, p<0,001; r=-0, 420, p<0,001, respectively) (Table 1–2). Conclusions There were high or moderate correlations between the BETY scale and valid and reliable scales that are developed for these parameters. The BETY scale can be considered as a valid scale in patients with RA. References [1] Kisacik P, Unal E, Akman U, Yapali G, Karabulut E, Akdogan A. Investigating the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis. Complementary therapies in clinical practice. 2016;22:38–43. [2] Ünal E, Arin G, Karaca Nb, Kiraz S, Akdoğan A, Kalyoncu U, et al. Romatizmalı hastalar için bir yaşam kalitesi ölçeğinin geliştirilmesi: madde havuzunun oluşturulması. Journal of Exercise Therapy and Rehabilitation. 2017;4(2):67–75. Disclosure of Interest None declared

AB1452-HPR Which one has a greater effect on function and the psychosocial status in jia?: disease type or the presence of pain

Background Juvenile idiopathic arthritis (JIA) is a chronic inflammatory childhood disease with symptoms such as joint inflammation, pain and loss of quality of life.1 Types of disease and the presence of pain can impact the child psychosocially, as well as affecting functional activity.2 Objectives The aim of this study is to examine the results of functional and psychosocial status according to the disease type and the presence of pain symptoms in children with JIA. Methods The study included 71 children diagnosed with JIA who applied to the Hacettepe University İhsan Doğramacı Children’s Hospital Rheumatology Department. Following the collection of demographic information, functional status was assessed with the Child Health Assessment Questionnaire (CHAQ) and psychosocial and functional status was assessed with the scale developed in Hacettepe University Faculty of Health Sciences Department of Physiotherapy and Rehabilitation for functional and psychosocial status of children with rheumatism by Edibe Ünal.3 Children were divided into groups according to disease type as oligoarthritis or polyarthritis and the presence or absence of pain. Results Table 1 shows the mean age and numbers of children. There was no difference between the groups according to disease type (p>0,05). On the other hand, comparing scores for the CHAQ total, CHAQ general VAS assessment, functional and psychosocial status according to the presence or absence of pain revealed significant differences (p<0,05).Abstract AB1452HPR – Table 1 Assessment values and comparison statistics Disease Type Pain Oligoarthritis(n=51) Polyarthritis(n=20) p Present(n=21) Absent(n=50) p Age (years) 10,88±3,81 13,50±3,92 0016 11,71±3,77 11,58±4,12 0885 CHAQ Total 0,28±0,29 0,46±0,41 0127 0,51±0,4 0,26±0,27 0012 CHAQ (General VAS) 2,49±2,43 3,93±3 0068 4,46±2,86 2,24±2,3 0002 Function (range 0–30) 4,72±4,85 5,05±6,32 0766 7,85±6,6 3,54±4,02 0004 Psychosocial (range 0–30) 23±5,67 14,5±5,82 0363 16±5,74 12,34±5,4 0012 Function; Psychosocial; Functional and Psychosocial subscales of Ünal’s scale.3 Conclusions We conclude that pain has a greater effect on functional, psychosocial and overall disease assessment in children with JIA when compared to the disease type. Thus, it must be taken into consideration that child’s ability to cope with pain should be improved. References [1] Angelo Ravelli, Alberto Martini. Juvenile idiopathic arthritis.The Lancet2007, 369(9563); 767–778. [2] Laura E Schanberga, John C Lefebvreb, et al. Pain coping and the pain experience in children with juvenile chronic arthritis. Pain1997, 73(2); 181–189. [3] Kısacık Pınar,Ünal Edibe, et al. Juvenil İdiyopatik Artritli Hastalarda Çok Yönlü Bir Değerlendirme Sistemi Oluşturulması Delphi Çalışması. 2016, Annals Of Paediatric Rheumatology Disclosure of Interest None declared

AB1447-HPR Biopsychosocial status of jia patients: perspectives of daily living activities, disease activity and family impact

Background Juvenile Idiopathic Arthritis (JIA) is the most frequent chronic rheumatic disease during childhood. It can result in disabilities, loss of quality of life and mood changes.1 Furthermore, literature reviewing the effects of arthritis on children and family is inonsistent, with studies showing significant difference or not, compared to healthy children.2 Objectives The purpose of this study is to present results regarding the functional status, psychosocial status and disease activity of children with JIA and their effects on the child’s family. The second aim is to present the correlations between these parameters. Methods The study included children diagnosed with JIA who applied to Hacettepe University İhsan Doğramacı Children’s Hospital Rheumatology Department. After demographic data was collected, all children were assessed with Child Health Assessment Questionnaire (CHAQ) for daily living activities, with the Juvenile Arthritis Disease Activity Score (JADAS) for disease activity and with a newly developed scale from Hacettepe University Faculty of Health Sciences Department of Physiotherapy and Rehabilitation for children with rheumatism by Edibe Ünal(3 for functional and psychosocial status. Cut-off point was accepted as ≤2.7 for disease activity.4 The Family Impact Scale (FIS) was used to assess perspective of parents. Results A hundred and ninety-six children were included in the study. The mean age of children was 12,44±3,97 and female/male ratio was 55,6/44,4. Although the mean JADAS score was 3,33±4,21, it only detected active disease in 81 children. There was a moderate correlation between CHAQ (Pain) and functional scores of Ünal’s scale and JADAS score. CHAQ total score was well correlated with function and psychosocial scores. The correlation between FIS and other scales was very low.Abstract AB1447HPR – Table 1 Descriptives Mean±SD JADAS 3,33±4,21 CHAQ (Total) 0,32±0,38 CHAQ (Pain) 2,31±3,01 CHAQ (General VAS) 3,52±2,99 Function (range: 0–30) 4,09±5,85 Psychosocial (range: 0–30) 13,25±5,76 FIS 43,6±10.12 Function; Psychosocial; Functional and Psychosocial subscales of Ünal’s scale.3 Abstract AB1447HPR – Table 2 Correlations Conclusions Our results show that pain and function alter disease activity in children with JIA. It is seen that psychosocial states of children and their functional states expressed by their own knowledges also affect their daily life. These changes did not affect the wievpoint of the family. References [1] Spiegel L, Kristensen KD, et al. Juvenile idiopathic arthritis characteristics: Etiology and pathophysiology. Seminars in Orhodontics2015, 21(2); 77–83 [2] Susan T. Reisine. Arthritis and the Family. Arthritis Rheum1995, 8(4);265–271. [3]. Kısacık Pınar,Ünal Edibe, et al. Juvenil İdiyopatik Artritli Hastalarda Çok Yönlü Bir Değerlendirme SistemiOluşturulması Delphi Çalışması. 2016, Annals Of Paediatric Rheumatology. [4] Bulasovic Calasan M, De Vries LD, et al. Interpretation of the Juvenile Arthritis Disease Activity Socre: responsiveness, clinically important differences and levels of disease activity in prospective cohorts of patients wiht juvenile idiopathic arhritis. Rheumatology(Oxford)2014, 53(2); 307–312. Disclosure of Interest None declared

AB1439-HPR The effects of different exercise protocols on functional status and aerobic capacity in patients with ankylosing spondylitis

Background Although there is the emphasis on the importance of lifelong regular exercise to improve the efficacy of medication in the treatment of ankylosing spondylitis (AS) patients, there is a lack of information about the safe exercise dosage in clinical practice. Objectives In this study, we aimed to investigate the effects of different exercise protocols on functional status and aerobic capacity in patients with ankylosing spondylitis. Methods Thirty-one ankylosing spondylitis patients were evaluated and grouped according to their arrival order. Patients’ spinal mobility (Bath Ankylosing Spondylitis Mobility Index), disease activity (Bath Ankylosing Spondylitis Disease Activity Index), flexibility (back scratch test), pulmonary functions (forced vital capacity with pulmonary function test, maximal inspiratory and expiratory pressures with respiratory muscle strength test), aerobic capacity (oxygen consumption test with submaximal modified Bruce protocol), fatigue level (Fatigue Severity Scale) and sleep quality (Pittsburgh Sleep Quality Index) were assessed. Group 1 (n=16) did both aerobic training and clinical pilates exercises, while group 2 (n=15) only did aerobic training. Patients did exercises for 8 weeks, 3 days a week under the supervision of a physiotherapist and then measurements were repeated. Results According to the measurements, it was found that disease activity level, respiratory muscle strength was improved (p<0.05) in both groups. When clinical pilates exercise was given additionally to aerobic training spinal mobility (BASMI score), upper extremities flexibility, forced vital capacity, fatigue severity and sleep quality (p<0.05) was also improved. Conclusions As a result of the study, it was noted that when clinical pilates exercises applied together with the aerobic exercise training in ankylosing spondylitis patients, effectiveness on functional status and aerobic capacity was increased. Disclosure of Interest None declared

FRI0637-HPR The Effects of Clinical Pilates Exercises on Kinestesia and Position Sense in Patients with Osteoarthritis of The Knee: Table 1

Background Proprioception is a deep perception which constitutes kinesthesia and position sense. In particular, it is extremely affected due to cartilage degeneration in patients with osteoarthritis (OA) of the knee (1–3). Although exercise treatment is suggested as an effective method in OA, there is no study that investigates the effects of clinical pilates exercises on proprioception in patients with OA of the knee. Objectives The aim of this study is to investigate the effects of clinical pilates exercises on kinesthesia and position sense in patients with knee OA. Methods 39 patients with knee osteoarthritis defined as Kellgren-Lawrence (K-L) grade1 and 2 at mean age 55.95± 5.54 years and disease duration 6.59± 3.15 years were participated in this study (Control group; 20 patients, Exercise group; 19 patients). Exercise group attended in clinical pilates exercises sessions for three times a week (one hour session) during ten weeks. Kinesthesia and position sense were assessed with PMS-1000 Proprioception Test, Sport Expert Proprioceptional Sports Tech. Instrument. All measurements were repeated after ten weeks. Results Although the kinesthesia perception of patients improved (p<0.05), position sense did not improve in exercise group (p>0.05). There were no improvements in control group according to pre- and post-treatment values.Table 1 BETY group (n=19) Control group (n=20) P intergroups X ± SD p X ± SD p Before After Before After Kinestesia 3.04±2.84 2.33±1.74 0.050 1.87±1.47 2.18±2.23 0.938 0.672 Position sense 1.75±1.44 1.08±0.70 0.480 2.27±2.73 1.20±0.96 0.121 0.865 Conclusions As a conclusion, clinical pilates exercises should be kept in mind in terms of kinesthesia in patients with OA of the knee. We recommended that in further OA-related-studies using clinical pilates exercises, position sense should be examined in more detail. References Felson DT, Gross KD, Nevitt MC, Yang M, Lane NE, Torner JC, et al. The effects of impaired joint position sense on the development and progression of pain and structural damage in knee osteoarthritis. Arthritis and rheumatism. 2009;61(8):1070–6. van der Esch M, Steultjens M, Harlaar J, Knol D, Lems W, Dekker J. Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee. Arthritis and rheumatism. 2007;57(5):787–93. Cammarata ML, Dhaher YY. Associations between frontal plane joint stiffness and proprioceptive acuity in knee osteoarthritis. Arthritis care & research. 2012;64(5):735–43. Disclosure of Interest None declared

AB1099-HPR Comparison of The Effect of Daily Living Activities and Depression on Quality of Life in Patients with Ankylosing Spondylitis and Rheumatoid Arthritis

Background Increasing activity and improving function are valuable parameters to prevent disability (1,2). The relationship between the functional impairment in depression and the activities of daily living was well known in terms of the quality of life in chronic diseases (3). However, studies comparing these effects on various rheumatic diseases were not sufficient. Objectives This study was conducted to compare the effects of depression and activities of daily living on quality of life for the patients with two different rheumatic diseases (Ankylosing Spondylitis (AS) and Rheumatoid Arthritis (RA)). Methods 265 patients with AS and 111 patients with RA were included in the study. The demographic data were collected for two groups. Mean age of the study group was 39.88±13.33. All patients were evaluated with disease-specific questionnaires according to their diseases. The patients with AS were asked to fill the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) for quality of life, and the Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL) were used for RA patients. Beck Depression Index (BDI) was used to assess depression levels of the subjects, and Health Assessment Questionnaire (HAQ) to assess activities of daily living in both groups. Results A mild and positive correlation was found between HAQ (p<0.001, r=0,564), BDI (p<0.001, r=0.477) and RAQoL scores. Similarly, a mild and positive correlation was found between HAQ (p<0.001, r=0.513), BDI (p<0.001, r=0.443) and ASQoL scores. In all patients, there was a fair-mild positive correlation between HAQ and BDI scores (p<0.001, r=0.350) (Table 1).Table 1. Correlation between all variables BDI ASQoL RAQoL HAQ r=0,350 r=0,513 r=0,564 p<0.001 p<0.001 p<0.001 BDI r=0,443 r=0,477 p<0.001 p<0.001 Conclusions It is concluded that the depression level and the activities of daily living has similar effects on the quality of life for RA and AS patients. Also depression should be taken into consideration in both rheumatic diseases. References Corbacho MI, Dapueto JJ. Assessing the functional status and quality of life of patients with rheumatoid arthritis. Revista brasileira de reumatologia. 2010;50(1):31–43. Kingsley G, Scott IC, Scott DL. Quality of life and the outcome of established rheumatoid arthritis. Best practice & research Clinical rheumatology. 2011;25(4):585–606. Braun J, Sieper J. Anklyosing Spondylitis. The Lancet. 2007;369(9570):1379–1390. Disclosure of Interest None declared

FRI0619-HPR Investigating The Effects of A Multidimensional Exercise Program on Symptoms and Antiinflammatory Status in Oa Patients of The Knee

Background Effects of exercise on pain, physical function, daily living activities and cytokines have been investigated in osteoarthritis (OA) patients (1). However there is no reported multidimensional approach including all these parameters at once in OA patients. On the other hand, the cognitive exercise therapy approach (BETY: Bilişsel Egzersiz Terapi Yaklaşımı) was used as a multidimensional exercise model including effects of improvements on symptoms and anti-inflammatory status in ankylosing spondylitis patients (2). Objectives The purpose of this study is to investigate the effects of a multidimensional (BETY) exercise program on symptoms and anti-inflammatory status in OA patients of the knee. Methods Forty patients with knee osteoarthritis defined as Kellgren-Lawrence (K-L) grade1 and 2, were included in this study, and divided randomly into two groups (BETY group and control). Health Assessment Questionnaire (HAQ), The Western Ontario and McMaster Universities Arthritis Index (WOMAC) was used for functional evaluation and IL-6 were analyzed for anti-inflammatory status in both groups. Control group did not get any exercise intervention. However, BETY group were participated to exercise sessions 3 times a week for 10 weeks. All measurements were repeated after 10 weeks in both groups. Results WOMAC pain, physical function and WOMAC total score values were decreased significantly (p<0.05) in exercise group. However HAQ, WOMAC stiffness score were remained stable according to pretreatment values in this group (p>0.05). Although any significant change in IL-6 in both groups were not observed, IL-6 decreased in BETY group. Moreover, TNF-a showed significant increase in control group (p<0.05). No change was observed for other values between pre- and post-treatment in control group (p>0.05). There was no difference between two groups after 10 weeks (p>0.05).Table.1. Comparison of the all scores BETY group (n=19) Control group (n=21) P intergroups X ± SD p X ± SD p Before After Before After WOMAC pain 3.94±2.20 3.44±2.00 0.019 3.09±1.49 2.87±1.78 0.531 0.373 WOMAC function 4.30±1.91 3.24±1.81 0.013 3.40±1.56 3.01±2.37 0.045 0.610 WOMAC stiffness 0.46±0.22 0.41±0.23 0.223 0.35±0.24 0.34±0.23 0.832 0.419 WOMAC total 8.71±4.16 7.09±3.72 0.015 7.00±3.14 6.23±4.14 0.099 0.452 HAQ 11.88±8.50 9.29±9.06 0.224 8.38±6.29 6.42±5.45 0.171 0.490 IL-6 5.21±6.12 2.96±1.77 0.053 2.68±0.76 2.45±1.14 0.195 0.524 TNF-a 4.45±2.00 4.65±2.47 0.753 3.44±2.10 4.27±2.09 0.047 0.641 Conclusions This study is an original study in terms of analyzing exercise-induced TNF-a and IL-6 relationship in OA patients of the knee. We concluded that BETY program did not cause negative effects in OA patients. BETY should be taken into consideration as a multidimensional exercise program for OA patients. References Zhang, S.L., Liu, H.Q., Xu, X.Z., Zhi, J., Geng, J.J. Effects of exercise therapy on knee joint function and synovial fluid cytokine levels in patients with knee osteoarthritis. Mol. Med. Report. 2013;(7):183–186. Kisacik, P., Unal, E., Akman, U., Yapali, G., Karabulut, E., Akdogan, A. Investigating the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis. Comp Ther&Clin Pract 2016;(22):38–43. Disclosure of Interest None declared