The Management of Upper Limb Amputation Rehabilitation: Synopsis of the 2022 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline for Acquired Amputation

Abstract

Upper limb amputation can result in significant functional impairment necessitating a comprehensive rehabilitation approach throughout the continuum of care. In 2022, the Departments of Veteran Affairs and Defense completed an updated clinical practice guideline for the management of upper limb amputation rehabilitation. This practice guideline was developed by a workgroup of subject-matter experts from a variety of disciplines. Twelve key questions were developed by the workgroup using the PICOTS (population, intervention, comparator, outcomes, timing of outcomes measurement, and setting) format to establish the scope of the literature review. Eighteen recommendations were developed through extensive review of the available literature and use of the Grading of Recommendations, Assessment, Development and Evaluation criteria. The strength of each recommendation was determined based on the quality of the research evidence and the additional domains of the Grading of Recommendations, Assessment, Development and Evaluation criteria. Of the 18 recommendations, 4 were found to have sufficient evidence to suggest for use of a particular rehabilitation management strategy. Thus, the 2022 Department of Veteran Affairs and Department of Defense clinical practice guideline provides updated, evidence-based information on the care and rehabilitation of persons with upper limb amputation. However, a significant lack of high-quality evidence in upper limb amputation rehabilitation limited evidence-based clinical guidance to assist healthcare providers in managing this population.

Innovative Robotic Technologies and Artificial Intelligence in Pharmacy and Medicine: Paving the Way for the Future of Health Care—A Review

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Measurement of Functional Use in Upper Extremity Prosthetic Devices Using Wearable Sensors and Machine Learning

“…A major goal of upper extremity (UE) post-amputation rehabilitation is to increase the use of the prosthetic limb both in and outside the patient’s home [ 1 , 2 , 3 ]. Currently, clinicians and researchers have no objective, quantitative, low-cost, and practical method to measure real-world functional use (FU) of that limb sensitively and specifically outside a laboratory setting [ 4 , 5 , 6 , 7 ]. We define functional use as movements that contribute to the performance of activities of daily living (i.e., reaching to grasp, gesturing, balancing functions), and nonfunctional movements are associated with gait and whole-body movements.…”

Prevalence and Predictors of Unmet Need for Upper-Limb Prostheses: An Observational Cohort Study

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