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

The authors did not critically appraise study quality because the designs were too heterogeneous. Results could not be combined into a single estimate because study designs, populations, and outcome measures varied widely. Only 8.2% of studies followed participants beyond 2 years, so long-term recovery is not well described. No study started data collection during the preprosthetic phase, and only 7 covered the prosthetic phase. Most studies came from Europe (42.4%) and North America (40%), with few from Asia (5.9%), Africa (3.5%), and Oceania (4.7%). Race or ethnicity was reported in only 25 studies (29.41%), and socioeconomic characteristics were reported in fewer than 40% of studies. Studies often excluded people with cognitive or communication impairments (41.2%), so patients who need communication support may be underrepresented. Although the search allowed several languages, all included studies were published in English. The review used fixed time windows of 3-6 months for mid-term and beyond 6 months for long-term, which may not fit every patient. Some included studies may have mixed traumatic and nontraumatic amputations because inclusion required only that at least 50% of participants had nontraumatic causes.

The authors declared no conflicts of interest related to this study. The work was supported by the Student Opportunity Research Grant from the Department of Physical Therapy, University of Nevada, Las Vegas. The authors state that the research was conducted independently and that no external funding or commercial relationships influenced the design, data collection, analysis, or interpretation. Several authors disclosed unrelated financial relationships: Encompass Health, a patent (US patent no. 10335058), National Network of Libraries of Medicine, Medical Library Association, Department of Defense, Nevada IDeA Network of Biomedical Research Excellence, Department of Veterans Affairs, Bandagist Jan Nielsen in Denmark, University of Kentucky travel support, and an unpaid position in the Academy of Federal Physical Therapy.

Do not read this review as showing that any amputation rehabilitation treatment works. It maps what has been studied and where evidence is missing. The authors did not critically appraise study quality or combine results into a single answer.