Strategies supporting parent-delivered rehabilitation exercises to improve motor function after paediatric traumatic brain injury: A systematic review

David Young, Sarah Cawood, Kathryn Mares, Robbie Duschinsky, Wendy Hardeman

Research output: Contribution to journalArticlepeer-review


Aim: To identify and analyse ways in which parents are supported to deliver rehabilitation exercises to their child after traumatic brain injury (TBI), conceptualized as strategies.

Method: A systematic search was completed using seven online databases and three grey literature databases, from inception to November 2021. The included studies focused on physical rehabilitation in children after TBI with the involvement of parents as hands-on deliverers or facilitators of rehabilitation (e.g. supervising the exercise).

Intervention descriptions were reviewed to identify strategies; this was followed by
fine-grained analysis using the Behaviour Change Wheel to identify intervention components. Risk of bias was analysed using the revised Cochrane Risk-of-Bias Tool for Randomized Trials or the Risk Of Bias In Non-randomized Studies - of Interventions.

Results: Six interventions including 211 participants and one trial protocol met the
inclusion criteria. All studies included a proportion of children diagnosed with TBI
and four studies included mixed samples of acquired brain injury or cerebral palsy. All interventions included elements of goal setting and instruction.

Interpretation: Interventions focus heavily on the initiation of physical rehabilitation, but focus less on the longer-term maintenance of rehabilitation delivery. Further research should integrate perspectives from parents to inform the development of new interventions.
Original languageEnglish
JournalDevelopmental Medicine and Child Neurology
Early online date4 Oct 2023
Publication statusE-pub ahead of print - 4 Oct 2023

Cite this