Bıyık Kübra Seyhan, Özal Cemil, Tunçdemir Merve, Üneş Sefa, Delioğlu Kıvanç, Günel Mintaze Kerem
Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
Turk J Pediatr. 2021;63(2):223-236. doi: 10.24953/turkjped.2021.02.006.
Coronavirus disease 2019 (COVID-19) pandemic was effective all over the world. The stay-athome period was proposed to protect against the pandemic. The aim of this study was to investigate the effects of the COVID-19 pandemic stay-at-home period on body structures and functions, activity and participation levels, and environmental factors of children with cerebral palsy (CP) from the parental perspective in Turkey.
A twenty-question survey, using the International Classification of Functioning, Disability and Health for Children and Youth set to understand the functional changes of children with CP during the stay-athome period, was sent to parents in this prospective study. Motor function levels of children were determined by the Gross Motor Function Classification System parent report. The structural equation model was used for statistical analysis.
One hundred and three parents of children with CP participated. At least one of four children with CP had increased levels of anxiety (41.8%), and increased level of a sensation of pain (34%) and sleep problems (25.2%). More than half of the children had increased tonus (67%), decreased range of motion (60.2%), decreased physical activity level (55.3%), and decreased support level of rehabilitation services (82.6%). During the stayat- home period activity and participation levels and environmental factors of children explained the changes of body functions as 70% and 33% (RMSEA=0.077, p < 0.05).
This study is the first study to examine the functional health of children with CP biopsychosocially during the COVID-19 stay-at-home period. According to the parents, the functional health of children with CP was affected at different levels during the COVID-19 pandemic. Body functions may also be affected positively if physical activity level, home program and environmental supports increase.
2019年冠状病毒病（COVID-19）大流行在全球范围内产生了影响。为防范该大流行，人们提出了居家措施。本研究旨在从土耳其家长的角度调查COVID-19大流行居家期间对脑瘫（CP）儿童的身体结构与功能、活动及参与水平以及环境因素的影响。
在这项前瞻性研究中，向家长发送了一份包含20个问题的调查问卷，该问卷采用《儿童和青少年功能、残疾与健康国际分类》，旨在了解CP儿童在居家期间的功能变化。儿童的运动功能水平由《粗大运动功能分类系统》家长报告确定。采用结构方程模型进行统计分析。
103名CP儿童的家长参与了研究。至少四分之一的CP儿童焦虑水平升高（41.8%）、疼痛感觉增强（34%）以及出现睡眠问题（25.2%）。超过半数的儿童肌张力增加（67%）、活动范围减小（60.2%）、身体活动水平下降（55.3%）以及康复服务支持水平降低（82.6%）。在居家期间，儿童的活动及参与水平和环境因素对身体功能变化的解释率分别为70%和33%（RMSEA=0.077，p<0.05）。
本研究是首项在COVID-19居家期间从生物心理社会角度研究CP儿童功能健康的研究。根据家长的说法，在COVID-19大流行期间，CP儿童的功能健康在不同程度上受到了影响。如果身体活动水平、家庭训练计划和环境支持增加，身体功能也可能受到积极影响。
