Effectiveness of telerehabilitation to improve motor capacity in patients with lower limb amputation: A systematic review.

Abstract

Lower limb amputation affects mobility, balance, and independence, limiting quality of life. Although effective, traditional rehabilitation is often inaccessible because of geographic and financial barriers. Telerehabilitation offers a promising alternative by improving gait, strength, and patient engagement. However, variability in protocols and outcome measures hinders standardization, requiring further research to establish best practices and long-term efficacy. This systematic review followed PRISMA 2020 guidelines and was registered on PROSPERO (CRD42024593498). Studies were identified through PubMed, Scopus, Cochrane Library, and Google Scholar using a predefined Boolean search. Filters included full-text availability, human subjects, English language, and clinical trials published between 2014 and 2024. Eligible studies focused on exercise-based telerehabilitation for people with lower limb amputation (≥18 years). Four randomized controlled trials, including a total of 215 participants with lower limb amputation, were included. The primary outcome was walking capacity (2- or 6-minute walk test). Motor capacity was mainly assessed through walking-based outcomes, including walking distance and functional endurance, with some studies also assessing balance-related performance. Telerehabilitation shows comparable functional outcomes to conventional physiotherapy and consistent benefits in engagement and confidence in people with lower limb amputations, whereas uncertainty remains regarding superiority and long-term functional effectiveness.