Overview of Cochrane Systematic Reviews for rehabilitation interventions in persons with amputation: a mapping synthesis.

INTRODUCTION

This review aimed to collect the current evidence from the Cochrane systematic reviews (CSRs) concerning interventions for rehabilitation of people with amputation, in the context of the World Health Organization - Package of Interventions for Rehabilitation.

EVIDENCE ACQUISITION

The Cochrane Rehabilitation team led the CSRs' search. Search strings were composed of "amputation" and "rehabilitation" and run in the Cochrane Library. We used the AMSTAR 2 to assess the methodological quality of the included CSRs. All rehabilitation-relevant data were summarized in an evidence map.

EVIDENCE SYNTHESIS

Out of the 95 CSRs found, eight related to people with amputation and rehabilitation. We found very low-certainty evidence to support the use of gabapentin in treating phantom limb pain. There was very low-certainty evidence against the use of memantine. Very low-certainty evidence showed faster wound healing, shorter time gaps from amputation to first prosthetic fit, shorter hospital stays and short-term changes in swelling after rigid dressing for people with transtibial amputations. Very low-certainty evidence revealed no difference for mobility assessment or adverse events after different forms of motor rehabilitation after transtibial amputation.

CONCLUSIONS

Evidence for interventions for rehabilitation after amputation is scarce and the available evidence is of very low certainty. More studies of higher quality are needed to provide evidence to ensure that people with an amputation receive the best rehabilitation possible.