Journal of Occupational Rehabilitation

, Volume 28, Issue 4, pp 656–665 | Cite as

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

  • Benjamin J. Darter
  • Carolyn E. Hawley
  • Amy J. Armstrong
  • Lauren Avellone
  • Paul Wehman


Purpose 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 identified 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 identified as contributing to physical functioning and employment after amputation. Conclusions Outcomes after amputation can vary widely with many potentially inter-related factors contributing. The factors identified 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.


Amputee Rehabilitation Disability Return-to-work 



The authors wish to thank Michael West for his contributions with completing the database searches.


The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of Veterans Affairs or the United States government.


Support for this project was provided through Clinical and Translational Science Awards (CTSA) No. KL2TR000057 from the National Center for Advancing Translational Sciences, and Rehabilitation Research and Training Center Grant No. CDF 84.133b-4 from the US Department of Health and Human Services. The work was also supported with resources at the Hunter Holmes McGuire VA medical center.

Compliance with Ethical Standards

Conflict of interest

We, the authors, affirm that we have no financial affiliation (including research funding) or involvement with any commercial organization that has a direct financial interest in any matter included in this manuscript.


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Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2018

Authors and Affiliations

  1. 1.Department of Physical TherapyVirginia Commonwealth UniversityRichmondUSA
  2. 2.Department of ResearchHunter Holmes McGuire Veteran Affairs Medical CenterRichmondUSA
  3. 3.Department of Rehabilitation CounselingVirginia Commonwealth UniversityRichmondUSA
  4. 4.Rehabilitation Research and Training CenterVirginia Commonwealth UniversityRichmondUSA
  5. 5.Department of Physical Medicine and RehabilitationVirginia Commonwealth UniversityRichmondUSA

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