{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:54:07Z","timestamp":1791179647631,"version":"4.1.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017594","name":"Medical Science and Technology Project of Zhejiang Province","doi-asserted-by":"publisher","award":["\u7f16\u53f72025KY626"],"award-info":[{"award-number":["\u7f16\u53f72025KY626"]}],"id":[{"id":"10.13039\/501100017594","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017594","name":"Medical Science and Technology Project of Zhejiang Province","doi-asserted-by":"publisher","award":["\u7f16\u53f72025KY609"],"award-info":[{"award-number":["\u7f16\u53f72025KY609"]}],"id":[{"id":"10.13039\/501100017594","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically evaluate the effects of early versus delayed rehabilitation training interventions (RTI) on clinical outcomes in patients receiving extracorporeal membrane oxygenation (ECMO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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)\u2009=\u20090.43, 95% CI: 0.26\u20130.69,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001], shortened ICU LOS [mean difference (MD)\u2009=\u2009\u22121.12 days, 95% CI: \u22121.30 to \u22120.94,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001], and reduced hospital LOS (MD\u2009=\u2009\u22124.69 days, 95% CI: \u22128.11 to \u22121.27,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.007). No significant differences were found in mechanical ventilation duration (MD\u2009=\u20090.14 days,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.914), ECMO duration (MD\u2009=\u2009\u22121.77 days,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.136), or in-hospital mortality (RR\u2009=\u20090.72,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.097). Sensitivity analysis excluding one study demonstrated a greater reduction in hospital LOS significant (MD\u2009=\u2009\u22125.82 days, 95% CI: \u22129.34 to \u22122.30,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), while other outcomes remained unchanged.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD420251025533<\/jats:ext-link>\n                      , PROSPERO CRD420251025533.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1919668","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:32:34Z","timestamp":1791178354000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A systematic review and meta-analysis of the timing of rehabilitation training intervention for recipients of extracorporeal membrane oxygenators"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhen","family":"Cheng","sequence":"first","affiliation":[{"name":"Emergency and Intensive Care Unit Center, Department of Emergency Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Du","sequence":"additional","affiliation":[{"name":"Emergency and Intensive Care Unit Center, Department of Emergency Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuangqin","family":"Zheng","sequence":"additional","affiliation":[{"name":"Emergency and Intensive Care Unit Center, Intensive Care Unit, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoheng","family":"Zheng","sequence":"additional","affiliation":[{"name":"Emergency and Intensive Care Unit Center, Department of Emergency Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingling","family":"Cheng","sequence":"additional","affiliation":[{"name":"Emergency and Intensive Care Unit Center, Department of Emergency Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengfei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Emergency and Intensive Care Unit Center, Intensive Care Unit, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenmo","family":"Shi","sequence":"additional","affiliation":[{"name":"Emergency and Intensive Care Unit Center, Intensive Care Unit, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health and Nursing, Hangzhou Normal University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zheng","sequence":"additional","affiliation":[{"name":"Emergency and Intensive Care Unit Center, Department of Emergency Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aili","family":"Shi","sequence":"additional","affiliation":[{"name":"Tongde Hospital of Zhejiang Province Affiliated to Zhejiang Chinese Medical University College of Integrated Traditional Chinese and Western Medicine Clinical Medicine)","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1186\/s40001-024-01837-0","article-title":"Extracorporeal membrane oxygenation technology for adults: an evidence mapping based on systematic reviews","volume":"29","author":"Xie","year":"2024","journal-title":"Eur J Med Res"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2536","DOI":"10.1001\/jama.2020.9148","article-title":"Extracorporeal membrane 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