JMIR Publications

ABSTRACT

Background:

Acquired brain injury in children can lead to motor and cognitive impairment that often requires long-term treatment. At present, implementing corresponding effective interventions at home is a method to improve the functional status of patients. We, therefore, conducted a systematic review of the effects of web-based telerehabilitation program on functional outcomes in children with brain injury and supplemented the findings with a meta-analysis.

Objective:

Aims 1: To evaluate the effects of web-based tele-training therapy used at home on children with brain injury.  Objective 1: To extract data of post-intervention function from the treatment and control groups of each study.  Objective 2: To perform a meta-analysis, pooling the extracted data, to establish the significance of web-based training on these functions. Aims 2: To explore a new treatment strategy for children with brain injury that allows them to achieve the effect of rehabilitation training simply through physical activity or playing games at home.

Methods:

PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched for randomized controlled trials (RCTs) on the application of Web-based telerehabilitation program in children with brain injury up to December 2022, and the methodological quality was assessed. Relevant data were extracted and Meta-analysis was performed using RevMan5.3 software.

Results:

A total of 17 studies involving 848 patients were included. Web-based telerehabilitation can improve the motor function (SMD=0.30, 95%CI=0.07~0.54, P < 0.05), physical activity level (SMD=0.42, 95%CI=0.11~0.73, P < 0.05), lower limb strength (SMD=0.52, 95%CI=0.13~0.90, P < 0.05) and visual ability (SMD=0.26, 95%CI=0.02~0.50, P < 0.05) of children with brain injury. It can also improve the executive function of working memory (SMD=0.36, 95%CI=0.15~0.57, P < 0.05), attention (SMD=0.38, 95%CI=0.09~0.66, P < 0.05) and processing speed (SMD=0.33, 95%CI=0.07~0.58, P < 0.05).

Conclusions:

Web-based telerehabilitation helps to improve motor function, physical activity level, lower limb strength, working memory, attention, and processing speed, thereby improving the quality of life in children with brain injury. Clinical Trial: This systematic review and meta-analysis is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. An initial review protocol was pre-registered at International Prospective Register of Systematic Reviews (PROSPERO), and the number is CRD42022373501.