Siahaan Andre Marolop Pangihutan, Ivander Alvin, Indharty Rr Suzy, Tandean Steven, Ginting Anastasia Grace Milenia, Ginting Masrini, Khosasi Felix
Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Clin Exp Pediatr. 2024 Nov;67(11):569-579. doi: 10.3345/cep.2023.01256. Epub 2024 Oct 28.
Concussion is a global public health problem that affects many children worldwide. Most patients present with postconcussion syndrome and normal brain imaging findings. Despite the high incidence of concussion in children, published research on nonpharmacological management is lacking and much more often concerns pharmacological interventions. This systematic review aimed to evaluate the role of nonpharmacological interventions in managing concussion based on randomized controlled trials. The PubMed, Scopus, Web of Science, and Cochrane databases were extensively searched for articles published between January 2013 and July 2023. A modified patient intervention, comparison, and outcome framework was used to construct the search strategy and eligibility criteria. Risk of bias was assessed using the Risk of Bias-2 tool. A total of 16 studies conducted between January 2013 and July 2023 were analyzed. Three studies were conducted in an acute care setting (<24-hour postinjury) involving rest, computer time, and doing nothing, while the other 13 studies were conducted in a chronic care setting (>24-hour postinjury) and included aerobic exercise, collaborative care intervention, cervical spine rehabilitation, education by physiotherapists, a hyperbaric oxygen therapy protocol, family intervention therapy, virtual reality, traditional occupational therapy, virtual rehabilitation, oculomotor control exercises, vestibular rehabilitation, coordination exercises, and balance exercises. This systematic review highlights the importance of nonpharmacological therapy in pediatric concussion cases. Active rehabilitation may yield promising outcomes. Another interesting approach may be useful in pediatric concussion management. However, this systematic review shows a lack of high-quality literature supporting nonpharmacological pediatric concussion treatments.
脑震荡是一个全球性的公共卫生问题，影响着世界各地的许多儿童。大多数患者表现为脑震荡后综合征，脑部影像学检查结果正常。尽管儿童脑震荡的发病率很高，但关于非药物治疗的已发表研究却很缺乏，更多的是关于药物干预的研究。本系统评价旨在基于随机对照试验评估非药物干预在脑震荡管理中的作用。我们在PubMed、Scopus、Web of Science和Cochrane数据库中广泛检索了2013年1月至2023年7月发表的文章。采用改良的患者、干预措施、对照和结局框架来构建检索策略和纳入标准。使用偏倚风险-2工具评估偏倚风险。共分析了2013年1月至2023年7月期间进行的16项研究。三项研究在急性护理环境（受伤后<24小时）中进行，涉及休息、电脑使用时间和无所事事，而其他13项研究在慢性护理环境（受伤后>24小时）中进行，包括有氧运动、协作护理干预、颈椎康复、物理治疗师教育、高压氧治疗方案、家庭干预治疗、虚拟现实、传统职业治疗、虚拟康复、动眼控制练习、前庭康复、协调练习和平衡练习。本系统评价强调了非药物治疗在儿童脑震荡病例中的重要性。积极的康复治疗可能会产生有希望的结果。另一种有趣的方法可能对儿童脑震荡的管理有用。然而，本系统评价表明缺乏支持非药物儿童脑震荡治疗的高质量文献。
