Abstract
OBJECTIVE: Although growing evidence supports the benefits of physical exercise for amputees, existing studies present inconsistent findings. This systematic review and meta-analysis aimed to evaluate whether exercise interventions can effectively enhance physical performance and quality of life in individuals with lower-limb amputation. METHODS: Seven databases (PubMed, Cochrane Library, OVID, Scopus, PsycINFO, CINAHL, and Web of Science) were systematically searched up to April 21, 2025. Study quality was assessed using the RoB 2 tool, and meta-analyses were performed using R software (version 4.1.3). RESULTS: A total of 18 randomized controlled trials were included, with 7 studies incorporated into the meta-analysis. Evidence ranging from low to moderate quality suggests that exercise interventions yield significant benefits for individuals with limb amputation. Compared to usual care, exercise significantly improved gait speed [WMD = 0.009, 95% CI (0.03, 0.16), P = 0.004], 2-min walk test performance [WMD = 8.81, 95% CI (1.92, 15.7), P = 0.012], and Timed Up and Go test scores [WMD = -2.01, 95% CI (-3.90, -0.13), P = 0.037]. No significant difference was observed in the Life-Space Community Index [WMD = -0.44, 95% CI (-2.48, 1.61), P = 0.676]. Qualitative findings further supported the beneficial effects of exercise, although outcomes varied depending on exercise modality and assessment tools. In addition, heterogeneity in intervention protocols and participant characteristics limited the ability to conduct formal subgroup analyses or draw definitive conclusions. CONCLUSION: Targeted exercise prescriptions can improve physical performance and quality of life in individuals with limb amputation. These findings support the integration of individualized exercise strategies into rehabilitation programs. However, heterogeneity in participant characteristics (e.g., age, gender, etiology, and amputation level) remains underexplored. Future research should address this diversity to optimize rehabilitation strategies for different subpopulations.