key: cord-0978255-9y1j4pt7 authors: SHAMSODDINI, Alireza; BAZIGAR, Behzad; DALVAND, Hamid title: Need to Perform Rehabilitation Exercises at Home by Parents of Children with Neurological Diseases to Maintain Performance During COVID-19 Lockdown date: 2021 journal: Iran J Child Neurol DOI: 10.22037/ijcn.v16i1.30019 sha: e4bf4e2fa70b50d819d253c38a2b92d8ab8f7090 doc_id: 978255 cord_uid: 9y1j4pt7 With the outbreak of the novel pandemic coronavirus disease 2019 worldwide, numerous pediatric rehabilitation clinics have closed to support social and physical distancing, and therapists similar to other individuals are staying at their homes. There is a common concern of parents and caregivers that how and with what quality children’s rehabilitation exercises should proceed. Most children with neurological diseases have problems, such as muscle spasticity, range of motion (ROM) limitation, muscle shortening, balance loss, and mobility and movement impairments. The normalization of muscle tone, preservation of ROM, muscle stretch, and improvement of fine and gross motor skills and balance are essential activities that need to be considered. Therefore, this study aimed to summarize the necessities of a home-based rehabilitation exercise program during the quarantine period. Since the end of 2019, due to the outbreak of coronavirus disease 2019 (COVID- 19) in China and its subsequent epidemic around the world, which is a deadly disease, a public health emergency has been created (1) . According to the World Health Organization, this lethal virus is transmitted among individuals through direct, indirect (i.e., contaminated objects or surfaces), or close contact with infected individuals via mouth and nose secretions, especially if individuals have close contact with each other or if individuals cough or sneeze (1, 2) . Iran J Child Neurol. Autumn 2021 Vol. 15 No. 4 for these children by parents? Which aspects of children's rehabilitation exercises and activities are essential priorities? The most important goals of home-based rehabilitation exercises and activities programs for children with neurologic diseases (9) (10) (11) (12) (13) There are epidemiological, clinical, and review studies about home-based rehabilitation programs for children with neurological diseases. This study will briefly and concisely discuss how to perform these home-based rehabilitation exercises and activities. More than 80% of children with cerebral palsy develop spasticity, which is a constant contraction of muscles. When muscles contract, they constantly overstretch the joints, which limits ROM. As children are constantly growing, uncontrolled spasticity can induce abnormal postures, movements stiffness, and even muscle growth inhibition (14, 15) . Preventive actions, such as quarantine and no contact or minimization of contact with others, may effectively limit the rapid spread of this virus (2) . then, it should be removed, and the skin should be dried. If a child's skin is sensitive to cold, cold therapy should never be used (16) . A heating pad increases muscle elasticity and causes the muscle to relax. Therefore, the heating pad should be used combined with stretching and exercises (17). Children with neurologic diseases often receive passive stretching that is intended to maintain or increase their joint passive ROM (18) . Passive ROM is performed in such a way that child's parents move a part of the body, and the child has no role in the movement. Parents do not need to use much energy and expertise to do exercises. Therefore, all parents can use passive exercises for their children. As passive movements damage a child's joints and muscles, passive ROM exercises should be executed until the child feels pain (19) . Passive ROM exercises are suitable for children who have severe to moderate spasticity and joint stiffness and are still unable to control their movements as much as they should (20) . Table 1 lists the most important passive movements. In children with neurological disorders, stretching exercises were performed to manage spasticity in the form of passive and active stretching, positioning, and isotonic and isokinetic stretching (21) . Table 2 shows the most important stretching exercises for children with muscle stiffness. For the improvement of ROM, passive or active stretches could be applied by parents or as initial conservative treatments. Walking or any mobility after stretching interventions is important (22) . 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Physical management of children with cerebral palsy Treatment of cerebral palsy and motor delay Effectiveness of proprioceptive training over strength training in improving the balance of cerebral palsy children We do not have received any fund for this article Study concept by, Alireza Shamsoddini. Shamsoddini. Drafting and Editing by Alireza Shamsoddini and Behzad Bazgir. The authors declare that there is no conflict of interest.