Recovery After Nontraumatic Lower Limb Amputation: A Scoping Review of Longitudinal Research Studies.

OBJECTIVE

Longitudinal research studies are essential for understanding the time course of functional recovery after lower limb amputation (LLA). The purpose of this scoping review was to evaluate the existing evidence base regarding midterm to long-term outcomes following nontraumatic LLA.

DATA SOURCES: A scoping review was conducted per the Joanna Briggs Institute and Open Science Framework guidelines. Based on purpose, 7 databases (PubMed, CINAHL, Embase, Scopus, Web of Science, SportDiscus, and Google Scholar) were searched for studies published between 2000 and 2024, in English, Mandarin Chinese, Tagalog, Persian, or Spanish.

STUDY SELECTION: Eligible studies must include ≥50% of participants with nontraumatic major LLA within 3 years after their amputation and report outcomes at ≥2 time points spanning ≥3 months.

DATA EXTRACTION: We extracted data including study design, phase of rehabilitation, duration of follow-up, participant characteristics, outcome measures used, and intervention purpose and types.

DATA SYNTHESIS: Of 5936 records screened, 85 were included in this review. Most studies were conducted in Europe (42.4%), with much less representation from Asia, Oceania/Australia/New Zealand, Africa, and Latin America. The studies encompass data from a total of 424,422 participants (mean age: 58.3y; 55% men). Specific to time since amputation, 57 studies (67%) started immediately after amputation, and only 21% of studies followed patients beyond 1 year postamputation. The most commonly reported outcome domains are performance-based (19.5%), psychological (18.3%), and other medical outcomes (17.2%). Of the 174 unique outcome measures identified, 55.7% are patient-reported, and 44.2% are performance-based measures.

CONCLUSIONS

This review highlights a growing body of evidence regarding longitudinal recovery after nontraumatic LLA. The current evidence base focuses primarily on the perioperative phase. Identified gaps in research include disparity in geographical and population representation, lack of long-term follow-up, and lack of participation outcomes such as social reintegration and returning to work.