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Factors Influencing Functional Outcomes and Return-to-Work After Amputation: A Review of the Literature

by Benjamin Darter, Carolyn Hawley, Amy Armstrong, Lauren Avellone, & Paul Wehman

Darter, B., Hawley, C., Armstrong, A., Avellone, L. & Wehman, P. (2018). Factors Influencing Functional Outcomes and Return-to-Work After Amputation: A Review of the Literature. Journal of Occupational Rehabilitation, 0, 1-10.

Amputation is a life changing event that can significantly impact an individual’s physical and mental well-being. Our objective was to review literature exploring the impact of amputation upon a person’s functioning and inclusion in the workplace.  Methods Medline, CINAHL, and PsycINFO were searched using keywords related to amputation, employment and  community reintegration. Eligible studies were published since 2000 and one of the following study designs: randomized controlled trial, non-randomized controlled trial, retrospective study, prospective study, concurrent cohort study, or cross sectional study. Studies for civilians with amputation as well as service members and Veterans with amputation were considered for inclusion.

Results The search identifed 995 articles, 25 of which met inclusion/exclusion criteria and were included in the review. While strong evidence for correlations and predictors of outcomes after amputation were limited, multiple factors were identifed as contributing to physical functioning and employment after amputation.

Conclusions Outcomes after amputation can vary widely with many potentially interrelated factors contributing. The factors identifed may also serve to inform the development of interventions aiming to improve functional performance and reintegration after amputation. Furthermore, the review highlights the need for more high quality prospective studies.

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