Ogourtsova Tatiana, Boychuck Zachary, O'Donnell Maureen, Ahmed Sara, Osman Galil, Majnemer Annette
Research Center of the Jewish Rehabilitation Hospital, CISSS (Center Intégré de Santé et de Services Sociaux) Laval, Site of CRIR, Quebec, Canada.
Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
Phys Occup Ther Pediatr. 2023;43(2):129-175. doi: 10.1080/01942638.2022.2106468. Epub 2022 Aug 30.
To determine the level of evidence for the effectiveness of telerehabilitation against comparison interventions in improving child- and parent-related outcomes in children and youth with developmental disabilities.
A systematic approach, comprised of a comprehensive search; transparent study selection, data extraction, quality assessment by independent reviewers; and synthesis of sufficiently similar data (per diagnostic group, health profession, and overall level of evidence for each outcome) was undertaken.
Fifty-five studies (29 randomized trials) were included across six diagnostic groups and ten health professions. Common telerehabilitation targets varied across diagnostic groups and included motor function, behavior, language, and parental self-efficacy. Telerehabilitation was found to be either more effective or as effective versus comparison intervention in improving 46.9% or 53.1% of outcomes, respectively. It was never found to be detrimental or less effective. Strong to moderate, limited, and insufficient levels of evidence were found for 36.5%, 24.5%, and 38.6% of the outcomes, respectively.
There is sufficient evidence suggesting that telerehabilitation is a promising alternative when face-to-face care is limited. It is comparable to usual care and is more effective than no treatment. Blending in-person and telerehabilitation approaches could be beneficial for the post-pandemic future of rehabilitation in pediatric care.
确定远程康复与对照干预措施相比，在改善发育障碍儿童和青少年与儿童及家长相关结局方面的有效性证据水平。
采用系统方法，包括全面检索；透明的研究选择、数据提取，由独立评审员进行质量评估；以及对足够相似的数据（按诊断组、卫生专业和每个结局的总体证据水平）进行综合分析。
纳入了六个诊断组和十个卫生专业的55项研究（29项随机试验）。不同诊断组的常见远程康复目标各不相同，包括运动功能、行为、语言和家长自我效能感。结果发现，在改善46.9%或53.1%的结局方面，远程康复分别比对照干预更有效或效果相当。从未发现其有不利影响或效果较差。分别有36.5%、24.5%和38.6%的结局证据水平为强至中度、有限和不足。
有充分证据表明，当面对面护理受限，远程康复是一种有前景的替代方案。它与常规护理相当，且比不治疗更有效。将面对面和远程康复方法相结合可能有利于儿科护理康复的疫情后未来。
