Development of expert consensus to guide physical rehabilitation in children and adolescents with acquired brain injury during the subacute phase

• Main Authors: Christiaan Gmelig Meyling (Author), Olaf Verschuren (Author), Ingrid C.M. Rentinck (Author), Virginia Wright (Author), Jan Willem Gorter (Author), Raoul H. Engelbert (Author)
• Format: Book
• Published: Medical Journals Sweden, 2023-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.2340/jrm.v55.12303; 1651-2081
• Keywords: acquired brain injury; children and adolescents; delphi study; occupational therapy; physical activity; physiotherapy; Therapeutics. Pharmacology; RM1-950
• Source: Journal of Rehabilitation Medicine, Vol 55 (2023)

Objective: To develop consensus among experts to guide physical rehabilitation in children and adolescents with acquired brain injury during the subacute phase. Design: International Delphi study. Methods: A 3-round online Delphi study was conducted with 11 international experts in rehabilitation for children and adolescents with acquired brain injury. The first round consisted of open-ended questions; the second and third round consisted of ranking 139 statements on a 5-point Likert scale. Results: The panel reached consensus on 116/139 statements. Consensus was reached on the importance of age, pre-injury developmental stage and the clinical presentation of the child when determining content and focus of physical rehabilitation. In addition, consensus was reached on the importance of participation-focused interventions, and involvement of family members in goal-setting and therapeutic activities. Although dosage was deemed very important, no consensus was reached for determination of dose-response variables to suit and influence the child's needs. Conclusion: This study provides a framework for clinicians to design physical rehabilitation interventions in children with acquired brain injury in the sub-acute recovery phase. The promotion of physical activity in meaningful contexts and involvement of family members are considered as important components to optimize recovery.