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Early protocolized rehabilitation improves functional outcomes and quality of life in pediatric neurocritical patients at 24 weeks compared to usual care.

In a single-blind RCT of 196 pediatric neurocritical patients (aged 1-18 years), early protocolized rehabilitation initiated within 72 hours of mechanical ventilation significantly improved Pediatric Cerebral Performance Category scores at 24 weeks (mean difference 0.133, 95% CI 0.055-0.205, p<0.001). Significant improvements were also observed in behavior, adaptive function, sleep patterns, quality of life, and family functioning.

Last updated: Aug 26, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Early Protocolized Rehabilitation Versus Usual Care in Improving Functional Outcomes in Pediatric Neurocritical Patients: A Randomized Controlled Trial.

observational

Elwadhi A, Panda PK, Tyagi AK, Neyaz O, Kaur A, Tiwari LK, Sharawat IK · Neurocritical care (2025)

Participants: N/A
Duration: 24 weeks
Intervention: Early protocolized rehabilitation (EPR) initiated within 72 hours of mechanical ventilation, customized by a multidisciplinary team, with daily sessions for one week, then three times weekly for one month, and monthly after discharge plus weekly teleconsultations.
Outcome: Pediatric Cerebral Performance Category score at 24 weeks; also Child Behavior Checklist, Vineland Adaptive Behavior Scale, Children's Sleep Habits Questionnaire, Pediatric Quality of Life Inventory, and Family Assessment Device scores.
Effect Size: Mean difference 0.133 (95% CI 0.055-0.205) for primary outcome
Population: Pediatric neurocritical patients aged 1-18 years in the pediatric intensive care unit.

Result:

PubMed: 40908418DOI: 10.1007/s12028-025-02357-3

Mechanism Graph

Early initiation of rehabilitation within 72 hours of mechanical ventilation
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Customized multidisciplinary rehabilitation sessions (daily for 1 week, then 3x/week for 1 month, then monthly after discharge)
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Supplemented with weekly teleconsultations
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Result: Improved functional outcomes and quality of life at 24 weeks

Limitations

  • ⚠Single-blind design may introduce performance bias
  • ⚠No long-term follow-up beyond 24 weeks reported
  • ⚠Specific details on blinding of outcome assessors not fully described in abstract

Frequently Asked Questions

What is early protocolized rehabilitation in pediatric neurocritical care?▼

It is a customized rehabilitation program initiated within 72 hours of mechanical ventilation, involving daily sessions for one week, then three times weekly for one month, and monthly after discharge, with weekly teleconsultations, delivered by a team of specialists.

How was functional outcome measured in this study?▼

The primary outcome was the Pediatric Cerebral Performance Category score at 24 weeks. Secondary outcomes included behavior, adaptive function, sleep patterns, quality of life, and family functioning.

What were the main results of the trial?▼

The intervention group showed significantly better functional outcomes (mean difference 0.133, p<0.001) and improvements in all secondary measures including sleep patterns (Children's Sleep Habits Questionnaire) compared to usual care.

Who was eligible for this study?▼

Pediatric neurocritical patients aged 1-18 years in the pediatric intensive care unit who required mechanical ventilation.

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References

  1. 1.Elwadhi A, Panda PK, Tyagi AK, Neyaz O, Kaur A, Tiwari LK, Sharawat IK. "Early Protocolized Rehabilitation Versus Usual Care in Improving Functional Outcomes in Pediatric Neurocritical Patients: A Randomized Controlled Trial.." Neurocritical care, 2025. PMID: 40908418 DOI: 10.1007/s12028-025-02357-3
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.