Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children and adolescents, which manifests itself before the age of 16. Almost 15,000 people in Germany are affected. Symptoms manifest themselves in severe joint inflammation, swelling, or hyperthermia, which can ultimately lead to relieving posture or restricted movement.
The doctor recommends avoiding strain through sporting activity out of concern about an uncontrolled worsening of the disease. This increases the risk of a chronic lack of exercise with corresponding secondary diseases.
Prof. Dr. Ansgar Schwirtz, Head of the Associate Professorship of Biomechanics in Sports, the Research Associates Dr. Josephine Gizik, Nadja Baumeister and employees of the German Center for Paediatric and Adolescent Rheumatology want to improve the post-inpatient care of children and adolescents with rheumatism in the active stage of the disease, by using a digitally supported sports counselling application. The three-year project is being funded by the Innovation Committee of the Joint Federal Committee (GBA) with around 1.8 million euros, of which 570.000 euros TUM will receive.
"With another project funded by the Joint Federal Committee, we look forward to bringing children and adolescents with rheumatism back to sport at a stage of their illness when a ban on sport was previously the rule. Biomechanical and performance-diagnostic analyses, as well as surveys and sports medicine examinations, form the basis for individual recommendations, the implementation of which we can closely monitor digitally at home," explains project manager Prof. Schwirtz.
To increase the patients' physical activity and quality of life, a controlled randomized study with initial and final examinations at the project partner of the German Center for Paediatric and Adolescent Rheumatology and a twelve- to 18-week intervention "at home" will be carried out. "We are including patients with a high level of disease activity in our study. This means chronically affected patients with an active level of inflammation often have motor deficits. Using various methods, such as the bicycle ergometry test, a 3D movement analysis or consultations and interviews. The aim is to create a targeted sports program for the patients that they can carry out from home," says Dr. Gizik, explaining the procedure. To achieve the necessary power, 185 patients will participate in the study.
One of the challenges is everyday life when those affected no longer have to operate in a clinical setting but in their familiar environment: "At home, patients find it difficult to properly strain themselves. They also no longer have the opportunity to enquire with therapists or doctors. This leads to uncertainty, especially if the illness takes a turn for the worse. Patients are then also faced with the question of whether or not the recommended sports program can be carried out on these days," says the Research Associate, summarizing the challenges.
The app developed by the TUM and German Center for Paediatric and Adolescent Rheumatology in collaboration with the consortium partner aQua and the service provider 4A-Side GmbH is intended to provide a simple way of looking after patients at home. In addition to e-monitoring, video consultations and patient feedback, the sports program can be individually adapted: "Patients can use the app to view and carry out individual recommended sports exercises or compiled sports programs, for example. This means that children and adolescents are given specific instructions on how to exercise that are tailored to their condition. The app will also provide feedback, for example, on their current state of health," says Dr. Gizik.
The main advantage for patients is that feedback can be responded to immediately. "Communication with us can occur at any time via the app, for example, if a video consultation is required." Ultimately, patient feedback means that adjustments can always be made to the sports program. Patients receive direct feedback on what sporting activity is possible or not.
"With the Rhe-Turn project, we want patients to achieve the national recommendations for physical activity in children and adolescents. This would significantly improve quality of life, physical activity and, at best, could even reduce long-term costs in the healthcare system," explains Dr. Gizik.
Other consortium partners in the project are the German Center for Paediatric and Adolescent Rheumatology (DZKJR) in Garmisch-Partenkirchen; aQua-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH; the German Rheumatism Research Centre Berlin (DRFZ), the German Paediatric Rheumatism Foundation and the German Rheumatism League.
To the homepage of the Associate Professorship of Biomechanics in Sports
Contact:
Prof. Dr Ansgar Schwirtz
Associate Professorship of Biomechanics in Sports
Georg-Brauchle-Ring 60/62
80992 München
phone: 089 289 24580
e-mail: ansgar.schwirtz(at)tum.de
Dr. Josephine Gizik
Associate Professorship for Biomechanics in Sports
Georg-Brauchle-Ring 60/62
80992 München
phone: 089 289 24648
e-mail: josephine.gizik(at)tum.de
Text: Bastian Daneyko
Photos: GBA/private