Predictive factors of functional mobility in adults with lower-limb amputation: A prognostic systematic review
Bibliographic record
Abstract
Lower-limb amputation (LLA) has a profound impact on functional mobility, which is essential for maintaining independence and quality of life. With a rising number of LLAs performed annually, particularly due to diabetes-related complications, understanding the factors that influence mobility outcomes is critical for optimizing rehabilitation strategies. This systematic review aimed to identify and evaluate prognostic factors associated with functional mobility in adults with LLA. A comprehensive literature search was conducted in PubMed, EMBASE, CINAHL, and Cochrane databases, supplemented by gray literature sources, following PRISMA-P guidelines. Eligible studies examined various prognostic factors affecting mobility outcomes, which were assessed for quality using the Quality In Prognosis Studies tool. Fourteen studies were included, encompassing prospective, retrospective, and cross-sectional designs. Identified prognostic factors were categorized into 4 key domains: sociodemographic, medical, physical function, and psychological. Age, sex, comorbidities, and level of amputation emerged as primary determinants of mobility, with psychological factors such as cognitive function and mental health also playing a significant role. Although higher amputation levels, older age, and multiple comorbidities were associated with reduced mobility, mental well-being and male sex were linked to better outcomes. Limited evidence was found regarding other potential predictors, including race/ethnicity, prosthetic use, balance, employment status, and activity level, highlighting the need for further high-quality research. These findings emphasize the importance of a multidimensional rehabilitation approach that considers both physical and psychological factors to enhance mobility and overall well-being in individuals with LLA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.035 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.008 |
| Bibliometrics | 0.010 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".