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Measurement and reporting of physical rehabilitation interventions in pediatric critical care: a scoping review
David J Zorko1, Julie C Reid2, Janelle Unger3
1Department of Pediatrics, McMaster University, Hamilton, Canada.
Insights
Research on physical rehabilitation for critically ill children is limited and focuses on respiratory interventions and short-term outcomes. Reporting of these interventions is suboptimal, hindering reproducibility and efficacy assessment.
Area of Science:
- Pediatric Intensive Care
- Rehabilitation Medicine
- Critical Care Research
Background:
- Physical rehabilitation is crucial for critically ill children but research in this area is developing.
- Existing studies often focus on respiratory interventions and outcomes within the pediatric intensive care unit (PICU).
- There's a need to evaluate the quality and completeness of reporting for these interventions.
Purpose of the Study:
- To describe and evaluate physical rehabilitation research in critically ill children.
- To assess the reporting quality of physical rehabilitation interventions in this population.
Main Methods:
- A systematic search of five electronic databases up to December 2018 identified prospective studies in PICUs.
- Study characteristics, outcomes, and interventions were extracted.
- Reporting quality was assessed using standardized tools, and intervention reporting completeness was evaluated using the Consensus on Exercise Reporting Template (CERT).
Main Results:
- Twenty studies with 2644 patients were included; most were small, with a median sample size of 57.
- Respiratory interventions (e.g., chest physiotherapy) were most common (55%), followed by physical activity interventions (45%).
- Study reporting quality was generally good, but intervention reporting completeness was moderate (61.9%).
Conclusions:
- Physical rehabilitation research in critically ill children is characterized by small studies, a focus on respiratory interventions, and short-term outcomes.
- The reporting of physical rehabilitation interventions is suboptimal, impacting clinical application.
- Utilizing frameworks like CERT could enhance future study design and reporting.
Purpose:
To describe and evaluate physical rehabilitation research in critically ill children, including physical rehabilitation intervention reporting.
Methods:
We searched five electronic databases to 31 December 2018 for prospective physical rehabilitation studies conducted in pediatric intensive care units (PICU). Screening was conducted independently in duplicate. Study characteristics, outcomes, and interventions were extracted from included studies. Quality of study reporting was assessed using standardized tools. Completeness of physical rehabilitation intervention reporting was assessed using the Consensus on Exercise Reporting Template (CERT).
Results:
We included 20 studies enrolling a total of 2644 patients. Median (Q1,Q3) sample size was 57 (44,104). Seven studies (35%) were randomized controlled trials. Eleven studies (55%) evaluated respiratory interventions, most commonly multicomponent chest physiotherapy (73%). Nine studies (45%) evaluated physical activity interventions, most commonly progressive mobility (56%). The majority of stated outcomes (92.5%) were limited to the PICU setting. Median [Q1,Q3] quality of study reporting was good (77.2% [66.7%,87.4%]), and completeness of physical rehabilitation intervention reporting was moderate (61.9% [45.9%,71.5%]).
Conclusion:
Physical rehabilitation studies in critically ill children were small, and focused on evaluating respiratory-based interventions and short-term PICU-based outcomes. Reporting of physical rehabilitation interventions was suboptimal. Use of CERT may improve design and reporting in future studies.Implications for rehabilitationWhile physical rehabilitation research in critically ill children is a growing field, there are currently few studies evaluating physical rehabilitation interventions in this population.Physical rehabilitation studies to date have been small, focused on evaluating respiratory-based interventions and short-term outcomes limited to the PICU setting.The reporting of physical rehabilitation interventions in this population is suboptimal, making it challenging for clinicians to reproduce interventions and appraise their efficacy or safety.
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