A systematic review and meta-analysis of the timing of rehabilitation training intervention for recipients of extracorporeal membrane oxygenators.
4 affiliations
- 1Emergency and Intensive Care Unit Center, Department of Emergency Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.
- 2Emergency and Intensive Care Unit Center, Intensive Care Unit, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.
- 3School of Public Health and Nursing, Hangzhou Normal University, Hangzhou, China.
- 4Tongde Hospital of Zhejiang Province Affiliated to Zhejiang Chinese Medical University College of Integrated Traditional Chinese and Western Medicine Clinical Medicine), Hangzhou, China.
Abstract
Objective
To systematically evaluate the effects of early versus delayed rehabilitation training interventions (RTI) on clinical outcomes in patients receiving extracorporeal membrane oxygenation (ECMO).Methods
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), non-randomized controlled studies, and observational cohort studies comparing early and delayed RTI in patients receiving ECMO. We searched databases including Embase, PubMed, Web of Science, ScienceDirect, China National Knowledge Infrastructure, China Science and Technology Journal Database, and China Biology Medicine disc from inception to 1 April 2025. Study selection, data extraction, and quality assessment were performed independently by two reviewers. Outcomes included complications, intensive care unit (ICU) and hospital length of stay (LOS), duration of mechanical ventilation, ECMO duration, and in-hospital mortality.Results
Twelve studies (five RCTs, four non-RCTs, and three cohort studies) were included. Compared with delayed RTI, early RTI significantly reduced the risk of complications [risk ratio (RR) = 0.43, 95% CI: 0.26-0.69, P < 0.001], shortened ICU LOS [mean difference (MD) = -1.12 days, 95% CI: -1.30 to -0.94, P < 0.001], and reduced hospital LOS (MD = -4.69 days, 95% CI: -8.11 to -1.27, P = 0.007). No significant differences were found in mechanical ventilation duration (MD = 0.14 days, P = 0.914), ECMO duration (MD = -1.77 days, P = 0.136), or in-hospital mortality (RR = 0.72, P = 0.097). Sensitivity analysis excluding one study demonstrated a greater reduction in hospital LOS significant (MD = -5.82 days, 95% CI: -9.34 to -2.30, P = 0.001), while other outcomes remained unchanged.Conclusions
Early RTI is associated with reduced complications and improved recovery outcomes (ICU/hospital stay) in ECMO patients compared with delayed RTI. However, due to the limited number and moderate quality of included studies, these findings should be interpreted with caution. High-quality RCTs are needed to confirm these results.Systematic review registration
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251025533, PROSPERO CRD420251025533.
Related
- Efficacy and safety of exercise rehabilitation across the valve intervention pathway: A systematic review and meta-analysis
- Waitlist mortality and post transplant survival amongst non-extracorporeal membrane oxygenation high-urgency heart transplant recipients before and after the 2018 policy change.
- Effects of different durations of exercise-based pulmonary rehabilitation intervention in patients with idiopathic pulmonary fibrosis : A systematic review and meta-analysis
- Regenerative therapies in rehabilitation with interfaces with occupational medicine, geriatrics, and oncology: the example of extracorporeal shock wave therapy
- Evaluating the functional impact of yoga-based cardiac rehabilitation following percutaneous coronary intervention
BibTeX
@article{cheng2026systematic,
title = {{A systematic review and meta-analysis of the timing of rehabilitation training intervention for recipients of extracorporeal membrane oxygenators.}},
author = {Zhen Cheng and Liping Du and Shuangqin Zheng and Xiaoheng Zheng and Lingling Cheng and Mengfei Zhang and Chenmo Shi and Tianyu Zhang and Wei Zheng and Aili Shi},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1919668},
url = {https://europepmc.org/article/MED/42898614},
note = {CC BY},
}
RIS
TY - JOUR
TI - A systematic review and meta-analysis of the timing of rehabilitation training intervention for recipients of extracorporeal membrane oxygenators.
AU - Zhen Cheng
AU - Liping Du
AU - Shuangqin Zheng
AU - Xiaoheng Zheng
AU - Lingling Cheng
AU - Mengfei Zhang
AU - Chenmo Shi
AU - Tianyu Zhang
AU - Wei Zheng
AU - Aili Shi
PY - 2026
DA - 2026/10/05
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1919668
UR - https://europepmc.org/article/MED/42898614
AB - Objective To systematically evaluate the effects of early versus delayed rehabilitation training interventions (RTI) on clinical outcomes in patients receiving extracorporeal membrane oxygenation (ECMO).Methods We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), non-randomized controlled studies, and observational cohort studies comparing early and delayed RTI in patients receiving ECMO. We searched databases including Embase, PubMed, Web of Science, ScienceDirect, China National Knowledge Infrastructure, China Science and Technology Journal Database, and China Biology Medicine disc from inception to 1 April 2025. Study selection, data extraction, and quality assessment were performed independently by two reviewers. Outcomes included complications, intensive care unit (ICU) and hospital length of stay (LOS), duration of mechanical ventilation, ECMO duration, and in-hospital mortality.Results Twelve studies (five RCTs, four non-RCTs, and three cohort studies) were included. Compared with delayed RTI, early RTI significantly reduced the risk of complications [risk ratio (RR) = 0.43, 95% CI: 0.26-0.69, P < 0.001], shortened ICU LOS [mean difference (MD) = -1.12 days, 95% CI: -1.30 to -0.94, P < 0.001], and reduced hospital LOS (MD = -4.69 days, 95% CI: -8.11 to -1.27, P = 0.007). No significant differences were found in mechanical ventilation duration (MD = 0.14 days, P = 0.914), ECMO duration (MD = -1.77 days, P = 0.136), or in-hospital mortality (RR = 0.72, P = 0.097). Sensitivity analysis excluding one study demonstrated a greater reduction in hospital LOS significant (MD = -5.82 days, 95% CI: -9.34 to -2.30, P = 0.001), while other outcomes remained unchanged.Conclusions Early RTI is associated with reduced complications and improved recovery outcomes (ICU/hospital stay) in ECMO patients compared with delayed RTI. However, due to the limited number and moderate quality of included studies, these findings should be interpreted with caution. High-quality RCTs are needed to confirm these results.Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251025533, PROSPERO CRD420251025533.
SN - 2296-858X
ER -