title: Physical rehabilitation interventions for adult patients with critical illness across the continuum of recovery: an overview of systematic reviews protocol.
abstract: BACKGROUND
  Patients admitted to the intensive care unit with critical illness often experience significant physical impairments, which typically persist for many years following resolution of the original illness. Physical rehabilitation interventions that enhance restoration of physical function have been evaluated across the continuum of recovery following critical illness including within the intensive care unit, following discharge to the ward and beyond hospital discharge. Multiple systematic reviews have been published appraising the expanding evidence investigating these physical rehabilitation interventions, although there appears to be variability in review methodology and quality. We aim to conduct an overview of existing systematic reviews of physical rehabilitation interventions for adult intensive care patients across the continuum of recovery.
  
  
  METHODS
  This protocol has been developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines. We will search the Cochrane Systematic Review Database, Database of Abstracts of Reviews of Effectiveness, Cochrane Central Register of Controlled Trials, MEDLINE, Excerpta Medica Database and Cumulative Index to Nursing and Allied Health Literature databases. We will include systematic reviews of randomised controlled trials of adult patients, admitted to the intensive care unit and who have received physical rehabilitation interventions at any time point during their recovery. Data extraction will include systematic review aims and rationale, study types, populations, interventions, comparators, outcomes and quality appraisal method. Primary outcomes of interest will focus on findings reflecting recovery of physical function. Quality of reporting and methodological quality will be appraised using the PRISMA checklist and the Assessment of Multiple Systematic Reviews tool.
  
  
  CONCLUSIONS
  We anticipate the findings from this novel overview of systematic reviews will contribute to the synthesis and interpretation of existing evidence regarding physical rehabilitation interventions and physical recovery in post-critical illness patients across the continuum of recovery.
  
  
  BACKGROUND
  PROSPERO CRD42015001068.
authors.affiliation: Lane Fox Clinical Respiratory Physiology Research Unit, Guy's and St. Thomas' NHS Foundation Trust, London, UK. bronwen.connolly@nhs.net.|Centre of Human and Aerospace Physiological Sciences, King's College London, London, UK. bronwen.connolly@nhs.net.|Guy's & St Thomas' NHS Foundation Trust and King's College London, National Institute of Health Research Biomedical Research Centre, London, UK. bronwen.connolly@nhs.net.
authors.forename: Bronwen
authors.initials: B
authors.lastname: Connolly
authors.affiliation: School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Ulster, UK. b.oneill@ulster.ac.uk.
authors.forename: Brenda
authors.initials: B
authors.lastname: O'Neill
authors.affiliation: School of Health in Social Science, The University of Edinburgh, Edinburgh, UK. lsalisbu@exseed.ed.ac.uk.
authors.forename: Lisa
authors.initials: L
authors.lastname: Salisbury
authors.affiliation: School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Ulster, UK. McDowell-K3@email.ulster.ac.uk.
authors.forename: Kathryn
authors.initials: K
authors.lastname: McDowell
authors.affiliation: School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK. b.blackwood@qub.ac.uk.
authors.forename: Bronagh
authors.initials: B
authors.lastname: Blackwood
mesh_terms: D003422:Critical Care; D016638:Critical Illness; D004434:Early Ambulation; D006801:Humans; D018908:Muscle Weakness / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012107:Research Design; D012196:Review Literature as Topic; D000078202:Systematic Reviews as Topic