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OBJETIVO: Refinar o Relato Familiar da Motricidade Grossa (GM­FR) utilizando a contribuição dos pais e avaliar as suas propriedades psicométricas. MÉTODO: Neste estudo metodológico, 12 pais de crianças e adolescentes com paralisia cerebral (PC), com idade entre 2 e 18 anos, classificados em todos os níveis do Sistema de Classificação da Função Motora Grossa (GMFCS), foram entrevistados sobre sua experiência na conclusão do GM­FR (validade de conteúdo). O feedback dos pais foi usado para refinar o instrumento que foi então preenchida por 146 famílias para avaliar a consistência interna, e a validade discriminativa e concorrente. 46 pais completaram o GM­FR novamente, 7 a 30 dias depois, para avaliar a confiabilidade teste­reteste. RESULTADOS: A pontuação do GM­FR, as imagens, as descrições e o número total de itens foram revisados com base no feedback dos pais. O GM­FR versão 2.0 demonstrou alta consistência interna (α de Cronbach = 0,99), ausência de efeitos piso/teto e excelente confiabilidade teste­reteste (coeficiente de correlação intraclasse = 0,99). Os escores do GM­FR discriminaram entre os níveis do GMFCS (p < 0,05) e foram fortemente correlacionados negativamente com o nível do GMFCS (r = −0,92; p < 0,001). Os escores do GM­FR correlacionaram­se de forma positiva e forte com o Gross Motor Function Measure­66 (r = 0,94; p < 0,001) e com o domínio de mobilidade do Pediatric Evaluation of Disability Inventory ­ Computer Adaptive Test (r = 0,93; p < 0,001). INTERPRETAÇÃO: A participação ativa das famílias no desenvolvimento do GM­FR facilitou a criação de um instrumento amigável à família. Este estudo fornece fortes evidências de confiabilidade e validade para apoiar o uso do GM­FR na prática clínica e em pesquisas para avaliar o desempenho motor grosso de crianças e adolescentes com PC.

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Recent advances in brain mapping tools have enabled the study of brain activity during functional tasks, revealing neuroplasticity after early brain injuries and resulting from rehabilitation. Understanding the neural correlates of mobility limitations is crucial for treating individuals with cerebral palsy (CP). The aim is to summarize the neural correlates of mobility in children with CP and to describe the brain mapping methods that have been utilized in the existing literature. This systematic review was conducted based on PRISMA guidelines and was registered on PROSPERO (n° CRD42021240296). The literature search was conducted in the PubMed and Embase databases. Observational studies involving participants with CP, with a mean age of up to 18 years, that utilized brain mapping techniques and correlated these with mobility outcomes were included. The results were analyzed in terms of sample characteristics, brain mapping methods, mobility measures, and main results. The risk of bias was evaluated using a checklist previously created by our research group, based on STROBE guidelines, the Cochrane Handbook, and the Critical Appraisal Skills Programme (CASP). A total of 15 studies comprising 313 children with CP and 229 with typical development using both static and mobile techniques met the inclusion criteria. The studies indicate that children"with'CP have increased cerebral activity and higher variability in brain reorganization during mobility activities, such as gait, quiet standing, cycling, and gross motor tasks when compared with children with typical development. Altered brain activity and reorganization underline the importance of conducting more studies to investigate the neural correlates during mobility activities in children with CP. Such information could guide neurorehabilitation strategies targeting brain neuroplasticity for functional gains.

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BACKGROUND: Participation of children with disabilities is an indicator of social inclusion, health, and well-being, and its evaluation needs to be included in the clinical practice of rehabilitation professionals. OBJECTIVES: To investigate the measurement properties of the Participation and Environment Measure - Children and Youth Brazilian version (PEM-CY Brazil). METHODS: We used the PEM-CY to evaluate participation and environment of children with and without disabilities in the home, school, and community settings. Based on COSMIN guidelines, we analyzed two measurement properties: internal consistency for all domains using Cronbach's alpha; and construct (known-groups) validity, i.e., the degree to which instrument scores identify differences between groups. T-tests, Mann-Whitney, or Chi-square tests compared children with and without disabilities. RESULTS: 101 Brazilian children (mean age=9.31 years) with (n = 62) and without (n = 39) disabilities were included. Internal consistency ranged from appropriate (0.70) to excellent (0.95) for all domains in all settings, except for Resources in the environment of the home setting (0.53). Regarding construct validity, PEM-CY participation scores were significantly different between groups in most domains. Children with disabilities were significantly less involved and participated in a smaller number of activities in all settings, in comparison to those without disabilities. The PEM-CY scores in all settings of the environment were significantly higher in the group of children without disabilities. CONCLUSION: Preliminary support was provided for the internal consistency and construct (known-groups) validity of the PEM-CY Brazil to measure participation and the environment in the Brazilian context. The PEM-CY can therefore be used by rehabilitation professionals in Brazil.

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AIM: To systematically review the evidence for intensive mobility training in cerebral palsy (CP) and to determine the minimum effective dose to improve mobility. METHOD: Randomized controlled trials (RCTs) or quasi-RCTs that included participants with CP, and which used intensive task-oriented training (TOT) mobility interventions and reported mobility outcomes, were included. Five databases were searched; two independent reviewers selected studies and extracted data. The Grading of Recommendations Assessment, Development, and Evaluation system and the Cochrane Risk of Bias 2 tool were used to rate the certainty of evidence at the outcomes level and to determine the risk of bias respectively. Meta-analyses were conducted with clinically homogeneous studies. Threshold dose was analysed through meta-regression. RESULTS: Forty-six RCTs with 1449 participants (mean age range 1 year 2 months to 16 years 4 months) were included. TOT had statistically and clinically significant effects on walking speed (p = 0.001), cadence (p = 0.02), gross motor function (p = 0.03), and functional mobility (p = 0.009) compared with control interventions. The threshold dose was undeterminable owing to the high heterogeneity of studies. INTERPRETATION: TOT may improve walking speed, walking endurance, and balance. Studies with homogeneous samples and outcomes are needed to support clinical recommendations for intensive mobility interventions.

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AIM: To refine the Gross Motor Family Report (GM-FR) using parents' input and to evaluate its psychometric properties. METHOD: In this measurement study, 12 parents of children and adolescents with cerebral palsy (CP), aged 2 to 18 years, classified in all levels of the Gross Motor Function Classification System (GMFCS), were interviewed about their experience completing the GM-FR (content validity). Parents' feedback was used to refine the measure which was then completed by 146 families to evaluate internal consistency, and discriminative and concurrent validity. Forty-six parents completed the GM-FR again, 7 to 30 days later, to evaluate test-retest reliability. RESULTS: GM-FR scoring, pictures, descriptions, and the total number of items were revised based on parents' feedback. The GM-FR version 2.0 demonstrated high internal consistency (Cronbach's α = 0.99), no floor/ceiling effects, and excellent test-retest reliability (intraclass correlation coefficient = 0.99). GM-FR scores discriminated between GMFCS levels (p < 0.05) and were strongly negatively correlated with GMFCS level (r = -0.92; p < 0.001). GM-FR scores correlated positively and strongly with the Gross Motor Function Measure-66 (r = 0.94; p < 0.001) and the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test mobility domain (r = 0.93; p < 0.001). INTERPRETATION: Active participation of families in the GM-FR's development facilitated creation of a family-friendly instrument. This study provides strong evidence of reliability and validity to support GM-FR use in clinical practice and research for assessing gross motor performance of children and adolescents with CP.

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BACKGROUND: Autonomy in participation of young adults with cerebral palsy (CP) is not well understood due to the lack of appropriate instruments, especially for the Brazilian population. The Rotterdam Transition Profile (RTP) categorizes autonomy in Participation (education, employment, finances, housing, leisure, intimate relationships, sexuality, transportation) and Health Services (care demands, services and aids, and rehabilitation services) domains. OBJECTIVES: To cross-culturally adapt the RTP for use in Brazil, and to describe the levels of autonomy in participation and associated factors of Brazilian youth with CP. METHODS: RTP was translated and content validity was investigated through an expert panel (n = 4 researchers and n = 4 clinicians); 30 adolescents and young adults with CP provided data for construct validity and internal consistency analysis. To analyze influencing factors, 56 youth with CP, mean age 25 years (SD = 6.9 years), with good cognitive level remotely responded to the RTP, sociodemographic information, and functional classifications (gross motor, manual ability). RESULTS: Following translation, content and construct validity were established, with changes made to improve the clarity of items. Cronbach's alpha (0.82) was considered good and test-reliability was fair to good for most items. High levels of autonomy were found in the areas of Leisure and Rehabilitation, with the lowest proportion of participants with autonomy in Housing, Intimate Relationships, and Finances. Autonomy in participation was associated with age, gross motor and manual ability classifications, and with context-related factors. CONCLUSION: The Brazilian Portuguese version of the RTP was considered valid and reliable. Findings will support transition planning for young people with CP.

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PURPOSE: The purpose of this study is to summarize the ICF foci, looking beyond body structures and function, and to analyze who has been assessed in research about adolescents and young adults (AYAs) with CP in the phase of transition to adulthood. METHOD: Medline, EMBASE, PsycINFO, and CINAHL databases were searched using terms related to cerebral palsy, adolescents/young adults, health development, participation, and independence. Studies including youth with CP (13-30 years old) published in English from 2014 to 2021 were considered. The methods of assessment reported in the included studies were used to identify the ICF foci and who was assessed. RESULTS: In this study, 86 studies were reviewed. The main ICF foci are activity and participation (51% of the studies), personal factors (23%), ICF not covered (14%), ICF not defined (9%), with environmental factors being the least focused ICF component (3%). Most studies assessed AYAs directly (49% of studies). CONCLUSIONS: Activity- and participation-related constructs are the leading research focus of studies, and more attention is needed concerning environmental factors. AYAs are the main source of information, and the perspectives of other key figures are also being valued. To bridge the gap between child and adult health care, a broader view of health development and approaches to explore AYA developmental issues must be taken.

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PURPOSE: To describe the perspective of caregivers about physical therapy (PT) during the COVID-19 pandemic and the effect of social distancing on the health of children with physical disabilities. METHODS: This survey research used a remote questionnaire to identify the perceptions of caregivers about the effect of the COVID-19 pandemic on the health of children and adolescents with physical disabilities and on PT services. Data were analyzed using the frequency of responses; open-ended questions were analyzed through a hybrid approach to thematic analysis. RESULTS: Caregivers of 47 children with cerebral palsy were included. Although most received regular PT services during the pandemic, worsened children's physical conditions and anxiety were prevalent. Caregivers believed that they lacked technical skills. CONCLUSIONS: Social distancing impacted the health of children with physical disabilities, especially their physical conditions. Identifying facilitators and barriers for PT services can be helpful in future similar scenarios.Video abstract Supplemental Digital Content available at:http://links.lww.com/PPT/A503.

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AIM: To describe current home participation (frequency, involvement) and caregiver's desire for change in home participation of children and adolescents with Down syndrome, as well as home environmental factors, and to explore the associations of personal and environmental factors with current participation and caregiver's desire for change. METHOD: Eighty-two caregivers (mean age = 45 years 10 months) of children and adolescents with Down syndrome (mean age = 10 years 7 months) were surveyed about the child's home participation and environmental factors using the Participation and Environment Measure-Children and Youth. Furthermore, children's personal and environmental factors were collected. Results are reported using descriptive analysis and correlations (Spearman's rank correlation coefficients and Mann-Whitney U test) to describe the relationship between current participation and caregiver's desire for change, with personal and environmental factors as ordinal and nominal variables respectively (p < 0.05). RESULTS: Children's participation was highest with regard to personal care management and lowest with regard to school-related activities. Most caregivers desired change in homework and household chores. Greater frequency was associated with male sex, caregiver less rigorous social distancing due to the COVID-19 pandemic, and children receiving therapies. Greater involvement was associated with younger age in children and higher environmental support. Older age in children was associated with caregiver's greater desire for change. INTERPRETATION: Personal and environmental factors correlated with participation in specific ways. Creative strategies to promote participation that consider caregiver's wishes should be undertaken.

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PURPOSE: To explore the feasibility of an intervention using modified ride-on cars in terms of acceptability and potential changes in goal attainment, mobility, social function, and participation of children with Congenital Zika Syndrome (CZS). MATERIALS AND METHODS: A pre- and post-intervention feasibility study was conducted with children with CZS, levels IV and V of the Gross Motor Function Classification System (GMFCS). The intervention consisted of 12 weeks of training (3 times a week for 40 min per session) and 4 weeks of follow-up. The primary outcomes included adherence, satisfaction, and learning in mobility. Secondary outcomes encompassed goal attainment, mobility, social/cognitive function, and participation. Descriptive statistics were performed. To explore potential individual changes with the intervention, Wilcoxon test was used to analyze Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT) data and Young Children's Participation and Environment Measure (YC-PEM)/Participation and Environment Measure for Children and Youth (PEM-CY), along with standard error measurements of the PEDI-CAT domains. RESULTS: Four children participated (median age 4.75 years; two females: three at level V on the GMFCS). Adherence was 75% of the total intervention time, and family members reported being satisfied or very satisfied. Children showed gains in learning the use of the modified ride-on cars and an increase in goal attainment after the intervention. Individual changes were observed in the PEDI-CAT domains (mobility and social/cognitive), but there were no significant changes in participation outcomes. CONCLUSIONS: Children with CZS at GMFCS levels IV and V can learn to use motorized ride-on cars, attainment goals, and experience satisfaction.

Motorized mobility for children with Congenital Zika Syndrome and severe physical and cognitive disabilities is feasible and can encourage future interventions focused on activities and participation.This research contributes to the understanding of the potential changes that motorized mobility can have on goal attainment, satisfaction, and learning.Motorized mobility can be a means to enable children with Congenital Zika Syndrome to have opportunities for participation and guarantee their rights.

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INTRODUCTION: Congenital Zika syndrome (CZS) is a health condition that has affected the development of thousands of children in Brazil. Because it is a new condition, its understanding is an ongoing process. Therefore, it is important to know the rehabilitation interventions being delivered to improve the functioning of these children. We aimed to describe the practices of physical therapists (PTs) and occupational therapists (OTs) who provide follow-up care for children with CZS in Brazil. METHODS: This cross-sectional study included PTs and OTs who assist children with CZS in Brazil. An online questionnaire was used to verify the participants' personal characteristics and professional work environment, as well as the rehabilitation programs they implemented in Brazil for children with CZS. Data were analyzed using descriptive statistics. RESULTS: A total of 116 professionals (79 PT and 37 OT) who work mainly in public health services (81.9%) participated in the study. Of these, 24.1% plan interventions based on reading scientific articles, 66.4% did not report using the biopsychosocial model, 52.6% do not perform any assessments before starting an intervention, 31.9% use neurodevelopmental treatment, and 22.4% use sensorimotor stimulation interventions. The majority of the interventions are delivered 1 to 2 times a week, lasting up to 1 hour. CONCLUSIONS: Professional training and knowledge translation strategies are needed to implement evidence-based practices and improve the quality of rehabilitation programs for Brazilian children with CZS.

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AIMS: To describe the implementation of paediatric rehabilitation telehealth at a physical therapy (PT) unit in Brazil during the COVID-19 pandemic and to describe the perception about this modality by two groups: (1) undergraduate PT students using telehealth during their clinical rotations in this unit and (2) the caregivers of children with disabilities receiving the services. METHODS: Twenty-one PT interns (19 females; 25 ± 2 years of age) and seven caregivers (seven females; 40 ± 6 years of age) of seven children with disabilities (five females; 10 ± 4 years of age; five children diagnosed with cerebral palsy) responded to an online questionnaire about their experience with the telehealth programme. Participant attendance and frequency of objective responses were reported descriptively; open-ended responses were analysed qualitatively and grouped according to broad themes. RESULTS: 71.4% of interns rated telehealth as an excellent or good experience, and 28.6% did not appreciate it. In addition, 28.6% of them thought that telehealth should be part of the mandatory internship. Regarding caregivers, 85.8% judged the telehealth programme as excellent or good. Both interns and caregivers cited pros and cons related to technology, professional resources, communication skills and caregiver-related aspects, among others. CONCLUSIONS: Specific teaching strategies had to be utilised for implementation of telehealth. Despite being a novel modality for interns and caregivers, telehealth was well accepted.

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OBJECTIVE: The purpose of this study was to investigate the cognitive-motor dual-task costs (DTCs) on postural sway of children with typical development (TD) and children with cerebral palsy (CP) during the sit-to-stand movement. METHODS: Twenty children with TD (mean age = 9.35 years) and 17 children with CP (mean age = 8.29 years) randomly performed 3 test conditions: simple motor task, low-complexity cognitive-motor dual-task, and high-complexity cognitive-motor dual-task. The sit-to-stand movement was divided into 3 phases for data analysis: preparation (P1), rising (P2), and stabilization (P3). For each of these phases, the DTCs were calculated by the percentage change in the center of pressure area of sway, velocity of sway, and duration variables between the simple and dual-task conditions. Analysis of variance was applied to test the group, task conditions, and interaction effects. RESULTS: Children with CP had lower DTC than children with TD in area of sway in P1 and P2 variables; anteroposterior velocity of sway in P1, P2, and P3; and duration in P3. Children with TD had higher DTC in the high-complexity cognitive-motor dual-task than in the low complexity one. Children with CP did not show adaptations between the dual-task conditions, showing no differences in DTCs. CONCLUSION: The simultaneous performance of a motor task and a cognitive task seems to affect children with CP and children with TD differently, but the effects depend on the specific demands of each task. These results demonstrate the importance of rehabilitation actions to place demands involving a variety of postural sway strategies. IMPACT: DTCs are different for children with TD and children with CP. Assessment and rehabilitation strategies must take into account the postural sway behavior of these children.

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PURPOSE: The International Alliance of Academies of Childhood Disability created a COVID-19 Task Force with the goal of understanding the global impact of COVID-19 on children with disabilities and their families. The aim of this paper is to synthesize existing evidence describing the impact of COVID-19 on people with disabilities, derived from surveys conducted across the globe. METHODS: A descriptive environmental scan of surveys was conducted. From June to November 2020, a global call for surveys addressing the impact of COVID-19 on disability was launched. To identify gaps and overlaps, the content of the surveys was compared to the Convention on the Rights of the Child and the International Classification of Functioning, Disability and Health. RESULTS: Forty-nine surveys, involving information from more than 17,230 participants around the world were collected. Overall, surveys identified that COVID-19 has negatively impacted several areas of functioning - including mental health, and human rights of people with disabilities and their families worldwide. CONCLUSION: Globally, the surveys highlight that impact of COVID-19 on mental health of people with disabilities, caregivers, and professionals continues to be a major issue. Rapid dissemination of collected information is essential for ameliorating the impact of COVID-19 across the globe.

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We investigated factors related to postural sway during sit-to-stand movement in children and adolescents with Down syndrome (DS). Our assessment of participants followed the biopsychosocial model. Body function and structure were represented by muscle strength and postural sway during sit-to-stand movement, which were assessed by manual muscle testing and kinetics analysis, respectively. The Gross Motor Function Measure and Pediatric Balance Scale depicted the activity component. In addition, we included these relevant contextual factors: age, Home Observation for Measurement of the Environment, family income, and maternal schooling. A correlation analysis verified a suspected association between biopsychosocial and postural sway variables. There were significant separated correlations between postural sway in the three phases of the sit-to-stand movement, and age, GMFM-88 dimension D, and muscle strength. Thus, postural control in sit-to-stand movement was related to biopsychosocial factors involving different life aspects of children and adolescents with DS, and these factors should be addressed in rehabilitation therapy intended to improve postural control among these individuals.

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The COVID-19 pandemic interrupted face-to-face health services, leveraging telehealth strategies. The aim of this cross-sectional study was to investigate, from a parent's perspective, the feasibility of a remote assessment of functioning in children with developmental disabilities during the pandemic and related contextual factors, based on how parents carry out the assessment. Parents of children with developmental disabilities (mean age = 7.56 ± 3.68) responded to a remote assessment via electronic forms and telephone interview. We analyzed parents' perspectives about the feasibility of the assessment. We also tested the association between feasibility score and sociodemographics/pandemic experience. Regression analysis tested if children's functioning characteristics predicted feasibility. A total of 57 mothers completed the remote assessment, and more than 95% did not report difficulties in accessing/responding to electronic forms. They scored remote assessment as easy and feasible, and reported no difficulties with telephone interview. Greater feasibility rates were related to lower maternal age (rho Spearman = -0.290; p = 0.029). The model shows that children's characteristics predicted 20.4% of feasibility (p < 0.005). Remote assessment showed to be feasible. Younger mothers might consider easier-to-use technologies, beyond considering remote assessment more viable. These results can guide the next steps in research and remote clinical practice.

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Objective: Assess the effect of nonimmersive virtual reality (VR) training as complementary rehabilitation on body oscillation in children with cerebral palsy (CP) while standing on different bases of support and surfaces. Materials and Methods: Twenty-three children with unilateral CP randomly allocated to an intervention group (IG, n = 12) or control group (CG, n = 11). The IG underwent two weekly 50-minute sessions of VR training over 8 weeks, associated with conventional therapy, while the CG was submitted to two 45-minute sessions of conventional neurodevelopmental-based physiotherapy a week over the same time period. Participants were evaluated on a force platform under control conditions (CCs) (rigid surface, feet parallel); semitandem stance; flexible surface (FS) with feet parallel; and flexible surface in a semitandem (FSST) stance. The effect of the group and time factors on the center of pressure oscillation variables was analyzed by repeated-measures analysis of variance (ANOVA), with significance set at 0.05. Results: The main effect observed was for time on the FS, with a decline in the amplitude of mediolateral (ML Amp) (P = 0.01) and mediolateral root mean square (P = 0.01) after intervention. In the IG, ML Amp also declined after intervention under CCs (P = 0.02) and total velocity increased for FSST (P = 0.04). The percentage change was significant only in the IG. Conclusion: VR training as complementary rehabilitation can help improve body oscillation in children with CP and mild functional impairment. Nonimmersive VR can be considered a complementary tool for the physical rehabilitation of children with CP. This study was registered with the Brazilian Clinical Trials Registry (RBR-3zty4w).

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Considering that somatosensory impairments may impact motor performance in individuals with cerebral palsy (CP), a better understanding of these relations is relevant to planning interventions. To synthesize research evidence to date on the interrelationships between the somatosensory functions of touch and proprioception with motor functions in persons with CP, we systematically searched Embase, CINAHL, PsycINFO, and Medline databases for studies relating these variables that were published in English from the inception of these databases to November 2020. We targeted the following content categories in our literature search: (a) cerebral palsy; (b) sensory functions; (c) tactile functions; (d) proprioception functions; and (e) motor functions. The selection, data extraction, and methodological quality assessment of these studies were performed in duplicate. We retrieved and analyzed information regarding the studies' methodological approaches and synthesized results. The 11 studies that met our inclusion criteria showed that, in individuals with CP, impairments in tactile discrimination, proprioception, and stereognosis are related to motor functions in terms of overall manual ability, grip strength, postural control and locomotion. Thus, clinical practitioners should attend to somatosensory aspects of motor impairment in individuals with CP. More research is needed to clarify the direction of these associations.

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PURPOSE: Postural control assessment in children with Down syndrome (DS) may contribute to understanding the impact of impairments in Body Structures and Functions on Activities and Participation, providing a biopsychosocial approach to support clinical practice. The present study aimed to systematically review the literature addressing postural control in children and adolescents with Down syndrome, with a focus in the interactions among the components of the International Classification of Functioning (ICF). METHODS: We conducted a tailored search in PubMed; Web of Science, SCOPUS and Science Direct databases. RESULTS: We identified 20 full-texts that fulfilled the inclusion and exclusion criteria. Children and adolescents with DS showed lower postural stability across studies. The ICF components most commonly addressed were Body Structure and Function and Activity. Although the studies measured these components, they did not analyze the interrelationships of components when describing the determinants of postural control in this population. CONCLUSIONS: Overall, the studies indicate that children and adolescents with DS show decreased postural stability and greater vulnerability to sensory changes than their typical peers. There is a lack of studies using the biopsychosocial approach. Only few studies have related the activity level of the participants with the variables of postural control. None of them addressed components of Participation and Environmental Factors. The poor methodological quality of the included studies limits the translation of results to clinical practice. Further studies addressing children with disabilities, such as DS, should utilize the ICF framework, thus providing a biopsychosocial approach of health in these individuals.IMPLICATIONS FOR REHABILITATIONChildren with Down syndrome show decreased postural stability and greater vulnerability to sensory changes than their typical peers.In clinical practice, when assessing postural control of individuals with DS, rehabilitation professionals should not only address components of Body Structures and Functions, but also investigate their impact on Activity and Participation.Training of postural control should address strategies that include natural environments and participation situations.The biopsychosocial approach provided by the ICF framework should be implemented in clinical practice.

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INTRODUCTION: Social isolation and lifestyle changes provoked by the COVID-19 pandemic have negatively affected the level of physical activity of the elderly people. OBJECTIVE: To evaluate the available evidence related to the level of physical activity (PA) of elderly people during the COVID-19 pandemic. METHODS: This is a systematic review, registered on PROSPERO (CRD42021241116), which included cross-sectional and cohort studies. Embase, Pubmed, Cochrane, Web of Science and Scopus databases were used to search for the studies. Finally, the New Castle-Ottawa Quality Assessment scale was used to measure the quality of the studies. RESULTS: 25 studies were found, being 14 cross-sectional and 11 cohort studies. The studies showed that the elderly population was highly affected in relation to the level of physical activity and lifestyle during restrictions, quarantine and lockdowns caused by the COVID-19. There was a significant reduction in physical activity levels, leading to declines in physical fitness and increased sedentary lifestyle, factors directly related to the increase in frailty in this population. CONCLUSION: The level of physical activity in the elderly population decreased during the quarantine period of COVID-19 worldwide. Strategies to maintain physical condition must be encouraged with physical exercises that meets the needs of the elderly in the current pandemic scenario, in order to maintain and improve the health of this population.

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