Moverx: Digital Exercise Prescriptions for Kids with Juvenile Idiopathic Arthritis

Objectives Juvenile idiopathic arthritis (JIA) patients require regular rehabilitation exercises to improve and maintain joint range of motion (ROM).[1] Access to therapy may be limited for some patients, most community clinics lack allied health team members, and poor adherence arises from brief in-person instruction with or without written details and reminders given subsequently. To address this problem, a multidisciplinary team at Montreal Children’s Hospital (MCH) have developed an extensive library of exercise videos to be prescribed by Pediatric Rheumatology Care Providers (PRCPs) as indicated by their individual patients’ needs. Previous work has demonstrated: (1) satisfaction with the video content by PRCPs[2]; (2) patient preference for videos over written handouts[3]; and (3) improved exercise technique accuracy in follow-up encounters with prescription of these videos. To date, there has been a significant barrier to dissemination of the video library to PRCPs outside MCH in a secure manner. This project leveraged a novel online platform housed at the Hospital for Sick Children (SickKids) in Toronto, namely the UCAN CAN DU research network to prescribe ROM exercise videos to patients with Rheumatological diagnoses. Methods A nonrandomized, prospective, interrupted time series quality improvement project guided by the Model for Improvement framework was initiated in April 2025 and is ongoing. Encounters within scope were in-person visits with established Rheumatology patients aged 2-17 years who had an indication for ROM exercise prescription. Results To date, 25 ROM exercise video links have been shared with patients/patient families. Initial PDSA cycles focused on several technical challenges, such as creating a unique URL link of source videos to patients. Subsequent focus has been on promoting access at home and securing feedback from patients/families. Preliminary survey response was 20%; however, informal feedback from >90% of those who did access the videos at home illustrated high satisfaction and self-efficacy (Figure 1). Prescribers found the process easy, though logistical barriers such as password protected access during busy clinics reduced satisfaction. Conclusion Preliminary results suggest success in leveraging this novel online platform to prescribe ROM exercise videos to patients with Rheumatological diagnoses in a secure and user-friendly manner. Future directions will center on dissemination of platform access to sites across Canada and entail a large-scale study that closely tracks any technical issues and incentivizes patient/family feedback. We anticipate that successfully and appropriately spreading access to this platform will address the unmet needs of PRCPs, especially those without access to allied health. References [1.] Philpott J. J Paediatr Child Health 2010;15:213-8. [2.] Ramdani S. [Abstract. Poster 91.] J Rheumatol 2019;46:802-3. [3.] Stinson J. Arthritis Care Res 2008;59:65-72.