TITLE: Early mobilization for acute heart failure: a systematic review and meta-analysis protocol
AUTHORS: Masatsugu Okamura, Yuki Kataoka, Shunsuke Taito, Takashi Fujiwara, Atsushi   Ide, Hideyuki   Oritsu, Masashi   Shimizu, Yoshitaka  Shimizu, Ryoko  Someya, Masaaki   Konishi

[DESCRIPTION]
<div class = "text-blocks"><div class = "text-block"><span style = "font-weight:bold;">Background</span></div><div class = "text-block">    Early mobilization for inpatient acute heart failure has been applied in clinical practice, but there is no consensus on the specific timing, efficacy, and safety of its initiation. For patients with heart failure, exercise therapy when their condition has stabilized has been shown to improve quality of life and reduce readmission rates. Although scoping reviews have been reported on early mobilization after acute myocardial infarction, no systematic review of early mobilization in patients with heart failure who are older and have a higher rate of multiple disabilities and physical deterioration than those with myocardial infarction has been reported, and its definition, efficacy, and safety have not been fully clarified. In heart failure, physical functions such as grip strength and activity of daily living (ADL) have been found to be associated with distant outcomes such as readmission rates and mortality, and early mobilization for acute heart failure, initiated to prevent physical conditioning and decline in ADLs, can contribute to these outcomes.</div><br/><div class = "text-block"><span style = "font-weight:bold;">Purpose</span></div><div class = "text-block">    The purpose of this study is to conduct a scoping review and systematic review of early mobilization for hospitalized heart failure to clarify its current definition and to evaluate its effectiveness and safety.</div><br/><div class = "text-block"><span style = "font-weight:bold;">Method and analysis</span></div><div class = "text-block">[Part 1]</div><div class = "text-block">Scoping review of early mobilization for heart failure (clinical definition)</div><div class = "text-block">The purpose of our scoping review is to clarify current clinical definition of early mobilization for acute heart failure.</div><div class = "text-block">We describe this protocol that follows the PRISMA extension for scoping reviews (PRISMA-ScR) statement. We also use the scoping review framework by The Joanna Briggs Institute (JBI) following five stages approach: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; and (5) collating, summarizing, and reporting the results.</div><br/><div class = "text-block">[Part 2]</div><div class = "text-block">Systematic review and meta-analysis of early mobilization for acute heart failure</div><div class = "text-block">Based on the scoping review above, we will design PICO and conduct a systematic review and meta-analysis to examine the efficacy and safety of early mobilization for acute heart failure.</div><div class = "text-block"><span>We used a systematic review protocol template (</span><a href="https://dx.doi.org/10.17504/protocols.io.biqrkdv6" style = "text-decoration:underline;color:blue;cursor:pointer;"><span style = ":;">dx.doi.org/10.17504/protocols.io.biqrkdv6</span></a><span>). We followed the Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 for preparing this protocol.</span></div><br/><div class = "text-block"><span style = "font-weight:bold;">Ethics and dissemination</span></div><div class = "text-block">    In this systematic review, only data from previously conducted studies will be analyzed. We will publish this systematic review in peer-reviewed journals.</div></div>

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