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Tsakona P1, Hristara -Papadopoulou A1, Tsiroukidou K2
1Alexander Technological Institute of Thessaloniki, Physiotherapy Department, Thessaloniki, Greece, 2Aristotel University of Thessaloniki, Medicine, Thessaloniki, Greece
Background: Diabetes Mellitus type 1 is a chronic illness that disrupts family functioning and causes high stress levels for both parents and children by affecting their physical and mental health n their everyday life. Most studies aimed at improving psychological disorders such as behavioral problems or depression have used non-standardized interventions involving groups of adolescents and adults with diabetes mellitus. Studies with interventions in young children are mainly related to parents. Τhe studies so far have reported ways to manage parental anxiety with the help of counseling, meditation and educational programs. There is no similar research to produce results using physiotherapeutic techniques.
Purpose: The purpose of this study was to assess stress levels in young children and adolescents with DT1 (7-17 years old) and in their parents and to evaluate the effectiveness of a stress physiotherapeutic management program (active moderate intensity exercise, progressive muscle relaxation(PMR), pressure at specific acupuncture points, diaphragmatic relaxation breathing,(DRB)) in reducing perceived and parenting stress, increasing internal locus of control, promoting healthy lifestyle, normalizing glucose levels and reducing hypoglycaemic episodes.
Methods: This is a pilot, randomized controlled trial that was held at the Hippocratic Hospital of Thessaloniki. A total of 101 subjects, an intervention group of 26 children (7 - 17 years old) and 28 parents (n = 54) and a control group of 25 children and 22 parents (n = 47) participated. The measurement tools included questionnaires for the assessment of perceived stress, perception of health, quality of life and depression. The value of glycosylated hemoglobin and hypoglycemic episodes of children was measured.
Results: After 12 weeks of intervention, the trait anxiety of children was reduced about 7 units (p = 0,001) and the state anxiety about 10 (p = 0,001). Significant difference was not observed in the glycosylated hemoglobin levels between the two groups, but was observed a significant reduction in hypoglycemic episodes of the class (42%, p = 0,028) in the children of the intervention group relative to the control group where they remained quite high. In the intervention parents' group, the symptoms of depression, anxiety and stress decreased significantly. The mean score of depression decreased from 5.86 to 2.89, (p = 0.010) nearly 3 units, anxiety 1.89 (p = 0.019) and stress 2.14 (p = 0.048) units respectively.
Conclusion(s): The physiotherapy program was associated with changes in the physical and psychological symptoms of children and adolescents with TD1 and their parents. It turned out to have had a positive impact on depression and stress and a significant improvement in their quality of life in various lifestyle parameters
Implications: The parents, the children and adolescents who attended the program described improved family relationships, knowledge and understanding, greater confidence and increased self-confidence in managing diabetes. Also the reduction of hypoglycaemic episodes in young children and adolescents of the intervention group is indicative of improvement and stabilization of the glycemic control. Similar future research on long-term benefits of a physiotherapeutic intervention program is warranted for more objective outcomes.
Keywords: Diabetes Mellitus Type 1, Family stress, Physical Treatment
Funding acknowledgements: None
Purpose: The purpose of this study was to assess stress levels in young children and adolescents with DT1 (7-17 years old) and in their parents and to evaluate the effectiveness of a stress physiotherapeutic management program (active moderate intensity exercise, progressive muscle relaxation(PMR), pressure at specific acupuncture points, diaphragmatic relaxation breathing,(DRB)) in reducing perceived and parenting stress, increasing internal locus of control, promoting healthy lifestyle, normalizing glucose levels and reducing hypoglycaemic episodes.
Methods: This is a pilot, randomized controlled trial that was held at the Hippocratic Hospital of Thessaloniki. A total of 101 subjects, an intervention group of 26 children (7 - 17 years old) and 28 parents (n = 54) and a control group of 25 children and 22 parents (n = 47) participated. The measurement tools included questionnaires for the assessment of perceived stress, perception of health, quality of life and depression. The value of glycosylated hemoglobin and hypoglycemic episodes of children was measured.
Results: After 12 weeks of intervention, the trait anxiety of children was reduced about 7 units (p = 0,001) and the state anxiety about 10 (p = 0,001). Significant difference was not observed in the glycosylated hemoglobin levels between the two groups, but was observed a significant reduction in hypoglycemic episodes of the class (42%, p = 0,028) in the children of the intervention group relative to the control group where they remained quite high. In the intervention parents' group, the symptoms of depression, anxiety and stress decreased significantly. The mean score of depression decreased from 5.86 to 2.89, (p = 0.010) nearly 3 units, anxiety 1.89 (p = 0.019) and stress 2.14 (p = 0.048) units respectively.
Conclusion(s): The physiotherapy program was associated with changes in the physical and psychological symptoms of children and adolescents with TD1 and their parents. It turned out to have had a positive impact on depression and stress and a significant improvement in their quality of life in various lifestyle parameters
Implications: The parents, the children and adolescents who attended the program described improved family relationships, knowledge and understanding, greater confidence and increased self-confidence in managing diabetes. Also the reduction of hypoglycaemic episodes in young children and adolescents of the intervention group is indicative of improvement and stabilization of the glycemic control. Similar future research on long-term benefits of a physiotherapeutic intervention program is warranted for more objective outcomes.
Keywords: Diabetes Mellitus Type 1, Family stress, Physical Treatment
Funding acknowledgements: None
Topic: Paediatrics
Ethics approval required: Yes
Institution: Alexander Techological Istitute of Thessaloniki
Ethics committee: Scientific Commitee of Alexander Techological Istitute of Thessaloniki
Ethics number: 43224
All authors, affiliations and abstracts have been published as submitted.
