Role of nonpharmacological concussion management in children: systematic review of randomized controlled trials.

Autor: Siahaan AMP; Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia., Ivander A; Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia., Indharty RS; Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia., Tandean S; Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia., Ginting AGM; Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia., Ginting M; Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia., Khosasi F; Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia., Elbert; Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Jazyk: angličtina
Zdroj: Clinical and experimental pediatrics [Clin Exp Pediatr] 2024 Nov; Vol. 67 (11), pp. 569-579. Date of Electronic Publication: 2024 Oct 28.
DOI: 10.3345/cep.2023.01256
Abstrakt: 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.
Databáze: MEDLINE