Body composition and motor function in children born large for gestational age at term.

BACKGROUND: This cross-sectional study compared body composition and motor function between children who were born large for gestational age (LGA) and those born appropriate for gestational age (AGA) and to investigate the association between gait quality and other variables. METHODS: Body composition was determined using a bioelectrical impedance analyzer. Motor functions were assessed using one-leg standing time, timed up-and-go test, five times sit-to-stand test, and three-dimensional gait analysis. We compared the results between two groups. We performed multiple regression analysis to evaluate the association between gait deviation index and variables of LGA, fat mass index, and motor functions (adjusted for age and sex). RESULTS: Children aged 6-12 years who were born LGA at term (n = 23) and those who were born AGA at term (n = 147) were enrolled. The LGA group had a higher fat mass index (2.9 vs. 2.2, p = 0.006) and lower gait deviation index (91.4 vs. 95.4, p = 0.011) than the AGA group. On multiple regression analysis, gait deviation index was associated with being LGA and fat mass index. CONCLUSIONS: In school-aged children who were born LGA, monitoring increased fat mass index and decreased gait deviation index could lessen the risk of metabolic syndrome and reduced gait function. IMPACT: Children aged 6-12 years who were born large for gestational age (LGA) at term showed a higher fat mass index and lower gait deviation index than those who were born appropriate for gestational age at term. No significant differences in balance function or muscle strength were observed between groups. On multiple regression analysis, gait deviation index was associated with being LGA at birth and fat mass index. In school-aged children who were born LGA, monitoring increased fat mass index and decreased gait deviation index could lessen the risk of metabolic syndrome and reduced gait function.

Breakpoints in complex chromosomal rearrangements correspond to transposase-accessible regions of DNA from mature sperm.

Constitutional complex chromosomal rearrangements (CCRs) are rare cytogenetic aberrations arising in the germline via an unknown mechanism. Here we analyzed the breakpoint junctions of microscopically three-way or more complex translocations using comprehensive genomic and epigenomic analyses. All of these translocation junctions showed submicroscopic genomic complexity reminiscent of chromothripsis. The breakpoints were clustered within small genomic domains with junctions showing microhomology or microinsertions. Notably, all of the de novo cases were of paternal origin. The breakpoint distributions corresponded specifically to the ATAC-seq (assay for transposase-accessible chromatin with sequencing) read data peak of mature sperm and not to other chromatin markers or tissues. We propose that DNA breaks in CCRs may develop in an accessible region of densely packaged chromatin during post-meiotic spermiogenesis.

Decreased walking efficiency in elementary school children with developmental coordination disorder trait.

OBJECTIVE: To compare walking efficiency, and associated physical function, between children, with and without developmental coordination disorder trait. DESIGN: Cross-sectional study. SETTING: The study was conducted in a Medical and Rehabilitation Center for Developmental Disabilities in Okazaki, Japan. SUBJECTS: The study included 286 children, 6-12 years of age, with and without developmental coordination disorder trait. Developmental coordination disorder trait was defined by a score below the -1 standard deviation on the Japanese version of the Developmental Coordination Disorder Questionnaire. Based on this criterion, 45 children (28 boys) were classified into the developmental coordination disorder trait group and the other 241 (115 boys) in the control group. MEASURES: The following physical function outcomes were measured: single leg stance test; step length variability; and walking efficiency, measured using the 2-min walk test. Logistic regression analysis was used to determine the association between developmental coordination disorder trait and lower walking efficiency and physical function. RESULTS: Compared to the control group, the developmental coordination disorder group showed lower walking efficiency (P = 0.026), higher step length variability (P = 0.047), and shorter single leg stance test (P = 0.001). Developmental coordination disorder was independently associated with walking efficiency (odds ratio, 1.03; 95% confidence interval [CI], 1.001-1.061; P = 0.041) and single leg stance test (odds ratio, 0.99; 95% CI, 0.978-0.996; P = 0.006), but not to step length variability, age, and sex. CONCLUSIONS: Lower walking efficiency increases energy expenditure in children with developmental coordination disorder trait. Interventions to improve walking efficiency could improve the physical function and participation of these children.

Gait characteristics of children with Williams syndrome with impaired visuospatial recognition: a three-dimensional gait analysis study.

Williams syndrome (WS) is a genetically based neurodevelopmental disorder characterized by intellectual disability and impaired visuospatial recognition. The aim of this study was to analyze the gait characteristics of WS children with impaired visuospatial recognition using a three-dimensional gait analysis (3DGA) to clarify the gait adaptation needed to compensate for it. 3DGA was performed in 8 WS children with impaired visuospatial recognition (mean age, 11.8 years) and 9 age-, sex-, height-, and weight-matched controls. Clinical data, fundamental motor tests, and gait variables while walking on a flat surface and walking up a mat were compared between the two groups, and the correlations between variables were analyzed in the WS children. WS children showed impairment of balance function without muscle weakness. In walking on a flat surface, the WS group showed reduced walking speed, short step length, increased variability of step length, increased knee flexion throughout the stance phase, increased horizontal pelvic range of motion (ROM), and a low Gait Deviation Index and a high Gait Profile Score, which are indices of gait quality. In walking up a mat, the WS group showed further reduced walking speed and decreased sagittal hip flexion and ankle dorsiflexion ROM in the swing phase. Impaired balance function was significantly correlated with increased variability of step length and decreased sagittal ankle dorsiflexion ROM in the swing phase. The detailed gait pattern of WS children with impaired visuospatial recognition was presented. These findings show that impaired visuospatial recognition and balance function contribute to gait adaptation.

A novel WTX mutation in a female patient with osteopathia striata with cranial sclerosis and hepatoblastoma.

Osteopathia striata with cranial sclerosis (OSCS) is an X-linked dominant sclerosing bone dysplasia. Typically affected females show macrocephaly, characteristic facial appearance, cleft palate, mild learning difficulties, hearing loss, sclerosis of the long bones and skull, and longitudinal striations visible on radiographs of the long bones, pelvis and scapulae. Typically affected males usually die at the fetal or early neonatal stage. Because of its variable expressivity, which ranges from asymptomatic to fetal death, clinical diagnosis of OSCS can be difficult. Here, we identify a unique female patient presenting with severe macrocephaly, characteristic facial appearance, developmental delay, and hepatoblastoma. Exome sequencing identified a novel de novo nonsense mutation (c.1045C>T, p.Glu349*) in the WTX gene associated with OSCS. The OSCS diagnosis was confirmed in this patient based on the hallmark appearance of longitudinal striations in long bones when viewed by X-ray. WTX is also known as a tumor suppressor gene, and somatic mutations in that gene have been identified in Wilms tumors. In addition to this patient, although two patients with OSCS have been reported to have colorectal cancer or ovarian cancer, Wilms tumor has never been reported in association with this disorder. Tumor susceptibility in patients with OSCS is discussed.

Mutations in HADHB, which encodes the ß-subunit of mitochondrial trifunctional protein, cause infantile onset hypoparathyroidism and peripheral polyneuropathy.

Mitochondrial trifunctional protein (MTP) is a hetero-octamer composed of four α- and four ß-subunits that catalyzes the final three steps of mitochondrial ß-oxidation of long chain fatty acids. HADHA and HADHB encode the α-subunit and the ß-subunit of MTP, respectively. To date, only two cases with MTP deficiency have been reported to be associated with hypoparathyroidism and peripheral polyneuropathy. Here, we report on two siblings with autosomal recessive infantile onset hypoparathyroidism, peripheral polyneuropathy, and rhabdomyolysis. Sequence analysis of HADHA and HADHB in both siblings shows that they were homozygous for a mutation in exon 14 of HADHB (c.1175C>T, [p.A392V]) and the parents were heterozygous for the mutation. Biochemical analysis revealed that the patients had MTP deficiency. Structural analysis indicated that the A392V mutation identified in this study and the N389D mutation previously reported to be associated with hypoparathyroidism are both located near the active site of MTP and affect the conformation of the ß-subunit. Thus, the present patients are the second and third cases of MTP deficiency associated with missense HADHB mutation and infantile onset hypoparathyroidism. Since MTP deficiency is a treatable disease, MTP deficiency should be considered when patients have hypoparathyroidism as the initial presenting feature in infancy.

Relationship between exercise habits and physical function in children aged 9-12 years.

Exercise improves physical health and positively impacts physical functions in children. Additionally, the habitual exercise established during childhood often continues into adulthood. Therefore, childhood is an important period for establishing healthy habits. Investigating the relationship between the presence or absence of daily exercise and physical functions may provide important information to confirm poor physical function in children with poor exercise habits. Therefore, this study examined the relationship between exercise habits as defined by the Japanese Ministry of Health, Labor, and Welfare and physical function in children aged 9-12 years. Approximately 239 children were included in this study. Participants answered a questionnaire about their exercise habits. We evaluated the skeletal muscle mass index, grip strength, standing broad jump, one-leg standing time, and gait deviation index. Logistic regression analyses were performed to assess exercise habit association with skeletal muscle mass index, physical function, and gait deviation index after adjusting for sex. Of the 239 children, 75.5% (n = 178) had exercise habits. A significant association was noted between exercise habits and skeletal muscle mass index and standing broad jump (skeletal muscle mass index: OR, 1.84; 95% CI, 1.01-3.36 and p<0.05; standing long jump: OR, 1.02; 95% CI, 1.00-1.04 and p<0.05). In conclusion, exercise regardless of exercise level for at least 30 min per day, 2 days per week, for at least 1 year is important for skeletal muscle mass and instantaneous lower limb muscular strength development in school-aged children.

Three-Dimensional Gait Analysis as a Biomarker for GTP Cyclohydrolase 1-Deficient Dopa-Responsive Dystonia.

BACKGROUND: GTP-cyclohydrolase 1-deficient dopa-responsive dystonia (GTPCH1-deficient DRD) typically presents in childhood with dystonic posture of the lower extremities, gait impairment, and a significant response to levodopa. We performed three-dimensional gait analysis (3DGA) to quantitatively assess the gait characteristics and changes associated with levodopa treatment in patients with GTPCH1-deficient DRD. METHODS: Three levodopa-treated patients with GTPCH1-deficient DRD underwent 3DGA twice, longitudinally. Changes were evaluated for cadence; gait speed; step length; gait deviation index; kinematic data of the pelvis, hip, knee, and ankle joints; and foot progression angle. RESULTS: Levodopa treatment increased the cadence and gait speed in one of three patients and increased the gait deviation index in two of three patients. The kinematic data for each joint exhibited different characteristics, with some improvement observed in each of the three patients. There was consistent marked improvement in the abnormal foot progression angle; one patient had excessive external rotation of one foot, another had excessive bilateral internal rotation, and the other had excessive internal rotation of one foot and excessive external rotation of the opposite foot, all of which improved. CONCLUSION: The 3DGA findings demonstrate that the gait pathology and recovery process in GTPCH1-deficient DRD vary from case to case. Changes in the foot progression angle and gait deviation index can enable the effects of treatment to be more easily evaluated.

Co-occurrence of 22q11 deletion syndrome and HDR syndrome.

22q11 deletion syndrome is one of the most common chromosomal deletion syndromes and is usually caused by a 1.5-3.0 Mb deletion at chromosome 22q11.2. It is characterized by hypocalcemia resulting from hypoplasia of the parathyroid glands, hypoplasia of the thymus, and defects of the cardiac outflow tract. We encountered a Japanese boy presenting with an unusually severe phenotype of 22q11 deletion syndrome, including progressive renal failure and severe intellectual disabilities. Diagnostic testing using fluorescent in situ hybridization revealed deletion of the 22q11 region, but this did not explain the additional complications. Copy number analysis was therefore performed using whole genome single nucleotide polymorphism (SNP) assay, which identified an additional de novo deletion at 10p14. This region is the locus for hypoparathyroidism, deafness, and renal dysplasia (HDR) syndrome caused by haploinsufficiency of GATA3. Together, these two syndromes sufficiently explain the patient's phenotype. This is the first known case report of the co-occurrence of 22q11 deletion syndrome and HDR syndrome. As the two syndromes overlap clinically, this study indicates the importance of carrying out careful clinical and genetic assessment of patients with atypical clinical phenotypes or unique complications. Unbiased genetic analysis using whole genome copy number SNP arrays is especially useful for detecting such rare double mutations.

MLL2 and KDM6A mutations in patients with Kabuki syndrome.

Kabuki syndrome is a congenital anomaly syndrome characterized by developmental delay, intellectual disability, specific facial features including long palpebral fissures and ectropion of the lateral third of the lower eyelids, prominent digit pads, and skeletal and visceral abnormalities. Mutations in MLL2 and KDM6A cause Kabuki syndrome. We screened 81 individuals with Kabuki syndrome for mutations in these genes by conventional methods (n = 58) and/or targeted resequencing (n = 45) or whole exome sequencing (n = 5). We identified a mutation in MLL2 or KDM6A in 50 (61.7%) and 5 (6.2%) cases, respectively. Thirty-five MLL2 mutations and two KDM6A mutations were novel. Non-protein truncating-type MLL2 mutations were mainly located around functional domains, while truncating-type mutations were scattered through the entire coding region. The facial features of patients in the MLL2 truncating-type mutation group were typical based on those of the 10 originally reported patients with Kabuki syndrome; those of the other groups were less typical. High arched eyebrows, short fifth finger, and hypotonia in infancy were more frequent in the MLL2 mutation group than in the KDM6A mutation group. Short stature and postnatal growth retardation were observed in all individuals with KDM6A mutations, but in only half of the group with MLL2 mutations.

Evaluation of Muscle Oxygen Dynamics in Children's Gait and Its Relationship with the Physiological Cost Index.

The response of muscle oxygen saturation, which is an index for the energy metabolism of muscles during walking in children, and its relationship to the physiological cost index, which indicates walking efficiency, are unknown. This study aimed to evaluate muscle oxygen saturation in lower extremity muscles during walking in children, its changes with age, and the relationship between the physiological cost index. The oxygen saturation was measured by the amount of change during a two-minute walk, and the physiological cost index was calculated from the change in heart rate before and after exercise and walking speed. Results were compared for each muscle, and the correlation between the two was examined. Changes in muscle oxygen saturation were greater in the lower leg muscles, significantly greater in the tibialis anterior at six to seven years, and in the gastrocnemius medial head at eight to ten years. The physiological cost index was significantly correlated with changes in muscle oxygen saturation in the tibialis anterior (r = 0.44, p < 0.001). The lower leg muscles were metabolically active in children's gait, and their response varied with age. Moreover, the muscle oxygenation dynamics of the tibialis anterior may influence walking efficiency.

Relationship between low-back pain and flexibility in children: A cross-sectional study.

Low-back pain is common among school-aged children. Decreased trunk flexibility in childhood influences low-back pain in adulthood. Previous studies examining the association between low-back pain and trunk flexibility in children are insufficient. Examining this association among elementary school children may help to better understand trunk flexibility in children with low-back pain and to modify the management of inflexibility. Therefore, this study aimed to identify the prevalence of low-back pain and its relationship with physical function among elementary school students. School-aged children aged 6-12 years were recruited in Japan between May 2018 and March 2023. Fingertip-to-floor distance, back muscle strength, pelvic tilt angle during gait, and the visual analog scale for low-back pain were measured. In addition, factors independently related to low-back pain were determined through logistic regression analysis. Low-back pain was reported in 9.6% of the 394 participants (boys, 191; girls, 203). All children with low-back pain presented with back pain when they moved; however, the pain was non-specific. Logistic regression analysis showed that the fingertip-to-floor distance was an independent risk factor for low-back pain (odds ratio, 0.921; p = 0.007). The odds ratios calculated in the logistic regression analysis confirmed that low-back pain frequency increased as the fingertip-to-floor distance decreased. The risk of low-back pain was associated with inflexibility, regardless of sex and muscle strength. These findings suggest that children with low-back pain must increase their trunk and lower extremity flexibility.

Gait performance and dual-task costs in school-aged children with Down syndrome.

OBJECTIVE: This cross-sectional observational study aimed to assess gait performance, its correlation with physical functions, and its dual-task costs in children with Down syndrome (DS), to investigate their gait adaptations. METHODS: Gait performance with or without movie-watching tasks was evaluated in 17 children with DS (age, 6-12 years) and 51 age- and sex-matched controls, using three-dimensional gait analysis. We compared participants' demographics, physical functions, and gait performance without tasks between the two groups. In the DS group, correlations between physical functions, the intelligence quotient, and gait variables were assessed. Dual-task costs for gait variables were also compared between the two groups. RESULTS: Children with DS showed poorer balance function and muscle strength and lower gait quality than the control group. In the DS group, there was a significant positive correlation between gait speed, step length, and intelligence quotient. There were no correlations between the balance function, muscle strength, intelligence quotient, and gait quality. Dual-task costs for gait speed, step length, and cadence were greater in the DS group; however, there was no significant difference in dual-task costs for gait quality between the two groups. CONCLUSION: These findings highlight the importance of providing appropriate interventions for motor functions in school-aged children with DS based on their gait performance in single- and dual-task conditions, as well as on their intelligence quotient.

Pathological gait in Rett syndrome: Quantitative evaluation using three-dimensional gait analysis.

OBJECTIVES: Ataxic-rigid gait is a characteristic gait pathology in patients with Rett syndrome (RTT). In the present study, we aimed to quantitatively evaluate gait pathology in patients with RTT using three-dimensional gait analysis (3DGA). METHODS: We performed 3DGA in 11 patients with RTT ranging from 5 to 18 years (median age, 9 years) and in 33 age-matched healthy female controls. We compared the results of 3DGA, including spatiotemporal gait parameters and comprehensive indices of gait kinematics, such as the Gait Deviation Index (GDI) and Gait Profile Score (GPS), between the two groups. The GPS consists of nine sub-indices called Gait Variable Scores (GVSs). Decline in GDI or elevation of GPS and GVS indicated greater abnormal gait pathology. RESULTS: The patients demonstrated significantly slower walking speed, lower step length/length of the lower extremities, lower cadence, wider step width, and higher coefficient of variation of step length than the controls. Moreover, the patients had a lower GDI and higher GPS than the controls. The patients also exhibited higher GVSs for eight out of nine gait kinematics, particularly the sagittal plane in the pelvis, hip, knee, and ankle joint; coronal plane in the pelvis and hip joint; and horizontal plane in the pelvis than the controls. CONCLUSIONS: Quantitative evaluation of gait pathology in patients with RTT is possible using 3DGA. We found that in addition to ataxic-rigid gait, abnormalities in the coronal plane of the pelvis and hip joint and the horizontal plane of the pelvis were prominent.

Physical Function of Japanese Preadolescents during the COVID-19 Pandemic.

Children's exercise habits have changed during the COVID-19 pandemic. This study aimed to examine the physical function and physical activity of preadolescent children before and during the COVID-19 pandemic. This cross-sectional study compared time spent in moderate-to-vigorous physical activity (MVPA), grip strength, single-leg standing time, and two-step tests of healthy children aged 10 to 12 years, enrolled from January 2018 to January 2020 (pre-COVID-19 group, n = 177) and from January 2021 to September 2022 (during-COVID-19 group, n = 69). The during-COVID-19 group had weaker grip strength (median: 14.4 vs. 15.8 kg; p = 0.012), worse performance on the two-step test (mean: 1.56 vs. 1.60; p = 0.013), and less MVPA (median: 4 vs. 7 h per week; p = 0.004). Logistic regression showed that the during-COVID-19 group was significantly related to weaker grip strength (odds ratio: 0.904, 95% CI: 0.829-0.986; p = 0.022) and worse performance in the two-step test (odds ratio: 0.976, 95% CI: 0.955-0.997; p = 0.028). The COVID-19 pandemic decreased exercise opportunities for preadolescent children, which may have had a negative impact on muscle strength and balance. It is essential to increase the amount of MVPA among preadolescent children.

Physical Functions among Children before and during the COVID-19 Pandemic: A Prospective Longitudinal Observational Study (Stage 1).

One major impact of the COVID-19 pandemic on children's lifestyles is the lack of exercise owing to activity restrictions. However, information regarding the way in which physical functions among children decline under these circumstances remains scarce. In this study, we compared the physical functions and life habits among children before and during the COVID-19 pandemic in Japan. The participants involved 40 children aged between 9-15 years (23 girls and 17 boys) who were examined medically both before and during the pandemic. The compared variables included muscle strength, static and dynamic balance functions, gait speed, body fat percentage, screen and sleep times, quality of life, and physical activity time. During the pandemic, compared to before the pandemic, children had lower levels of dynamic balance functions (p = 0.039), increased body fat percentages (p < 0.0001), longer screen time per day (p = 0.002), and shorter sleep time per day (p < 0.0001). Between the two periods, there were no significant differences in muscle strength, static balance functions, gait speed, quality of life, and physical activity time. The activity restrictions imposed as a result of the COVID-19 pandemic negatively affect dynamic balance functions, body-fat levels, and life habits among children.

Physical Activity Related to Body Muscle Mass Index and Stiffness Index in 7-to-10-Year-Old Girls.

The relationship between moderate-to-vigorous physical activity (MVPA) performance time and body muscle mass and stiffness index in pre-puberty school-aged girls has not been fully elucidated. The effect of sexual maturity on bone mass is more pronounced in girls. This study aimed to clarify the relationship between MVPA performance time and the above-mentioned factors. This was a prospective, population-based cohort study of 111 girls aged 7-10 years. Data were collected via medical examination, clinical measurements, and questionnaires. Spearman's ρ analysis was used to determine the association between skeletal muscle mass index (SMI) and stiffness index, muscle strength, and MVPA performance time. Participants who met the recommended MVPA level accounted for only 24.3% (n = 27) of all participating girls (n = 111). The following factors were significantly positively correlated with MVPA level at spearman's ρ analysis: SMI (r = 0.303, p = 0.001), stiffness index (r = 0.229, p = 0.015), grip strength (r = 0.283, p = 0.003), back muscle strength (r = 0.197, p = 0.038), and standing long jump distance (r = 0.288, p = 0.002). Multiple regression analysis's results revealed that SMI (ß = 0.237; p = 0.024) was associated with MVPA performance time. These results can help school-aged girls to pay adequate attention to having healthy physical activity habits to prevent the decline of skeletal muscle mass, stiffness index, and body muscle strength.

Decreased Balance Function in School-Aged Children with Behavioral Problems.

Children with behavioral problems have a high risk of impaired motor performance. However, the characteristics of balance functions and their associations with behavioral traits are unclear in this population. This study aimed to evaluate balance functions and their relationships with the degree of behavioral problems in school-aged children. A total of 209 children, aged 6-10 years, were divided into two groups, those with and those without behavioral problems, using the Strengths and Difficulties Questionnaire (SDQ). Physical assessments included the one-leg standing test (OLST), the two-step test, and the five-times-sit-to-stand test. We compared the data between groups and assessed for correlations in terms of total difficulties and the SDQ subscale scores. Children with behavioral problems showed significantly reduced the OLST results (p < 0.001) and the two-step test results (p = 0.008). The five-times-sit-to-stand test results did not show significant differences between groups. The OLST results were significantly correlated with emotional symptoms (r = -0.22, p < 0.001), hyperactivity/inattention (r = -0.29, p < 0.001), peer relationship problems (r = -0.22, p < 0.001), and total difficulties (r = -0.32, p < 0.001). Meanwhile, the two-step test results showed no significant correlation with the SDQ scores. Children with behavioral problems have poor balance function, thereby increasing the risk for instability. This suggests that the balance function of children with behavioral problems needs to be considered.

Three-dimensional gait analysis of lower extremity gait parameters in Japanese children aged 6 to 12 years.

We aimed to develop gait standards for gait parameters in school-aged Japanese children and assess age-related differences in gait patterns and parameters. Children aged 6-12 years (n = 424) were recruited from two elementary schools. An instrumented three-dimensional gait analysis system was used to record each child's gait kinematics, kinetics, and spatiotemporal parameters. Participants were subdivided into three age groups (Group A, 6-8 years; Group B, 9-10 years; and Group C, 11-12 years). LMS Chartmaker, version 2.54, was used to create a developmental chart for the gait pattern. The non-normalized step and stride lengths were significantly longer, and the cadence was lower in older children; however, the opposite outcome occurred when analyzing normalized data. Ankle moment differed significantly by age, and the maximum ankle moment was higher in older children than that in younger children. Furthermore, the hip and knee flexion angles during gait and the normalized spatiotemporal parameters of Japanese children aged 6-12 years differed by age and from those of children from other countries. The centile chart of the gait pattern is a useful tool for clinicians to assess developmental changes in the gait pattern and detect gait abnormalities in children.

Effect of the COVID-19 Emergency on Physical Function among School-Aged Children.

In April 2020, the Japanese government declared a state of emergency due to the novel coronavirus disease (COVID-19). Schools were closed and a stay-at-home order was issued in April and May 2020. This before-and-after study aimed to measure the effects of these COVID-19-related restrictions on physical function among Japanese children. The study included children aged 6-7 years, enrolled before and after the emergency declaration. Their body fat percentage, single-leg standing time, Gait Deviation Index score, and history of falls were compared. There were 56 and 54 children in the before and after groups, respectively. Children in the after group had a higher body fat percentage (p = 0.037), shorter single-leg standing time (p = 0.003), and a larger number of falls per month (p < 0.001) than those in the before group. In the logistic regression analysis, children in the after group had a significantly shorter single-leg standing time (odds ratio (OR): 0.985, 95% confidence interval (CI): 0.972-0.997, p = 0.013), a greater number of falls per month (OR: 1.899, 95% CI: 1.123-3.210, p = 0.017), and a higher body fat percentage (OR: 1.111, 95% CI: 1.016-1.215, p = 0.020) than those in the before group. The COVID-19 emergency restrictions had a negative effect on children's physical function, especially on balance.