Prosthetic rehabilitation and walking after arterial or dysvascular lower limb amputation: A narrative review
DOI:
https://doi.org/10.62827/fb.v27i8.1298Keywords:
Artificial Limbs; Exercise Therapy; Postural Balance.Abstract
Introduction: After amputation for arterial disease, receiving a prosthesis does not ensure useful everyday walking. Objective: To analyze evidence on prosthetic rehabilitation and walking recovery in adults with major amputation due to arterial disease and, as complementary evidence, dysvascular or mixed-etiology studies relevant to rehabilitation. Methods: Narrative review with PubMed searches conducted in August and September 2026, supplemented by reference tracking and official guidelines. Publications from 2021 to 2026 were prioritized, while relevant earlier studies were retained. The synthesis distinguished prosthetic access, walking capacity, habitual activity, and safety and classified applicability according to etiological composition. Results: Previous mobility, comorbidities, amputation level, and rehabilitation access were associated with prosthetic outcomes. Benefits of exercise and gait training programs were derived predominantly from heterogeneous populations and do not demonstrate efficacy specific to exclusively arterial amputation. Trials restricted to dysvascular amputation were scarce. Microprocessor-controlled knees reduced falls in older limited community ambulators who already used a prosthesis; evidence for initial prosthetic fitting remained preliminary. Behavioral interventions produced conflicting results, and everyday activity remained low after surgery. Conclusion: Rehabilitation should integrate clinical assessment, residual limb preparation, prosthetic fitting, and supervised progressive training. Benefit magnitude and maintenance depend on functional characteristics, etiology, and care context, with no universally established protocol for arterial amputations.
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Copyright (c) 2026 Rafael Viana dos Santos Coutinho, Igor Parada Marangoni, Matheus Moreira Silva, Maria Fernanda Valadares Silva, Felipe Gomes Paranhos (Autor)
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