2.1 Study registration
This protocol for systematic review has been registered in the PROSPERO with registration number CRD42020190863 and it is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines (13).
2.2 Study selection criteria
2.2.1 Study type: Randomised controlled trials (RCTs) of physiotherapy on physical health and mental health for COVID-19 in English language only will be added. RCTs that involve any one physiotherapy procedure to the patients and have one control treatment will be finalised. Animal studies, case-report, editorials, discussion and duplicate reports will not be taken.
2.2.2 Participants: All patients recovered with COVID-19 will be selected without taking age, gender, ethnicity and financial status into consideration.
2.2.3 Interventions: Physiotherapy procedure of any kind like mobilisation, manual therapy, cardio-respiratory physiotherapy, machine therapy or general physical therapy exercises will be included whereas Chinese therapies like acupuncture or any Chinese medicine will not be entertained. Control treatments can be treatments other than physiotherapy or inactivity.
2.2.4 Outcome measures: Physical health outcomes will be scales measuring the capability of performing daily living activities like Barthel Index or Functional Independence measure scale and questionnaires describing health status like Physical Health Questionnaire. Mental health outcomes will be the scales describing the psychological condition of patients like SRQ-20, Hamilton Depression scale or Hamilton Anxiety scale.
2.3 Data sources
The electronic databases search will be conducted from inception to June 2021. These are Web of Science, PubMed, Google scholar, China National Knowledge Infrastructure, EMBASE, Chinese Biomedical Literature Databases and Science-direct. Only RCTs will be included. Keywords will be used with free words combination according to difference in databases and extensive search will be done.
2.4 Search strategy
The teams that will be searched on PubMed will be “physiotherapy”, “physical therapy”, “cardio-respiratory therapy”, “physical exercise”, “rehabilitation”, “Corona Virus”, “Corona Virus Disease 2019”, “COVID-19”, “Randomised Controlled Trial”, “randomised”, “randomly”, “clinical trial”. MeSH headings and text words combinations will be used. Table 1 shows the search strategy for PubMed database.
Table 1. Search strategy
Search strategy for PubMed
|
Number
|
Search terms
|
1
|
Physiotherapy
|
2
|
Physical therapy
|
3
|
Cardio-respiratory therapy
|
4
|
Physical exercise
|
5
|
Rehabilitation
|
6
|
1 or 2-5
|
7
|
COVID-19
|
8
|
Corona Virus Disease 2019
|
9
|
Corona Virus
|
10
|
7 or 8-9
|
11
|
Randomised Controlled Trial
|
12
|
Randomised
|
13
|
Randomly
|
14
|
Clinical trial
|
15
|
11 or 12-14
|
16
|
6 and 10 and 14
|
2.5 Data collection and analysis
2.5.1 Selection of studies: Two reviewers (NR and VG) will separately chose the articles based on the titles and abstracts of the papers. Discussion on the results will be done between them. In case of disagreements, a third reviewer (AP) has to decide finally. Studies screening process is shown in the figure 1. Only full text literature will be obtained.
2.5.2 Data extraction: Data will be recorded electronically in terms of patients’ characteristics, interventions, eligibility criteria, outcomes, the study features and results. Disagreements between the two authors for data extraction, a third reviewer will come with the final decision.
2.5.3 Assessment and quality: Quality and assessment of risk of bias of the studies will be estimated with the help of Cochrane collaborative tool independently by the two reviewers.
2.5.4 Measures of treatment effect: In this convention, we will utilise 95% confidence interval (CI) hazard proportion to thoroughly establish the dichotomous information. For efficacy of 95% CI in continuous data, difference between means (M) and standard deviation (SD) will be used.
2.5.5 Dealing with missing data: Authors will be communicated via email. In case if missing data could not be revived, then the study will not be included.
2.5.6 Assessment of heterogeneity: The distribution of participant factors like sex, age, time of stay in hospital and intervention factors like nature of physiotherapy intervention and control intervention of the included studies will be compared. Methodological heterogeneity will be checked by using I2 with value less than equal to 50% and chi-square test (alpha=0.1).
2.6 Ethics
This paper is a systematic review protocol and ethical approval is not necessary for this.