Summary of findings: intervention: physical rehabilitation; comparison: usual care
| WHO domain outcome | Review author; N studies: N patients | Pooled effect (95% CI) | GRADE of evidence | Explanation |
|---|---|---|---|---|
| Impairment | ||||
| Peripheral muscle strength | Kayambu et al26 2 244 | Hedge's g=0.27 (0.02 to 0.52), p=0.03 | ϴϴ Low* | Downgraded −2 for serious risk of bias and imprecision |
| Respiratory muscle strength | Kayambu et al26 2 105 | Hedge's g=0.51 (0.12 to 0.89), p=0.01 | ϴϴ Low† | Downgraded −2 for serious risk of bias and imprecision |
| CIP/CIM | Hermans et al25 1 104 | RR 0.62 (0.39 to 0.96) p=0.03 | ϴϴϴϴ High | |
| Activity limitation | ||||
| Physical function‡ | Kayambu et al26 2 143 | Hedge's g=0.46 (0.13 to 0.78), p=0.01 | ϴϴ Low§ | Downgraded −2 for serious risk of bias and imprecision |
| Participation restriction | ||||
| Quality of Life | Kayambu et al26 2 154 | Hedge's g=0.40 (0.08 to 0.71), p=0.01 | ϴϴϴϴ High | |
| Healthcare utilisation | ||||
| VFD | Kayambu et al26 3 334 | Hedge's g=0.38 (0.16 to 0.59), p<0.001 | ϴϴϴ Moderate¶ | Downgraded −1 for imprecision |
| ICU LOS | Kayambu et al26 6 597 | Hedge's g=−0.34 (−0.51 to −0.18), p<0.001 | ϴϴϴϴ High | |
| Hospital LOS | Kayambu et al26 Hermans et al25** 5 441 | Hedge's g=−0.34 (−0.53 to −0.15), p<0.001 | ϴϴϴϴ High | |
| Hospital mortality | Kayambu et al26 Hermans et al25** 3 274 | OR 1.0. (0.54 to 1.85) p=1.0 | ϴϴϴϴ High | |
| Duration of MV | Hermans et al25 1 Not reported | Median (IQR) 3.4 days (2.3 to 7.3) vs 6.1 days (4.0 to 9.6), p not reported | ϴϴϴ Moderate†† | Downgraded −1 for inadequate reporting of effect |
Stage of recovery: in the ICU.
*50% no random allocation; 50% no concealed allocation; 50% no blinded assessors; 50% not reported measures of key outcomes >85% patients and outcome was measured at different end points.
†50% no concealed allocation; 50% no blinded assessors; 50% not reported measures of key outcomes >85% patients; 100% no ITT and unclear end point in one study.
‡Data from Kayambu et al,26 no pooled data reported in Calvo-Ayala et al.24
§50% no allocation concealment; 50% not reported measures of key outcomes >85% patients; 50% no ITT and outcome was measured at different end points.
¶Measured at different end points.
**Outcome from same RCT reported in both reviews.
††Inadequate reporting of effect.
CIP/CIM, critical illness polyneuropathy/myopathy; ICU, intensive care unit; ITT, intention to treat; LOS, length of stay; MV, mechanical ventilation; RCT, randomised controlled trials; RR, risk ratio; VFD, ventilator-free days.