Overview of Cochrane Systematic Reviews for rehabilitation interventions in persons with amputation: a mapping synthesis.
Arne Heyns, Frank-Robbrecht Dusar, Chiara Arienti and 1 others
PMID 40202277WHAT IT FOUND
Cochrane reviews found too little reliable evidence on rehabilitation after amputation to guide practice.
Some interventions remain uncertain, and three reviews found no randomized trials for TENS, vocational rehabilitation, or amputation level.
Key findings
01The search found 95 Cochrane systematic reviews, and eight were relevant to rehabilitation after amputation.
02The certainty of evidence was very low for all included reviews.
03Three reviews found no randomized controlled trials for TENS for phantom and stump pain, vocational rehabilitation for return to work, or through-knee versus above-knee amputation.
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
The overview only included Cochrane systematic reviews, so other systematic reviews and primary studies were not mapped. Most included reviews did not report funding sources, so financial influence in those reviews is not visible. Some included reviews did not report certainty ratings, and the overview authors assigned them. Three reviews found no randomized controlled trials for their questions, so they could not provide direct evidence. The included reviews themselves provided only very low-certainty evidence.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Italian Ministry of Health Ricerca Corrente, and the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
The easy way to misread this
Do not treat the few very low-certainty signals, such as rigid dressings or gabapentin, as proven benefits. The reviews were too limited and uncertain to guide practice.