Evidence-Based Medical Management and Physiotherapy Rehabilitation in Pediatric Traumatic Brain Injury: A Narrative Review.

Abstract

Children between the ages of one and 18 are at a heightened risk of death and impairment due to traumatic brain injury (TBI). TBI can be deadly and is usually categorized as mild, moderate, or severe according to the Glasgow Coma Scale (GCS). For individuals with a TBI and an abnormal GCS, the preferred modality is non-contrast CT of the head. This review focuses on the medical treatment and rehabilitation of children with TBI and their outcomes. This was searched in databases such as PubMed, Google Scholar, and EMBASE. The literature search criteria included "traumatic brain injury AND physiotherapy rehabilitation OR medical treatment," with additional filters applied, including full text, both male and female, ages below 18 years, and publications from 2012 to 2024. This study conducted research on the treatment and rehabilitation of children with TBI. Ten randomized clinical trials, non-randomized trials, and longitudinal cohort study randomized trials met the inclusion criteria, which include hyperbaric oxygen therapy, melatonin, nabiximols, psycho-educational intervention, online therapy, the virtual reality rehabilitation program, and conventional occupational therapy. The results show significant improvement in forearm supination, performance in daily living, quality of life, reduced anger, improved school functioning, improvement in TBI conditions, reduced hospital stay, activity facilitating recovery, and reduced prolonged symptoms. This review has addressed the effectiveness of various medical management and rehabilitation strategies, which are important in TBI and aim to mitigate post-traumatic/concussion impact and improve quality of life. Articles regarding children's TBI rehabilitation are comparatively few. One possible solution to this issue would be to encourage further rehabilitation intervention trials.