Psychological needs in individuals with lower limb amputation: a narrative review of evidence for clinical practice across the rehabilitation continuum.

Abstract

Purpose: To synthesize the psychological needs of individuals undergoing lower-limb amputation (LLA) and their association with overall adjustment across the rehabilitation continuum, in order to propose clinical recommendations spanning the entire continuum of care.

Materials and methods: A narrative review was conducted in accordance with the SANRA criteria, using MEDLINE, ScienceDirect, and PsycArticles. We identified peer-reviewed studies published between 2000 and July 2025 that met the following criteria: original research; focused on individuals with LLA; examined psychological, emotional, or psychosocial dimensions throughout the rehabilitation continuum care journey; studies that explored how psychological factors influence overall adjustment; written in English.

Results: A total of 28 quantitative and 12 qualitative studies were included. Individuals undergoing LLA report significant psychological distress from limb threat to long-term rehabilitation care, including anxiety, depression, body image disturbance, impairment in social life and sexuality, low balance confidence, and cognitive impairment.

Conclusions: Psychological distress is associated with poorer overall adjustment, confirming that mental health plays a key role in adaptation. The integration of structured psychological screening and personalized interventions targeting psychological and psychosocial needs may be beneficial throughout the rehabilitation continuum. Further studies are needed to assess the applicability for healthcare providers, and patient benefits of these recommendations.