Evidence map›Paper›PMID 42174305›Full record

SynthesisNeurocritical care2026

Rehabilitation in the Intensive Care Unit for Adults with Traumatic Brain Injury: A Systematic Review and Meta-analysis.

Fiona Howroyd, David McWilliams, Jonathan Weblin, Hon Sing Geoffrey Wu, Grace Turner, Fang Gao Smith, Tonny Veenith, Niharika A Duggal, Zubair Ahmed

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Fiona HowroydDepartment of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK. fjh722@student.bham.ac.uk.ORCID http://orcid.org/0000-0002-2306-3376
David McWilliamsUniversity Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Jonathan WeblinUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Hon Sing Geoffrey WuUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Grace TurnerSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Fang Gao SmithDepartment of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Tonny VeenithRoyal Wolverhampton Hospital, Wolverhampton, UK.
Niharika A DuggalDepartment of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Zubair AhmedDepartment of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTraumatic brain injury (TBI) is a leading cause of disability worldwide. Rehabilitation in the intensive care unit (ICU) is a recommended intervention for the critically ill. However, the safety and effectiveness of physical rehabilitation in adults admitted to the ICU with TBI is currently unknown.

objectivesThe primary objective was to evaluate the safety of physical ICU rehabilitation in adults with TBI, and secondary outcomes aimed to evaluate its effect upon physical outcomes and length of admission.

methodsFive electronic databases were searched up to 1 September, 2025, including studies investigating physical ICU rehabilitation interventions in adults with acute TBI. A narrative synthesis of safety outcomes was conducted owing to heterogeneity. Meta-analysis was performed for secondary outcomes using the random-effects model to compare pooled data for rehabilitation and no-rehabilitation groups. Risk of bias was assessed using the ROBINS-E tool for observational studies and the RoB2 tool for randomised studies.

resultsOverall, 13 studies consisting of 3582 adults with TBI were included. Four studies reported safety outcomes, reporting no or low rates of adverse events. Meta-analysis identified an increase in the Perme ICU Mobility Scores at ICU discharge in those that received ICU rehabilitation [Mean Difference 3.25 (2.05-4.44), p < 0.00001]. Risk of bias assessment identified very high risk of bias in observational studies and some concerns of bias in randomised studies.

conclusionsPhysical rehabilitation for adults with TBI in the ICU is potentially safe with suggested benefit upon mobility status at ICU discharge. Further high-quality studies of ICU rehabilitation for adults with TBI are required.

trial registrationPROSPERO CRD420251131380.

Indexed as

Brain Injuries, TraumaticCritical CareIntensive Care UnitsNeurological RehabilitationOutcome Assessment, Health CareAdultHumansCritical careHead injuryMobilisationPhysical therapyRehabilitation

Identifiers

PMID42174305
PMCPMC13642425

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.