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This is a systematic review of previously published studies and does not involve new human or animal participants; no institutional review board approval was required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"An internal written protocol specifying the PICOS question, two-tier eligibility framework, search strategy, risk-of-bias tools, and synthesis plan was finalised by the authors before database searches commenced (April 2025). The review was not prospectively registered in PROSPERO or any other public registry. We acknowledge this as a limitation of methodological transparency; to mitigate it, the protocol-defined elements (eligibility, outcomes, analysis plan) are described in full in this Methods section and in the PRISMA 2020 checklist (Online Resource 1: Supplementary Table\n                      \n                      ), and the unmodified internal protocol is available from the corresponding author on reasonable request.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Protocol and registration"}},{"value":"The originally planned quantitative meta-analysis was not conducted due to substantial heterogeneity across study designs, interventions, and outcome measures; this contingency (qualitative synthesis if heterogeneity precluded pooling) was pre-specified in the internal protocol. During revision, two studies (PARK-PICU Canada and PARK-PICU Brazil) were added following their identification by reviewers, and the search was re-run with expanded free-text terms (home exercise programme, home programmes, family education, progressive mobility, discharge planning).","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Protocol deviations"}},{"value":"The authors used generative AI tools solely for AI-assisted copy-editing (grammar, style, readability) as permitted under Springer Nature policy. No AI tool was used to draft scientific content, to generate citations or data, or to create figures. All intellectual content, analyses, judgements, and conclusions are those of the human authors, who accept full accountability for the final manuscript.","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Use of AI"}}],"article-number":"456"}}