Cognitive Exercise Therapy Approach (BETY) in JIA

September 13, 2025 updated by: Orkun Tüfekçi, Hacettepe University

Investigation of the Effectiveness of Cognitive Exercise Therapy Approach (BETY) in Juvenile Idiopathic Arthritis

Cognitive Exercise Therapy Approach (*Bilişsel Egzersiz Terapi Yaklaşımı*-BETY), an innovative method developed for adults with rheumatism, aims to promote behavioral change and prevent social isolation by focusing on exercises that provide pain management and functional gains. BETY also recognizes the importance of family education in achieving these goals. However, there is a need for studies on exercise approaches that fit the biopsychosocial model, such as BETY in childhood rheumatic diseases.

BETY is an innovative exercise approach based on the biopsychosocial model that aims to change the patient's cognitions through exercise, specifically developed for patients with rheumatism. This approach includes function-oriented trunk stabilization exercises, chronic pain management, and authentic dance therapy training targeting positive cognitive displacement. It is carried out in a routinized structure that continues for years on a face-to-face basis in groups and individually.

Interventions that provide physical and psychosocial support are needed in childhood rheumatic diseases. Learning to exercise the muscles surrounding the joints at the proper traction angle through exercise with BETY, gaining the ability to manage chronic pain during the day, gaining positive cognitive displacement skills, and having the opportunity to socialize through both individual and group exercises constitute the basis of the intervention.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

52

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Altındağ
      • Ankara, Altındağ, Turkey (Türkiye), 06100
        • Hacettepe University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Diagnosed with JIA,
  • Aged between 7 and 18,
  • Individuals who volunteered to participate in the study.

Exclusion Criteria:

  • Patients with advanced heart/lung/liver/kidney disease, neurologic disease and malignancies,
  • Individuals who have undergone major orthopedic surgery.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: BETY session group
JIA patients participating in BETY sessions.
Other: BETY
The cognitive Exercise Therapy Approach (Bilişsel Egzersiz Terapi Yaklaşımı-BETY) will be applied for 24 one-hour sessions, two days a week.
Active Comparator: Control Group
JIA patients followed up with a home exercise program.
Other: Control group
Control group will be followed up with a home exercise program, and notes will be taken.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Juvenile Arthritis Biopsychosocial Questionnaire-JAB-Q-Patient
Time Frame: Three months
Developed in 2018 in Turkey, it is a patient/parent-centered measurement method that helps to evaluate the biopsychosocial aspects of the patient, such as disease activity, posture, functional and psychosocial status, fatigue, performance at school. The results obtained from a total of 33 questions are used to evaluate the functional status of children, while their psychosocial status is recorded according to their answers to 21 questions. Scored between 0-164. A high score indicates a poor psychosocial status.
Three months
Juvenile Arthritis Biopsychosocial Questionnaire-JAB-Q-Family
Time Frame: Three months
JAB-Q is used to assess the biopsychosocial status of patients and their parents. JAB-Q is a multidimensional questionnaire with a parent (family) form. The questionnaire developed in Turkish is completed by one of the parents/persons responsible for the child. The family form assesses the biopsychosocial status of the parent from their perspective and scores between 0 and 38. Higher scores indicate worse biopsychosocial status.
Three months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Catastrophizing Scale - Parent Version (PCS-P)
Time Frame: Three months
It is assessed with a 5-point Likert scale ranging from 0 (never) to 4 (always) and consists of 13 items. Parallel to the child questionnaire, it assesses three domains: rumination, magnification, and helplessness. A total score between 0-52 is obtained; higher scores reflect a higher level of catastrophizing in parents.
Three months
Child and Adolescent Scale of Participation (CASP):
Time Frame: Three months
It is a 20-question questionnaire that evaluates the community participation of children and adolescents in school, neighborhood, and close environments. The questionnaire includes four sub-sections: 6 questions about home participation, four about neighborhood and community participation, five about school participation, and five about home and community participation. The questionnaire rating is expected by age (full participation), somewhat limited, very limited, not applicable, and not applicable. The family of the child or primary carer completes the questionnaire. The person completing the questionnaire is asked to select the answer that best describes the participation of a child in their care. As a result, the assessment is based between 0-100 points, with higher scores describing a better level of involvement.
Three months
Childhood Health Assessment Questionnaire (CHAQ)
Time Frame: Three months
The CHAQ assesses the functional abilities of children with JIA in activities of daily living. It consists of eight subsections (dressing and personal care, standing up, eating, walking, body care, reaching, holding, and activities). It also assesses pain and general well-being with a visual analog scale. Scores range between 0 and 3 points. A high score is an indicator of low functionality.
Three months
Pain Catastrophising Scale-Child (PPS-C)
Time Frame: Three months
It consists of 13 items describing different thoughts and feelings that children may experience when they feel pain. The questionnaire measures three areas: rumination, magnification, and helplessness. All items are evaluated on a 5-point Likert scale ranging from 0 (never) to 4 (always). Higher scores indicate more catastrophic pain beliefs. The total score is scored between 0 and 52.
Three months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Hacettepe University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 15, 2025

Primary Completion (Actual)

June 15, 2025

Study Completion (Actual)

September 12, 2025

Study Registration Dates

First Submitted

September 9, 2024

First Submitted That Met QC Criteria

September 9, 2024

First Posted (Actual)

September 19, 2024

Study Record Updates

Last Update Posted (Estimated)

September 18, 2025

Last Update Submitted That Met QC Criteria

September 13, 2025

Last Verified

September 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • SBA 24/1113

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Will not be shared to protect the data of individuals

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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