Clinician's Guide to the 2024 VA/DoD Clinical Practice Guideline for the Rehabilitation of Individuals with Lower Limb Amputation.

Abstract

In December 2024, the U.S. Department of Veterans Affairs (VA) and the U.S. Department of Defense (DoD) released a joint update of their 2017 clinical practice guideline (CPG) for the rehabilitation of individuals with lower limb amputation (LLA). This synopsis highlights the key aspects of the guideline development process and describes the CPG recommendations. The VA/DoD Evidence-Based Practice Work Group convened a joint VA/DoD guideline development work group (WG) that included clinical stakeholders and conformed to the Institute of Medicine's tenets for trustworthy clinical practice guidelines. The guideline WG conducted a patient focus group, developed key questions, and systematically searched and evaluated the literature from a eight year time frame (English-language publications from 6 July 2016 to 15 March 2024). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was utilized to evaluate the evidence and formulate recommendations. The WG developed 26 recommendations along with algorithms and supplemental materials to guide providers in providing evidence-based, interdisciplinary, patient-centered care through all phases of LLA rehabilitation. The CPG was reviewed by stakeholders outside the WG prior to approval by the VA/DoD Evidence Based Practice WG. This article summarizes key features of the guideline to help clinicians utilize the CPG to support patient-centered care.