Factors Influencing Functional Outcomes and Return-to-Work After Amputation: A Review of the Literature.
Benjamin J Darter, Carolyn E Hawley, Amy J Armstrong and 2 others
PMID 29397480WHAT IT FOUND
Amputation recovery varies widely in walking, pain, prosthetic use, and work.
Younger age, education, adjustment, prosthetic use, and job modifications were linked to return to work, not tested as causes.
Key findings
01In the reviewed studies, only 20 to 65% of participants could walk 500 m, and about half used an assistive device.
02Civilian employment after amputation ranged from 48 to 89% across studies, while 11 to 13% of service members continued on duty.
03Greater prosthetic use was correlated with employment, and most who returned moved to less physically demanding work or needed job modifications.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Most included studies were cross-sectional or retrospective, and they used different ages, causes of amputation, and outcome measures, so the review could not compare findings consistently. The samples were almost exclusively male and under 40 years, so it says little about women or older adults. The studies came from several countries with different benefit and policy structures, so work outcomes may not transfer to another local system. The review cannot separate system-level influences from individual-level influences, and prosthetic technology changed over the review period. It excluded qualitative studies, case reports, editorials, book chapters, and conference abstracts, so it does not capture lived experience or single-case detail.
Declared interests
The authors declare no financial involvement with any commercial organization. The article is marked as supported by NIH and non-PHS U.S. government research.
The easy way to misread this
Do not use these percentages to predict one patient's outcome. The review combined studies with different amputation causes, ages, countries, and measures, and most samples were male and under 40 years.