School of Nursing, Jilin University, Changchun, China.
The Second Hospital of Jilin University, Jilin University, Changchun City, China.
J Med Internet Res. 2023 Dec 25;25:e46957. doi: 10.2196/46957.
Acquired brain injury (ABI) in children and adolescents can lead to motor and executive impairments that often require long-term treatment. The implementation of web-based telerehabilitation therapy at home is a method to improve the functional status of patients. Therefore, we performed a systematic review of the effects of web-based telerehabilitation programs on functional outcomes in children and adolescents with brain injury and supplemented the findings with a meta-analysis.
This study evaluated the therapeutic effect of web-based telerehabilitation training on children and adolescents with brain injury to determine whether web-based telerehabilitation therapy improved motor function, executive function, physical activity level, lower limb strength, hand and upper limb function, visual processing skills, and occupational functional performance in children and adolescents with brain injury.
PubMed, Embase, Scopus, Web of Science, and the Cochrane Library were searched for randomized controlled trials on web-based telerehabilitation programs in children and adolescents with brain injury until December 2022, and the risk of bias was evaluated using the Cochrane Collaboration Tool. Relevant data were extracted, and a meta-analysis was performed using RevMan5.3 software.
Overall, 17 studies involving 848 patients were included. Web-based telerehabilitation therapy improved the motor function (standardized mean difference [SMD] 0.29, 95% CI 0.01-0.57; P=.04), physical activity level (SMD 0.42, 95% CI 0.11-0.73; P=.007), lower limb strength (SMD 0.52, 95% CI 0.13-0.90; P=.009), and visual processing skills (SMD 0.26, 95% CI 0.02-0.50; P=.04) of children and adolescents with brain injury. It also improved executive function in letter-number sequencing (SMD 1.26, 95% CI 0.26-2.26; P=.01), attention (SMD 0.38, 95% CI 0.09-0.66; P=.009), and symbol search (SMD 1.18, 95% CI 0.43-1.93, P=.002).
Web-based telerehabilitation therapy improved motor function, physical activity level, lower limb strength, letter-number sequencing, attention, and symbol search, which improved the quality of life in children and adolescents with brain injury. Web-based telerehabilitation programs provide great convenience for children and adolescents with ABI who need long-term treatment and allow them to exercise at home for rehabilitation training. The widespread implementation of remote interventions also provides children and adolescents in remote areas with better access to rehabilitation services. This review provides evidence for the effectiveness of web-based telerehabilitation therapy, but there was heterogeneity in some of the results because of different disease types and intervention programs. Future studies can expand the sample size according to disease type and increase follow-up time according to different exercise prescriptions to further refine the long-term effects of this intervention on various functions of children and adolescents with ABI.
PROSPERO CRD42023421917; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=421917.
儿童和青少年获得性脑损伤 (ABI) 可导致运动和执行功能障碍，通常需要长期治疗。在家中实施基于网络的远程康复治疗是改善患者功能状态的一种方法。因此，我们对基于网络的远程康复计划对脑损伤儿童和青少年的功能结果的影响进行了系统评价，并进行了荟萃分析。
本研究评估了基于网络的远程康复训练对脑损伤儿童和青少年的治疗效果，以确定基于网络的远程康复治疗是否可以改善脑损伤儿童和青少年的运动功能、执行功能、身体活动水平、下肢力量、手和上肢功能、视觉处理技能和职业功能表现。
检索 PubMed、Embase、Scopus、Web of Science 和 Cochrane 图书馆中关于儿童和青少年脑损伤的基于网络的远程康复计划的随机对照试验，直到 2022 年 12 月，并使用 Cochrane 协作工具评估偏倚风险。提取相关数据，并使用 RevMan5.3 软件进行荟萃分析。
共有 17 项研究纳入 848 名患者。基于网络的远程康复治疗可改善运动功能（标准化均数差 [SMD] 0.29，95%置信区间 [CI] 0.01-0.57；P=.04）、身体活动水平（SMD 0.42，95% CI 0.11-0.73；P=.007）、下肢力量（SMD 0.52，95% CI 0.13-0.90；P=.009）和视觉处理技能（SMD 0.26，95% CI 0.02-0.50；P=.04）。它还改善了脑损伤儿童和青少年的执行功能（字母-数字排序[SMD]1.26，95% CI 0.26-2.26；P=.01）、注意力（SMD 0.38，95% CI 0.09-0.66；P=.009）和符号搜索（SMD 1.18，95% CI 0.43-1.93，P=.002）。
基于网络的远程康复治疗可改善运动功能、身体活动水平、下肢力量、字母-数字排序、注意力和符号搜索，从而提高脑损伤儿童和青少年的生活质量。基于网络的远程康复计划为需要长期治疗的脑损伤儿童和青少年提供了极大的便利，使他们可以在家中进行康复训练。远程干预的广泛实施也为远程地区的儿童和青少年提供了更好的康复服务机会。本综述为基于网络的远程康复治疗的有效性提供了证据，但由于不同的疾病类型和干预方案，结果存在一定的异质性。未来的研究可以根据疾病类型扩大样本量，并根据不同的运动处方增加随访时间，进一步细化这种干预对脑损伤儿童和青少年各种功能的长期影响。
PROSPERO CRD42023421917；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=421917.
