Effect of Early Interdisciplinary Rehabilitation for Trauma Patients: A Systematic Review

Hanne Langseth Naess; Eirik Vikane; Eike Ines Wehling; Jan Sture Skouen; Rae Frances Bell; Lars Gunnar Johnsen

doi:10.1016/j.arrct.2020.100070

Effect of Early Interdisciplinary Rehabilitation for Trauma Patients: A Systematic Review

Arch Rehabil Res Clin Transl. 2020 Jun 25;2(4):100070. doi: 10.1016/j.arrct.2020.100070. eCollection 2020 Dec.

Authors

Hanne Langseth Naess^{1

2}, Eirik Vikane², Eike Ines Wehling^{2

3}, Jan Sture Skouen^{2

4}, Rae Frances Bell⁵, Lars Gunnar Johnsen^{6

7}

Affiliations

¹ Regional Trauma Center, Haukeland University Hospital, Bergen, Norway.
² Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway.
³ Department of Biological and Medicine Psychology, University of Bergen, Bergen, Norway.
⁴ Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
⁵ Regional Centre of Excellence in Palliative Care, Haukeland University Hospital, Bergen, Norway.
⁶ Department of Neuromedicine and Movement Science, University of Trondheim, Trondheim, Norway.
⁷ Norwegian National Advisory Unit on Trauma, Oslo, Norway.

Abstract

Objective: To perform a systematic review to assess the current scientific evidence concerning the effect of EIR for trauma patients with or without an associated traumatic brain injury.

Data source: We performed a systematic search of several electronic (Ovid MEDLINE, Embase, Cochrane Library Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health, and SveMed+) and 2 clinical trial registers (clinicaltrials.gov and International Clinical Trials Registry Platform). In addition, we handsearched reference lists from relevant studies.

Data extraction: Two review authors independently identified studies that were eligible for inclusion. The primary outcome measures were functional-related outcomes and return to work. The secondary outcome measures were length of stay in hospital, number of days on respirator, complication rate, physical and mental health measures, quality of life, and socioeconomic costs.

Data synthesis: Four studies with a total number of 409 subjects, all with traumatic brain-associated injuries, were included in this review. The included trials varied considerably in study design, inclusion and exclusion criteria, and had small numbers of participants. All studies were judged to have at least 1 high risk of bias. We found the quality of evidence, for both our primary and secondary outcomes, low.

Conclusions: No studies that matched our inclusion criteria for EIR for trauma patients without traumatic brain injuries could be found. For traumatic brain injuries, there are a limited number of studies demonstrating that EIR has a positive effect on functional outcomes and socioeconomic costs. This review highlights the need for further research in trauma care regarding early phase interdisciplinary rehabilitation.

Keywords: EIR, early interdisciplinary rehabilitation; ICU, intensive care unit; Patient reported outcome measures; RCT, randomized controlled trial; Rehabilitation; TBI, traumatic brain injury; Trauma; WHO, World Health Organization; Wounds and injuries; nervous system.

Publication types

Review