The Effect of Web-Based Telerehabilitation Programs on Children and Adolescents With Brain Injury: Systematic Review and Meta-Analysis.

Children and adolescents recovering from acquired brain injury often need long-term rehabilitation, and this systematic review asked whether web-based telerehabilitation programs done at home can improve their functional outcomes. The researchers pooled data from 17 randomized controlled trials involving 848 participants, comparing web-based training against other interventions or usual care, and combined the results using meta-analysis. Across the pooled studies, web-based telerehabilitation was associated with statistically significant improvements in motor function, physical activity level, lower limb strength, and visual processing skills, along with gains in specific executive function measures including letter-number sequencing, attention, and symbol search. Effect sizes ranged from small to moderate.

The authors note heterogeneity across results, likely reflecting differences in the underlying brain injury types and the specific intervention programs used, which limits how confidently the findings can be generalized across different patient groups or telerehabilitation formats.

If your child has had a brain injury, you may be wondering whether rehabilitation exercises done at home through a computer or app can actually help. This review looked at 17 studies involving 848 children and teenagers with brain injury, comparing web-based rehabilitation programs to other types of care. The combined results showed improvements in several areas: motor function, physical activity levels, leg strength, visual processing skills, and some aspects of executive function like attention and working memory (holding and using information, such as remembering a sequence of numbers).

These differences were statistically significant, meaning they were unlikely to be due to chance, though the size of the improvements ranged from small to moderate depending on the skill being measured. The researchers point out that the studies varied quite a bit in terms of the type of brain injury involved and how the telerehabilitation programs were designed, which makes it harder to know exactly how well these findings apply to any individual child's situation. No safety information was reported in this review.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review and meta-analysis pooled 17 randomized controlled trials (n=848) examining web-based telerehabilitation for children and adolescents with acquired brain injury, assessing outcomes across motor function, executive function, physical activity, lower limb strength, upper limb and hand function, visual processing, and occupational performance. Risk of bias was evaluated using the Cochrane Collaboration Tool, though specific risk-of-bias ratings for individual domains were not detailed in the abstract. Pooled analyses found statistically significant improvements favoring telerehabilitation in motor function (SMD 0.29), physical activity level (SMD 0.42), lower limb strength (SMD 0.52), visual processing (SMD 0.26), and executive function subdomains including letter-number sequencing (SMD 1.26), attention (SMD 0.38), and symbol search (SMD 1.18).

Effect sizes were generally small to moderate, with the letter-number sequencing and symbol search estimates showing wide confidence intervals suggesting less precision. The authors explicitly note heterogeneity attributable to differing disease types and intervention protocols across included trials, which constrains the certainty and generalizability of pooled estimates. Sample sizes for individual outcome comparisons were not uniformly large, and follow-up duration varied.

These findings support telerehabilitation as a feasible remote delivery model but the heterogeneous evidence base warrants cautious interpretation pending larger, disease-specific trials with longer follow-up.