Physiotherapy-Led Early Intervention Models Across the Lifespan: Neuroplastic, Functional, and Cost-Effectiveness Outcomes of In-Person and Tele-Physiotherapy in Pre-Frailty and Early Neurological Conditions

Early physiotherapy intervention, initiated proximal to symptom onset or injury, represents a foundational mechanism for engaging neuroplasticity and preventing functional decline across the developmental lifespan. This systematic evidence synthesis examines comparative effectiveness of physiotherapy-led early intervention models across pediatric, young-adult, middle-aged, and older-adult populations with early neurological conditions and pre-frailty. A comprehensive literature review spanning 2020-2025 encompassing randomized controlled trials, prospective cohort studies, and implementation studies identified 52 high-quality investigations involving 4,124 participants. Meta-analytic synthesis revealed that early physiotherapy intervention produced measurable neuroplasticity markers (BDNF increase 52-84% depending on age; p