背景:儿童和青少年获得性脑损伤(ABI)可导致经常需要长期治疗的运动和执行障碍。在家中实施基于网络的远程康复治疗是一种改善患者功能状态的方法。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功能结局的影响进行了系统评价,并通过荟萃分析补充了研究结果.
目的: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改善了运动功能,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,儿童和青少年脑损伤的职业功能表现。
方法:PubMed,Embase,Scopus,WebofScience,我们在Cochrane图书馆中搜索了关于脑损伤儿童和青少年网络远程康复计划的随机对照试验,直至2022年12月,并使用Cochrane协作工具评估偏倚风险.提取相关数据,使用RevMan5.3软件进行荟萃分析。
结果:总体而言,包括17项研究,涉及848名患者。基于网络的远程康复治疗改善了运动功能(标准化平均差[SMD]0.29,95%CI0.01-0.57;P=.04),身体活动水平(SMD0.42,95%CI0.11-0.73;P=.007),下肢力量(SMD0.52,95%CI0.13-0.90;P=.009),和视觉处理技能(SMD0.26,95%CI0.02-0.50;P=.04)的儿童和青少年的脑损伤。它还改善了字母数字排序的执行功能(SMD1.26,95%CI0.26-2.26;P=0.01),注意(SMD0.38,95%CI0.09-0.66;P=.009),和符号搜索(SMD1.18,95%CI0.43-1.93,P=0.002)。
结论:基于网络的远程康复治疗改善了运动功能,身体活动水平,下肢力量,字母数字排序,注意,和符号搜索,改善了儿童和青少年脑损伤的生活质量。基于网络的远程康复计划为需要长期治疗的ABI儿童和青少年提供了极大的便利,并允许他们在家中进行康复训练。远程干预措施的广泛实施还为偏远地区的儿童和青少年提供了更好的康复服务。这篇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,一些结果存在异质性。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,以进一步细化该干预措施对儿童和青少年ABI各种功能的长期影响。
背景:PROSPEROCRD42023421917;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=421917。
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.