• Li Khim Kwah, Jordan Green, Jane Butler, and Lawrence Lam.
• Health and Social Sciences Cluster, Singapore Institute of Technology, 10 Dover Dr, Singapore 138682, Singapore; and Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
• Phys Ther. 2019 May 1; 99 (5): 577-590.

BackgroundThe quality of clinical practice guidelines (CPGs) is important to ensure guideline adoption by clinicians.PurposeThe aim of this review was to identify CPGs for the management of limb amputations, appraise the quality of CPGs, and synthesize recommendations from comprehensive CPGs of high quality.Data SourcesMEDLINE, EMBASE, CINAHL, PEDro, guideline-specific websites, websites for associations or networks for people with amputations, and Google Scholar were searched from April 2007 to April 2017.Study SelectionPublications were included if they were CPGs or consensus statements/standards endorsed by a certified organization, covered the management of limb amputations, were freely accessible, and were written in English.Data ExtractionTwo reviewers independently screened titles and abstracts for eligible CPGs and rated the quality of CPGs using the Appraisal of Guidelines Research and Evaluation (AGREE-II) instrument.Data SynthesisOf the 15 included CPGs, 11 were of low to moderate quality and 4 were of high quality. Mean (or median) domain scores on AGREE-II were as follows: 83% for domain 1 (scope and purpose), 61% for domain 2 (stakeholder involvement), 7% for domain 3 (rigor of development), 65% for domain 4 (clarity and presentation), 24% for domain 5 (applicability), and 21% for domain 6 (editorial independence). Strong recommendations from comprehensive and high-quality CPGs were few and focused on the development of individualized treatment plans, exercises for improving physical function and the ability to perform activities of daily living, and the assessment of physical function and prognostic factors.LimitationsCPGs that were not written in English were excluded. Final recommendations from CPGs might differ if different criteria were used. Low domain scores on the AGREE-II might be due to poor reporting rather than poor methodology in the CPG development process.ConclusionsFew CPGs for the management of limb amputations were of high quality, and few recommendations were strong. To improve the quality of future CPGs, guideline developers should report funding and competing interests of members, provide information to aid in the practical application of CPGs, and use a systematic approach to search for evidence and derive strength of recommendations.© 2019 American Physical Therapy Association.

7 keywords...

hide…