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Remote Technology-Based Training Programs for Children with Acquired Brain Injury: A Systematic Review and a Meta-Analytic Exploration.
Behavioural Neurology ( IF 2.7 ) Pub Date : 2019-08-01 , DOI: 10.1155/2019/1346987
Claudia Corti 1 , Viola Oldrati 1 , Maria Chiara Oprandi 1 , Elisabetta Ferrari 1 , Geraldina Poggi 1 , Renato Borgatti 1 , Cosimo Urgesi 1, 2, 3 , Alessandra Bardoni 1
Affiliation  

Introduction. Multidisciplinary rehabilitation interventions are considered to be a need for children with acquired brain injury (ABI), in order to remediate the important sequelae and promote adjustment. Technology-based treatments represent a promising field inside the rehabilitation area, as they allow delivering interventions in ecological settings and creating amusing exercises that may favor engagement. In this work, we present an overview of remote technology-based training programs (TP) addressing cognitive and behavioral issues delivered to children with ABI and complement it with the results of a meta-analytic exploration. Evidence Acquisition. We performed the review process between January and February 2019. 32 studies were included in the review, of which 14 were further selected to be included in the meta-analysis on TP efficacy. Evidence Synthesis. Based on the review process, the majority of TP addressing cognitive issues and all TP focusing on behavioral issues were found to be effective. Two meta-analytic models examining the means of either cognitive TP outcomes or behavioral TP outcomes as input outcome yielded a nonsignificant effect size for cognitive TP and a low-moderate effect size for behavioral TP. Additional models on outcomes reflecting the greatest beneficial effects of TP yielded significant moderate effect sizes for both types of TP. Nevertheless, consistent methodological heterogeneity was observed, pointing to cautious interpretation of findings. A subgroup analysis on visuospatial skill outcomes showed a smaller yet significant effect size of cognitive TP, with low heterogeneity, providing a more reliable estimation of overall cognitive TP effects. Conclusions. Promising results on remote cognitive and behavioral TP efficacy emerged both at the review process and at the meta-analytic investigation. Nevertheless, the high heterogeneity that emerged across studies prevents us from drawing definite conclusions. Further research is needed to identify whether specific training characteristics and population subgroups are more likely to be associated with greater training efficacy.

中文翻译:

针对后天性脑损伤儿童的基于远程技术的培训计划:系统回顾和元分析探索。

简介。多学科康复干预被认为是获得性脑损伤(ABI)儿童的需要,以纠正重要的后遗症并促进调整。基于技术的治疗代表了康复领域内一个有前途的领域,因为它们允许在生态环境中进行干预并创建可能有利于参与的有趣练习。在这项工作中,我们概述了针对 ABI 儿童的认知和行为问题的基于远程技术的培训计划 (TP),并以元分析探索的结果对其进行了补充。证据获取. 我们在 2019 年 1 月至 2019 年 2 月期间进行了审查过程。审查纳入了 32 项研究,其中进一步选择了 14 项纳入 TP 疗效的荟萃分析。证据合成. 根据审查过程,发现大多数解决认知问题的 TP 和所有关注行为问题的 TP 都是有效的。两个元分析模型检查认知 TP 结果或行为 TP 结果作为输入结果的均值,得出认知 TP 的效应大小不显着,行为 TP 的效应大小为中低。反映 TP 最大有益效果的其他结果模型对两种类型的 TP 产生了显着的中等效应大小。然而,观察到一致的方法学异质性,表明对研究结果的谨慎解释。对视觉空间技能结果的亚组分析显示认知 TP 的影响较小但显着,异质性低,提供了对整体认知 TP 影响的更可靠估计。结论。在审查过程和荟萃分析调查中都出现了关于远程认知和行为 TP 功效的有希望的结果。然而,研究中出现的高度异质性使我们无法得出明确的结论。需要进一步的研究来确定特定的训练特征和人群亚组是否更有可能与更高的训练效果相关。
更新日期:2019-08-01
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