Lower Limb Amputation

The included studies covered amputation levels ranging from toe or foot amputation to below-knee and above-knee amputation. Lower limb amputation was defined as surgical removal of part or all of the lower extremity. The review focused on quantitative studies of adults with lower limb amputation that measured both pain and functional or mobility outcomes. Existing prosthetic outcome frameworks, including the ICF core set and ECLIPSE model, were built predominantly from high-income country data, limiting their relevance to LMIC settings. Key rehabilitation variables such as time since amputation and duration of prosthesis use were inconsistently reported across LMIC studies and could not be synthesised. An estimated 30–40 million people live with limb loss in LMICs, yet the evidence base for prosthetic rehabilitation outcomes in these settings is almost entirely absent. Trauma — including accidents, war, land mines, burns, and snake bites — was the most common cause of amputation among included participants. Bilateral lower limb amputations were included, though they often involve greater mobility limitations and rehabilitation needs.