title: Impairments, activity limitations and participation restrictions experienced in the first year following a critical illness: protocol for a systematic review.
abstract: Critical illness requiring intensive care unit (ICU) management is a life-altering event with ∼25% of ICU survivors experiencing persistent reductions in physical functioning, impairments in mental health, cognitive dysfunction and decreased quality of life. This constellation of problems is known as 'postintensive care syndrome' (PICS) and may persist for months and/or years. The purpose of this systematic review is to identify the scope and magnitude of physical problems associated with PICS during the first year after discharge from ICU, using the International Classification of Functioning, Disability and Health framework to elucidate the impairments of body functions and structures, activity limitations and participation restrictions.
  
  
  
  Medline (Ovid), Cochrane Database of Systematic Reviews (Ovid), Cochrane Central Register of Controlled Trials (Ovid), PubMed, CINAHL (EBSCO), Web of Science and EMBASE will be systematically searched for observational studies reporting the physical impairments of body functions and structures, activity limitations and participation restrictions associated with PICS. Two reviewers will assess the articles for eligibility according to prespecified selection criteria, after which an independent reviewer will perform data extraction which will be validated by a second independent reviewer. Quality appraisal will be performed by two independent reviewers. Outcomes of the included studies will be summarised in tables and in narrative format and meta-analyses will be conducted where appropriate.
  
  
  
  Formal ethical approval is not required as no primary data is collected. This systematic review will identify the scope and magnitude of physical problems associated with PICS during the first year after discharge from ICU and will be disseminated through a peer-reviewed publication and at conference meetings, to inform practice and future research on the physical problems associated with PICS.
  
  
  
  CRD42015023520.
authors.affiliation: Department of Rehabilitation Science, University at Buffalo, Buffalo, New York, USA.
authors.forename: Patricia J
authors.identifier: 0000-0001-9493-7205
authors.initials: PJ
authors.lastname: Ohtake
authors.affiliation: Montante Family Library, D'Youville College, Buffalo, New York, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Coffey Scott
authors.affiliation: Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Rana S
authors.initials: RS
authors.lastname: Hinman
authors.affiliation: Department of Physical Therapy, Mount Saint Mary's University, Los Angeles, California, USA.
authors.forename: Alan Chong
authors.initials: AC
authors.lastname: Lee
authors.affiliation: Physical Therapy Department, Utica College, Utica, New York, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Smith
mesh_terms: D000203:Activities of Daily Living; D060825:Cognitive Dysfunction; D016638:Critical Illness; D006801:Humans; D008603:Mental Health; D011788:Quality of Life; D013577:Syndrome; D000078202:Systematic Reviews as Topic
keywords: ICF; ICU Survivor; activities of daily living; physical functioning; post-intensive care syndrome