The effects of early rehabilitation in high-risk infants with brain injury: a systematic review and meta-analysis

BACKGROUND: A meta-analysis was conducted to examine the effects of early rehabilitation on the incidence of sequelae and associated disabilities in high-risk infants with brain injury. METHODS: English and Chinese medical databases including PubMed, Web of Science and Embase, China National Knowledge Infrastructure (CNKI) and Wanfang database, were search from 2005 to 2020 for relevant studies related to rehabilitation in high-risk children with brain injury. Patients who received basic treatment combined with early rehabilitation after brain injury formed the treatment group, and infants who only received basic treatment were considered the control group. The data were statistically analyzed using Stata16.0 analysis software. RESULTS: A total of 13 studies were included, involving 1,930 patients. Meta-analysis showed that the effective rate of early rehabilitation in the treatment of high-risk children with brain injury was significantly higher than that of the control group without early rehabilitation [odds ratio (OR) =4.98; 95% confidence interval (CI): 3.66 to 6.79]. Early rehabilitation also significantly improved patient adaptability [standardized mean difference (SMD) =0.632; 95% CI: 0.496 to 0.769], gross motor skills (SMD =0.971; 95% CI: 0.705 to 1.236), fine motor skills (SMD =0.904; 95% CI: 0.670 to 1.138), language skills (SMD =0.757; 95% CI: 0.483 to 1.030), and personal-social scores (SMD =0.786; 95% CI: 0.648 to 0.925) compared to patients in the control group. The mental development index (MDI) score (SMD =1.194; 95% CI: 0.839 to 1.549) and the psychomotor development index (PDI) score (SMD =0.973; 95% CI: 0.661 to 1.286) were significantly higher in the treatment group compared to the control group. DISCUSSION: Early rehabilitation therapy can improve the neuromotor and intellectual development in high-risk infants with brain injury.