Background. 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. Methods. 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. Results. 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). Conclusions. 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.

Hamstring strain injuries are one of the most common non-contact injuries in sports and have a high recurrence rate that can cause result in time away from competition or impaired performance on return to competition for athletes. 1,2 The causes of the hamstring strain injuries are multifactorial. It is believed that general muscle properties, including passive viscoelastic parameters (muscle tone, elasticity, and stiffness), help to avoid injuries and overtraining. 3 Each viscoelastic parameter plays an important role for enhancing muscular performance (including improving running speed, jumping) and reducing the onset of fatigue and risk for injury or recurrence. 4-6 Furthermore, they are also valuable in clinical use to evaluate treatment efficacy and progression of the symptoms. 3 The mechanical properties of muscles are described by their viscoelasticity when skeletal muscles are in a steady-state condition with no voluntary contraction. 7 Muscle tone is generated actively by the nervous system and passively by the muscle's intrinsic viscoelastic properties. The intrinsic aspects of muscle tone comprise passive stiffness and the inherent mechanical properties of the tissues. 7 Muscle elasticity represents the ability of the muscle to recover its initial shape after a contraction

The aim of the study was to determine the differences in upper limb function and activity/participation levels between preschool children with Narakas Groups 2a and 2b obstetric brachial plexus injury; and to determine the significance level of the factors affecting upper limb functions in these patients. Sixty-seven children, aged 3 to 7, who had not had surgical intervention, were evaluated in terms of joint movements, modified Mallet classification, Raimondi hand classification, brachial plexus outcome measure, paediatric outcome data collection instrument and stereognosis. There were significant functional differences between the groups, in favour of Group 2a. The movements affecting total function of the upper limb were: hand to spine ( p < 0.001), global abduction ( p < 0.001) and hand to mouth ( p < 0.001), in descending order of significance. Passive internal rotation was the most important passive joint movement affecting shoulder function ( p < 0.001). The results of this study suggest that more emphasis should be placed on the shoulder internal rotation in treatment strategies. Level of evidence: III

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The aim of this study was to determine the cut-off values of the range of internal rotation motion in the isolated glenohumeral joint that is required for functional tasks in children with an upper root injury of the brachial plexus. Internal rotation motion was measured using a universal goniometer in 97 participants. The Mallet Hand to Spine and Mallet Hand to Belly tasks were assessed as functional tasks that require internal rotation of the shoulder. For the Hand to Spine task, 41° passive and 30° active internal rotation were necessary to reach the S1 level. For the Hand to Belly task, 42° passive and 29° active internal rotation were required to place the palm on the belly without wrist flexion. Of our participants, 97% could touch the belly with or without wrist flexion, but 28% could not reach S1 in the Hand to Spine task. The results of this study show the necessary amount of internal rotation of the shoulder that should be considered in treatment strategies. Level of evidence: III

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Bu çalışmada torasik çıkış sendromlu hastalarda manuel tedavinin ağrı algısı ve solunum değişkenleri üzerine akut etkileri araştırıldı.Ça lış mapla nı:Çalışmaya torasik çıkış sendromlu 10 hasta (1 erkek, 9 kadın; ort. yaş 31.3±9.0 yıl; dağılım, 20-43 yıl) dahil edildi. Hastalar servikal omurga ve toraksı kapsayan tek bir manuel tedavi seansına alındı. Manuel tedavi programı olarak skalen, üst trapez, sternokleidomastoid, rektus abdominis, kalça fleksör kaslarına germe; birinci kaburga, servikal ve torakal omurga, sakroiliyak eklem ve toraks mobilizasyonu uygulandı. Üst kol ve boynun ağrı algısı görsel analog ölçeği ile değerlendirildi. Ölçümler 30 dakikalık manuel tedavi seansının öncesinde ve hemen sonrasında gerçekleştirildi. Pulmoner fonksiyon testi spirometre ile yapıldı. Solunum kas kuvveti (inspiratuar ve ekspiratuar kas kuvveti; sırasıyla maksimum inspiratuar basınç ve maksimum ekspiratuar basınç) ölçüldü. Solunum kas enduransı, maksimal inspiratuar basıncın %35'inde, sabit eşik yükü kullanılarak kaydedildi. Bul gu lar:Manuel tedavi girişimi sonrasında pulmoner fonksiyon değişkenleri ve maksimum ekspiratuar basınçta anlamlı değişim yoktu (p>0.05). Buna karşın, maksimum inspiratuar basınç ve solunum kas enduransı arttı (p<0.05). Üst kol ve boyundaki ağrı algıları tedavi sonrasında azaldı (p<0.05). So nuç:Torasik çıkış sendromlu hastalarda 30 dakikalık tek bir manuel tedavi seansı inspiratuar kas kuvvetini ve solunum kas enduransını artırırken pulmoner fonksiyon ve ekspiratuar kas kuvvetini artırmadı. Manuel tedavi hızlı ağrı azalması ile birlikte fonksiyonel solunumu ve primer solunum kaslarının daha etkili kullanımını kolaylaştırabilir. Cerrahi işlemlerden sonra düzenli manuel tedavinin solunum değişkenleri üzerine uzun dönem etkileri araştırılmalıdır.Anah tar söz cük ler: İnspiratuar kas kuvveti; manuel tedavi; torasik çıkış sendromu.