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REVIEW
Journal of Neurosurgical Sciences 2018 April;62(2):187-202
DOI: 10.23736/S0390-5616.17.04277-1
Copyright © 2017 EDIZIONI MINERVA MEDICA
language: English
Technology-assisted rehabilitation interventions following pediatric brain injury
Shari L. WADE 1 ✉, Megan E. NARAD 2, Emily L. SHULTZ 3, 4, Brad G. KUROWSKI 1, Aimee E. MILEY 2, Jessica M. AGUILAR 2, Anna-Lynne R. ADLAM 5
1 Division of Physical Medicine and Rehabilitation, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; 2 Division of Physical Medicine and Rehabilitation, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA; 3 Division of Physical Medicine and Rehabilitation, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA; 4 Department of Psychology, University of Cincinnati, Cincinnati, OH, USA; 5 Department of Psychology, University of Exeter, Exeter, UK
INTRODUCTION: Following traumatic brain injury (TBI), children experience a variety of physical, motor, speech, and cognitive deficits that can have a long-term detrimental impact. The emergence and popularity of new technologies has led to research into the development of various apps, gaming systems, websites, and robotics that might be applied to rehabilitation. The objective of this narrative review was to describe the current literature regarding technologically-assisted interventions for the rehabilitation of motor, neurocognitive, behavioral, and family impairments following pediatric TBI.
EVIDENCE ACQUISITION: We conducted a series of searches for peer-reviewed manuscripts published between 2000 and 2017 that included a technology-assisted component in the domains of motor, language/communication, cognition, behavior, social competence/functioning, family, and academic/school-based functioning.
EVIDENCE SYNTHESIS: Findings suggested several benefits of utilizing technology in TBI rehabilitation including facilitating engagement/adherence, increasing access to therapies, and improving generalizability across settings. There is fairly robust evidence regarding the efficacy of online family problem-solving therapy in improving behavior problems, executive functioning, and family functioning. There was less compelling, but still promising, evidence regarding the efficacy other technology for motor deficits, apps for social skills, and computerized programs for cognitive skills. Overall, many studies were limited in the rigor of their methodology due to small heterogeneous samples and lack of control groups.
CONCLUSIONS: Technology-assisted interventions have the potential to enhance pediatric rehabilitation after TBI. Future research is needed to further support their efficacy with larger controlled trials and to identify characteristics of children who are most likely to benefit.
KEY WORDS: Brain injuries - Telemedicine - Rehabilitation