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VOLUME 6, ISSUE 1 

 2023 

 

LITERATURE REVIEW 

 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & 

Orthotics Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

 

https://jps.library.utoronto.ca/index.php/cpoj/index
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https://publicationethics.org/members/canadian-prosthetics-orthotics-journal
https://doi.org/10.33137/cpoj.v6i1.42170


 

1 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

 

 

LITERATURE REVIEW 

 

PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS: A SCOPING REVIEW 

Costa-Parke A1, Di Lella A.M1, Walker A2, Verweel L2*, MacKay C2, 3 

1 Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada. 
2 West Park Healthcare Centre, Toronto, Canada. 
3 Department of Physical Therapy, University of Toronto, Toronto, Canada. 

  
 

 

 

 

  

 

 

 

 

 

 

 

 

 

 

INTRODUCTION   

Major limb loss is the partial or total amputation of an 

extremity that occurs at and/or above the ankle or wrist.1 

This type of amputation may result from diabetes or other 

vascular conditions, a traumatic event, cancer, or a 

congenital condition.2 Living with major limb loss can have 

profound physical implications for the individual.3 Evidence 

has shown that people with major limb loss experience 

reduced physical function, mobility, and pain.3 While the 

consequences of amputation can lead to physical and 

mobility limitations, research has suggested that 

psychosocial    and   mental   health   outcomes   are   also  

 

 

significant barriers to effective recovery post-amputation. 

People with limb loss can experience grief, social isolation, 

loss of self-esteem,3-6 and higher rates of depression, 

anxiety, and body image disorders.7 Limb loss is also known 

to impact social interactions, community participation, and 

engagement in daily activities.3,6 These challenges can 

negatively impact an individual's quality of life and 

psychosocial well-being.6 Despite substantial evidence of 

the psychosocial impacts of amputation8,9 rehabilitation 

programs often focus on physical recovery with limited 

resources targeting psychosocial support. 

Peer support is a non-medical intervention that offers a 

supportive relationship between individuals who have 

shared experiences with a condition.10,11 Peer support has 

been shown to be an important component in the care of 

individuals dealing with various health conditions, such as 

substance abuse12 and mental health illnesses.12,13  Fortuna 

 
OPEN  ACCESS 

ABSTRACT 

BACKGROUND: Major limb loss can have profound physical and psychosocial implications for individuals, 

impacting their quality of life and well-being. Despite the effectiveness of peer support in improving outcomes 

for various chronic conditions, its impact on individuals with major limb loss remains understudied. 

OBJECTIVE(S): This review aims to explore the existing literature on peer support for individuals with major 

limb loss. Specifically, exploring how the literature defines peer support; examining its implementation, 

identifying outcomes measured in peer support interventions, assessing the benefits for individuals with major 

limb loss, and identifying barriers associated with peer support provision. 

STUDY DESIGN: This review followed Arksey and O’Malley’s methodological framework, analysing relevant 

literature to identify evidence, definitions, and key factors related to peer support for individuals with major 

limb loss. 

METHODOLOGY: A comprehensive search in January 2023 utilized databases: MEDLINE, PsychInfo, 

Embase, and CINAHL. After a two-phase screening process, articles meeting specific criteria were included. 

Thematic and descriptive numerical analyses were applied to the extracted data. 

FINDINGS: Twenty-two articles were reviewed. Peer support was described as an opportunity to provide 

education, advice, and encouragement between individuals with lived experiences. Across the two 

intervention-based studies investigating peer support programs, outcome measures included physical, 

psychological, social, and quality of life. Qualitative studies described perceived benefits as improved 

psychosocial well-being and the opportunity to exchange knowledge. Perceived barriers included a lack of 

formal training and male-dominated groups, which deterred individuals with amputation from participating. 

CONCLUSION: The evidence from the findings of the review sheds light on the current understanding of peer 

support for individuals with amputation. Due to the limited number of studies available, future research is 

necessary to develop and evaluate the effectiveness of peer support interventions tailored to this population. 

 

ARTICLE INFO 

Received: December 7, 2023 

Accepted: December 24, 2023     

Published: December 28, 2023 

CITATION 

Costa-Parke A, Di Lella A.M, 

Walker A, Verweel L, MacKay 

C. Peer support for individuals 

with major limb loss: A scoping 

review. Canadian Prosthetics & 

Orthotics Journal. 2023; 

Volume 6, Issue 1, No.6. 

https://doi.org/10.33137/cpoj.v6i

1.42170 

KEYWORDS 

Amputation, Peer Support, Limb 

Loss, Scoping Review, Social 

Support, Prosthesis, 

Rehabilitation 

* CORRESPONDING AUTHOR: 

Lee Verweel, BSc, Msc  
West Park Healthcare Centre, Toronto, Canada. 

E-Mail: Lee.verweel@westpark.org  

ORCID ID: https://orcid.org/0000-0002-3363-8161 

Journal Homepage: https://jps.library.utoronto.ca/index.php/cpoj/index 

Volume 6, Issue 1, Article No.6. 2023 

 

 

https://doi.org/10.33137/cpoj.v6i1.42170
https://doi.org/10.33137/cpoj.v6i1.42170
https://doi.org/10.33137/cpoj.v6i1.42170
mailto:Lee.verweel@westpark.org
https://orcid.org/0000-0002-3363-8161
https://jps.library.utoronto.ca/index.php/cpoj/index


 

2 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

et al.13 used PeerTECH, a peer support program 

supplemented by technological use, and found 

improvements in quality of life, self-management, and self-

efficacy for managing health conditions, including mental 

illnesses such as schizophrenia and bipolar disorders, and 

comorbidities like diabetes and cardiovascular disease. 

Proudfoot et al.14 examined the inclusion of peer support in 

a psychoeducational program and found that the peer 

support programs led to greater adherence to treatment 

compared to the unsupported program. In addition, the peer 

support group led to decreases in stigmatization, a 

reduction in anxiety and depression.14 Similarly, individuals 

with diabetes reported that community-based peer support 

programs led by trained peers showed improvements in 

symptoms of depression, communication with healthcare 

practitioners, healthier lifestyle behaviours and increased 

self-efficacy.15 

Although there is a breadth of evidence available about peer 

support among other populations with chronic conditions 

(e.g., diabetes, mental illnesses), less is known about the 

nature and scope of research on peer support for individuals 

living with major limb amputation. A scoping review on peer 

support for trauma survivors, which included individuals with 

traumatic amputations, found that peer support provided 

trauma survivors with socioemotional support as well as 

assistance in daily management and life navigation post-

injury.16 However, studies of peer support following trauma 

may not be transferable to all individuals with limb loss, most 

of whom have amputations due to diabetes.17 To address 

this gap, the purpose of this scoping review was to examine 

the extent, nature, and scope of existing literature on peer 

support for people living with major limb loss to inform future 

research and practice. 

METHODOLOGY 

A scoping review was performed to identify existing 

literature and clarify the definitions and key factors 

associated with this topic.18 The review followed Arksey and 

O’Malley’s five-stage methodological framework, which 

outlines: (i) identifying the research questions; (ii) identifying 

relevant studies; (iii) study selection; (iv) charting the data; 

and (v) collating, summarizing, and reporting the results.19 

Identifying Research Question (Stage 1) 

The research questions used to guide the review were: (1) 

how does the current literature define peer support? (2) how 

has peer support been implemented (e.g., programs, 

interventions, informal supports) and at what stage (e.g., 

acute care, rehab, community)? (3) what are the outcomes 

measured in peer support interventions? (4) what are the 

benefits of peer support for the quality of life of individuals 

with major amputations, and (5) what are the risks or 

barriers to the provision of peer support? 

 

Identifying Relevant Studies (Stage 2) 

Literature searches were conducted in a period spanning 

January 2023 to April 2023 using the electronic databases 

of MEDLINE, PsychInfo, Embase, and CINAHL. The 

search strategy was customized to each database and used 

key terms that included “peer support”, “amputation”, and 

“major limb loss” (see Appendix A-D for search strategies). 

To supplement these searchers, a hand search of reference 

lists of retrieved articles was also conducted to scan for 

additional relevant studies. The four databases and hand-

searched articles were uploaded to the software Covidence. 

A two-phase screening process was conducted; the first 

involved the elimination of articles based on title and 

abstract, and the second involved a full-text review. To 

establish inter-rater reliability, two authors (Di Lella A.M and 

Costa-Parke A) separately conducted each phase and then 

met to reach a consensus. Disagreements between 

reviewers were resolved by consensus or by the decision of 

a third reviewer (MacKay C).  

Study Selection (Stage 3) 

The following inclusion criteria were used to guide the 

search and retrieve the articles: (1) published in the English 

language; (2) individuals with a major amputation, including 

trauma-related, surgical-related (cancer, infection, vascular, 

etc.), and congenital; (3) age range: 18 years and older; (4) 

studies should include some aspect of peer support, either 

formal or informal; (5) participants have either received peer 

support or provided peer support (with or without training); 

(6) articles should include primary data. Articles were 

excluded if: (a) they focused on minor limb amputations; (b) 

they focused on amputations in youth populations; (c) 

dissertations, study protocols, editorials, and conference 

proceedings.  

Charting the Data (Stage 4) 

The data-charting form was developed using an Excel sheet 

by two authors (Di Lella A.M and Costa-Parke A) to maintain 

the consistency of the variables being extracted. The 

authors independently extracted the data and met to reach 

a consensus on the variables. The data extracted were 

summarized and inputted into tables that included: (i) study 

details (e.g., title, authors, year, country); (ii) population 

characteristics and eligibility (e.g., type of major limb 

amputation); (iii) study design/methodology (e.g., study 

objectives, types of measures used);  (iv) peer support (e.g., 

definition, delivery method, practice setting); and (v) major 

findings (e.g., how studies define peer support, outcome 

measures, risks, and benefits).  

Collecting, Summarizing and Reporting the Results 

(Stage 5) 

After charting information from included studies, we 

produced a narrative account of findings in two ways. First, 

quantitative analysis was conducted including a frequency 

https://doi.org/10.33137/cpoj.v6i1.42170


 

3 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

analysis of the extent, nature and distribution of the studies 

included in the review. Second, the findings were organized 

thematically. We used a descriptive approach which 

involved allocating concepts or characteristics relevant to 

each research objective into overall categories. This 

included comparing information across studies, combining 

similar concepts, and summarizing ideas. Two authors (Di 

Lella A.M and Costa-Parke A) independently categorized 

data extracted from the articles to summarize the key ideas 

identified across articles and later met to reach a consensus 

on the findings. Other members of the research team were 

consulted to enhance validity and reduce biases in the 

results of the study. 

RESULTS 

Overview of study characteristics 

A total of 1103 articles were identified from four databases, 

and after duplicates were removed, 688 articles remained. 

The two authors (Di Lella A.M and Costa-Parke A) 

separately screened the titles and abstracts of the articles 

and a total of 147 were deemed eligible for full text review. 

Two authors (Di Lella A.M and Costa-Parke A) individually 

conducted a full-text review of these 147 and a total 22 

articles met the inclusion criteria (Figure 1).  

Articles reported primary data using qualitative methods 

(n=16), randomized controlled trials (RCT) (n=2), cross-

sectional studies (n=2), cost-analysis (n=1), and non-

controlled retrospective cohort study (n=1). Studies were 

conducted in Canada (n=4), the United States of America 

(n=7), Australia (n=4), the United Kingdom (n=2), the 

Democratic Republic of Congo (n=1), Scotland (n=1), 

Taiwan (n=1), and Iran (n=1). One of the studies by 

Anderson et al.20 was conducted in both the United 

Kingdom and Australia. The types of amputations discussed 

among the articles included participants with major lower 

extremity loss (n=15) or both major lower and upper 

extremity loss (n=7). Two studies reported on the effects of 

a peer support intervention. Seven articles explored the 

impacts of peer support as a primary objective, and 13 

articles explored peer support as a secondary or other 

finding (i.e., the articles did not study peer support but 

generated findings that demonstrated peer support as 

relevant to its participants).  See the full study details in 

Table 1.   

Definition of peer support 

Of the articles included in this study (n=22), there were only 

six that defined peer support, and these definitions varied in 

their explanations. Three studies described peers as a 

group of individuals who have experienced a major limb 

amputation.21-23 Peer support involved individuals with 

amputation sharing their lived experiences, either one-on-

one or between groups of individuals. 21,22,24-26 Observing 

peers further along in their amputation recovery was defined 

as a form of peer support.21 Three articles indicated that 

peer support was an opportunity for amputees to educate 

each other on how to engage in activities of daily 

living.22,24,26 This included guidance on improving mobility 

and functionality, such as walking on uneven surfaces, 

moving through crowds and navigating stairs.25 In addition, 

amputees were able to receive emotional and moral support 

from their peers by providing inspiration and 

encouragement.22,26 

Implementation of Peer Support 

Twelve studies discussed the types of settings in which peer 

support may be implemented. Seven of these studies 

described programs implemented in community settings, 

including charities, organizations, and clinics.21,22,24,27-30 

Four studies described programs facilitated in rehabilitation 

settings.25,31-33 While one study discussed peer support 

being implemented within a hospital and community 

setting.34 

Fifteen studies described the method by which peer support 

programs are delivered, which varied between formal and 

informal delivery formats. Eight studies outlined structured 

delivery methods in which participants engaged in 

organized peer support sessions led by a peer volunteer, 

with or without prior training in delivering peer support. 
21,24,27-30,34,35 Seven studies characterized informal delivery 

approaches, depicting them as a natural and chance 

encounter with another amputee, where the opportunity for 

knowledge and sharing of experiences could be 

exchanged.24,25,31-34,36 

Outcomes in Peer Support Interventions 

The effect of using peer support as a study intervention was 

explored by two RCTs.29,30 Physical health outcomes were 

measured using the Short Musculoskeletal Function 

Assessment, Chronic Pain Grade Questionnaire,29 and 

Brief Pain Inventory,30 which allowed for the assessment of 

musculoskeletal function and pain, respectively. The 

studies also examined psychological well-being outcomes 

such as depression, affect, and self-efficacy, including: the 

Patient Health Questionnaire Depression Module,29 the 

Centre for Epidemiologic Studies Depression,30 Positive 

and Negative Affect Schedule,30 Positive States of Mind,30 

and a Modified Self-Efficacy Scale.30 Social support 

outcomes were assessed using a multidimensional scale of 

perceived social support. Lastly, the studies examined 

quality of life as an outcome, and this was assessed using 

the World Health Organization Quality of Life Scale29 and 

Satisfaction with Life Scale.30 

Benefits of Peer Support  

All 22 articles included in this scoping review discussed the 

physical or psychosocial benefits of the provision of peer 

support.  

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4 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

Improved physical functioning 

Two RCTs29,30 reported on the impact of peer support on 

physical function. Wegener et al.30 reported that participants 

experienced a decrease in functional limitations six months 

following their participation in a peer support intervention. 

However, Turner et al.29 did not report an improvement; 

nevertheless, the authors noted possible explanations to be 

a lower physical baseline prior to study involvement as the 

participants were older adults.29 

Enhanced psychological well-being 

Four studies explored the benefits of psychological well-

being; these included two studies that examined peer 

support as a secondary objective32,37 and two RCTs.29,30 

Three studies reported that peer support involvement led to 

a reduction in symptoms of depression in their 

participants.29,30,36 While Liu et al.31 found that talking to 

peers provided an opportunity to alleviate emotional 

distress. 

Nineteen reported on the perceived benefits of social 

support and connectedness. The majority of these studies 

discussed how peer support provided an opportunity for 

participants to share experiences and give advice to each 

other, which allowed them to build social connections and 

aided in their recovery transition.20,22-28,33-35,37-41  

Studies have also reported that peer support groups 

facilitate the exchange of knowledge and education on how 

to engage in daily life with an amputation, which is perceived 

to be more beneficial than support from a 

clinician.21,24,28,34,35,37,40 

Ten of these articles discussed how engagement in 

amputee peer support groups provided participants with 

feelings of optimism and hope for the future.21-25,31,36,38 

Amorelli et al.21 reported that when participants observed 

other individuals with amputation engage in daily activities, 

they felt hopeful that they could still enjoy life like they once 

had. Likewise, Richardson et al.22 discussed how peer 

Studies from databases/registers (n = 1103) 

References removed (n = 415) 
Duplicates identified manually (n = 23)  
Duplicates identified by Covidence (n = 392) 

Studies screened (n = 688) Studies excluded (n = 541) 

Studies assessed for eligibility (n = 147) 

Reports excluded (n = 125): 
   Ineligible study design (n = 39)    
   Ineligible outcomes (n = 12) 
   Non-peer support intervention (n = 12) 
   Not written in English (n = 2) 
   Ineligible patient population (n = 4) 
   Peer support not included (n = 56) 

Studies included in review (n = 22) 

Id
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ti

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o

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e

n
in

g
 

 
In

c
lu

d
e
d

 
E

li
g

ib
il

it
y

  

 

Figure 1: PRISMA diagram. 

https://doi.org/10.33137/cpoj.v6i1.42170


 

5 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

support helped participants see that meaningful 

engagement in life can continue even after limb loss.  

Seven articles discussed how amputee peer support groups 

facilitated the building of friendships and communities 

beyond those of family and non-amputee friends.22,24,31,36,39-

41  

The relationships built while engaging in peer support 

groups were reported by three studies to have reduced the 

perceived social isolation participants felt after experiencing 

their amputation.24,31,37 Two articles also discussed how the 

relationships built in peer support groups provided 

individuals with amputation with emotional and social 

support.33,39 

Community participation and engagement 

The impact of peer support on re-engaging in daily activities 

post-amputation was discussed in two qualitative 

studies.21,38 Amorelli et al.21 studied peer support as a 

primary objective, and both studies reported that the advice 

and support received from peers inspired participants' 

engagement in the community and daily activities.38 

Impact on self-management, self-efficacy and well-being 

Four of the studies reported on the perceived benefit that 

peer support had an impact on self-management and well-

being.27,30,32,37 Participants reported that this type of social 

support boosted their self-esteem, confidence,27,32,37 and 

self-efficacy.30 In addition, this type of support group led to 

increased autonomy and well-being. One study, by 

Richardson et al.22 examined the impact of peer support 

from the mentors’ perspective and found that it gave them a 

sense of purpose and a feeling of usefulness. Additionally, 

Wegener et al.30 measured the effect of a peer support 

intervention on self-efficacy and found it led to an increase 

in participants.  

The acceptance and adaptation to major limb loss were 

explored in two qualitative studies22,31 and one RCT.29 The 

study by Liu et al.31 reported that observing peers’ success 

with limb loss helped participants put their experiences into 

perspective. Richardson et al.22 examined the impact of 

providing support as a peer mentor and found that this was 

a useful experience, as it not only increased well-being, but 

it aided the peer mentor in adjusting to their limb loss. The 

RCT conducted by Turner et al.29 measured satisfaction 

with life using the World Health Quality of Life Scale. The 

study found greater improvements in participants led by a 

licensed health professional paired with a peer support 

compared to the control participants that were provided with 

educational materials and no support from a professional or 

peer.29 

Barriers and Risks in the Provision of Peer Support 

Six studies discussed the perceived barriers and risks to the 

provision of peer support. 

Physical and Organizational-Level Barriers 

One cross-sectional study exploring peer support as a 

primary objective discussed a physical barrier to peer 

support.26 Participants in this study reported that the 

geographical distance of peer support meetings was 

inaccessible and inconvenient to them.  

Perceived organizational barriers were discussed in two 

qualitative studies.22,26 Nathan et al. 26 reported that the 

short duration and frequency of peer support meetings 

deterred participants from joining groups. While Richardson 

et al.22 reported that participants felt there was a lack of 

formal training for peer mentors facilitating peer support 

programs, which resulted in uncertainty about the role of 

peers and their reputability. 

Individual Level Barriers 

Three qualitative studies discussed barriers specific to the 

individual.22,24,26 Participant reluctance to join support 

groups stemmed from various factors, encompassing 

feelings of self-consciousness regarding involvement,24 

apprehension about opening up to peers and displaying 

vulnerability,26 or a perception that the discussed topics did 

not directly address their individual needs.26 The peer 

mentors facilitating peer support groups also expressed 

feelings of doubt and uncertainty about whether their 

delivery of peer support was beneficial to their 

participants.22 

Two qualitative studies reported on the perceived risks of 

the provision of peer support.22,28 Richardson et al.22 

reported that peer support was physically and emotionally 

burdensome for peer mentors and that there was a lack of 

support for their well-being. Mortimer et al.28 reported that 

the information discussed between peer mentors and 

mentees during informal peer support interventions can be 

misleading and cause distress to participants.  

Barriers to group dynamics 

Barriers to peer support group dynamics were discussed in 

four qualitative studies.24,26,35,37  Participants report that 

peer support groups can be intimidating to engage in due to 

their “cliquey” environments24,26 and they can increase an 

individual’s negative thoughts about their amputation.35 

Poor leadership and a lack of commonality among group 

members have also been described as factors deterring 

amputees from wanting to engage in peer support groups.26 

Three studies discussed that their peer support groups were 

male-dominated, making it difficult for women to connect 

with other female amputees, and reported a lack of support 

available for addressing female-specific needs.26,35,37  

 

 

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6 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

        Table 1: Study details. 
 

Author 
(Year) 

Location Design Study Objectives 
Type of 

Amputation 
Care 

Setting 
Sample 

Age Range 
(years) 

Sex 

Amorelli et 

al.21(2019) 
USA Qualitative 

To examine the components of the AU 
program through individual with 
amputation and healthcare professionals 
(HCPs) experiences, and to understand 
the value this program brings to the limb 
loss community.  

Major upper 
and lower 
limb 

Community 

n = 10 
(HCPs) 
n = 7 
(amputees) 

17+ 

n = 15 
(male) 
n = 2 
(female) 

Andersen et 

al.36 (2023) 

Democratic 
Republic of 
Congo 

Non-controlled 
retrospective 
cohort study 

To examine predictors of depression, 
anxiety, and stress prior to and following 
participation in the mental health and 
psychosocial support (MHPSS) 
intervention.  

Major upper 
and lower 
limb 

n/a 

n = 132 
(total) 
n = 100 
(amputees) 

0-70 

n = 93 
(male) 
n = 39 
(female) 

Anderson et 

al.20 (2022) 

UK & 
Australia 

Narrative 
exploration 
study 
(phenomenolo
gical 
approach) 

Examine the experiences and 
perspectives of prosthetic and orthotic 
users and explore their needs for the 
future.  

Major lower 
limb 

n/a n = 5 33-67 
n = 2 (male) 
n = 3 
(female) 

Anderson et 

al.24 (2019) 
Australia 

Qualitative 
(naturalistic 
enquiry) 

To understand participant motivation to 
join a mobility clinic, examine their 
experiences, and understand its 
perceived benefits to their mobility.  

Major lower 
limb 

Community n = 9 25-60 
n = 3 (male) 
n = 6 
(female) 

Brusco et 

al.27 (2023) 
Australia Cost analysis 

Explore the cost, impact, and willingness 
to pay for an Amputee Peer Support 
Program; a program offered by Limbs 4 
Life. 

n/a Community 

n = 38 
(HCPs) 
n = 86 
(program 
volunteers) 
n = 12 
(program 
participants) 

n (mean 
age): 40.7 
(HCPs) 59.2 
(program 
volunteers) 
70.2 
(program 
participants) 

HCP 
n = 8 (male) 
n = 5 
(female) 
  
Program 
volunteers 
n = 58 
(male) 
n = 28 
(female) 
  
Program 
participants 
n = 8 (male) 
n = 4 
(female) 

Dillon et 

al.34 (2020) 
Australia 

Qualitative 
(narrative 
inquiry 
approach) 

To understand the experiences of 
individuals who have had sequential 
partial foot and transtibial amputations.  

Major lower 
limb 

Hospital & 
Community 

n = 10 21-73 
n = 8 (male) 
n = 2 
(female) 

Keeves et 

al.38 (2022) 
Australia 

Exploratory 
qualitative 
study 

To determine the factors that facilitate 
and impede social and community 
participation following traumatic lower 
limb amputations.  

Major lower 
limb 

n/a n = 9 50-64 
n = 7 (male) 
n = 2 
(female) 

Lehavot et 

al.37 (2022) 
USA 

National 
qualitative 
study 

To understand the perspectives of 
women veterans with lower limb loss 
regarding prosthetic devices and care.  

Major lower 
limb 

n/a n = 30 40-80 
n = 30 
(female) 

Liu et al.31 

(2010) 
Taiwan 

Qualitative 
(phenomenolo
gical 
approach) 

To explore the perspectives of 
Taiwanese people who experienced a 
lower extremity amputation pre- and six 
months post-surgery.  

Major lower 
limb 

Rehabilitati
on 

n = 22 56-84 

n = 15 
(male) 
n = 7 
(female) 

MacBride et 

al.25 (1980) 
Canada Qualitative  

To examine individual withamputation 
perspectives on group meetings and to 
understand the psychological impact of 
amputation and its influence on the 
success of amputee programs.   

Major upper 
and lower 
limb 

Rehabilitati
on 

n/a 64 (median) 
3:1 (male: 
female ratio) 

MacKay et 

al.39 (2022) 
Canada Qualitative  

To examine the experiences of 
individuals in the community who have 
lower extremity dysvascular amputation.  

Major lower 
limb 

n/a n = 35 72-86 

n = 23 
(male) 
n = 12 
(female) 

 

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7 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

 

       Table 1 (Continued): Study details. 
 

Mayo et 

al.40 (2022) 
Canada 

Qualitative 
descriptive  

To examine the mental health needs of 
individuals with lower limb amputations 
and understand their perspectives on 
using iCBT as a coping strategy post-
amputation.  

Major lower 
limb 

n/a n = 10 43-77 
n = 9 (male) 
n = 1 
(female) 

McGill et 

al.41 (2021) 
UK 

Qualitative  
 

Explores the physical, psychological, 
and social experiences of veterans with 
limb loss and examines the factors that 
facilitate their independence.  

Major upper 
and lower 
limb 

n/a n = 32 40-95 

n = 30 
(male) 
n = 2 
(female) 

Messinger 

et al.32 

(2018) 

USA 

Cross-
sectional 
(interpretive 
phenomenolog
ical approach) 
 
 

To explore the social experiences and 
recovery outcomes of amputees in the 
Military Advanced Training Centre at 
Walter Reed National Military Medical 
Centre. 

Major lower 
limb 

Rehabilitati
on 

n = 20 25-45 

n = 19 
(male) 
n = 1 
(female) 

Mortimer et 

al.28 (2002) 
Scotland 

Qualitative 
 
 

Examine the experiences of amputees 
with (1) phantom limb pain, (2) 
perceptions of the current information 
provided about phantom pain, and (3) 
opinions about what information should 
be provided. 

Major lower 
limb 

Community n = 31 30-74 

n = 18 
(male) 
n = 13 
(female) 

Nathan & 

Winkler26 

(2019) 

USA 

Cross-
sectional 
survey design 
 
 

To explore the reasons a person with 
amputation will join, leave, or return to a 
peer support group as well as 
understand the role of technology-based 
support groups for amputees.  

Major upper 
and lower 
limb 

n/a n = 54 20-82 

n = 36 
(male) 
n = 18 
(female) 

Radenovic 

et al.33 

(2022) 

Canada 

Qualitative 
descriptive and 
discovery 
oriented 
approach 

Understand the experiences of 
individuals with major lower limb loss 
and the factors that influence their 
reintegration into the community.  

Major lower 
limb 

Rehabilitati
on 

n = 9 51-82 
n = 7 (male) 
n = 2 
(female) 

Richardson 

et al.42 

(2020) 

UK 

Qualitative 
(interpretative 
phenomenolog
ical analysis) 

To explore the experiences and 
perceptions of peer mentors delivering 
peer support interventions to lower limb 
amputees.  

Major lower 
limb 

Community n = 8 56-84 
n = 3 (male) 
n = 5 
(female) 

Stutts et 

al.35 (2015) 
USA 

Qualitative 
(interpretative 
phenomenolog
ical analysis) 

To explore the coping strategies, 
perceived social support, participation in 
support groups, and experiences of 
acceptance and growth in women with 
amputations.  

Major upper 
and lower 
limb 

n/a n = 30 23-81 
n = 30 
(female) 

Turner et 

al.29 (2021) 
USA 

Multisite, 2-
arm cluster 
RCT with 
masked 
outcome 
assessment 
 

Examine the effectiveness of the 
VETPALS intervention on physical, 
psychological, and quality of life domains 
for individuals with lower limb loss and 
understand the feasibility of 
incorporating this program into a national 
health care program.  

Major lower 
limb 

Community n = 147 

Control = 
64.12 
(mean) 
 
Treatment = 
64.89 
(mean) 

Control 
n = 76 
(male) 
  
Treatment 
n = 68 
(male) 

Valizadeh et 

al.23 (2014) 
Iran 

Qualitative 
content 
analysis 

Explores the experiences of lower limb 
amputees and examines the influence of 
support sources on their ability to adapt 
to their amputation.  

Major lower 
limb 

n/a n = 20 25-57 

n = 17 
(male) 
n = 3 
(female) 

Wegener et 

al.30 (2009) 
USA RCT 

Examined the effectiveness of a 
community-based self-management 
program on health outcomes for 
individuals with limb loss.  

Major upper 
and lower 
limb 

Community n = 502 

Control = 
56.9 (mean) 
 
Treatment = 
55.5 (mean) 

 
Control 
n = 134 
(male) 
n = 93 
(female) 
  
Treatment 
n = 151 
(male) 
n = 124 
(female) 
 

 

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8 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

DISCUSSION 

This scoping review describes the nature of the existing 

literature on peer support for individuals with major limb 

loss. Based on our findings, there appears to be no clear 

consensus on a definition of peer support. The literature 

also lacked comprehensive exploration of the 

implementation of peer support interventions, with only a 

limited number of studies detailing the various settings and 

delivery methods employed. Studies that discussed the 

settings of peer support gatherings mainly described them 

within community-based locations, and methods of delivery 

varied between formal and informal formats. Most of the 

research included in this review provided evidence through 

participants’ perceived experiences. There were only two 

RCTs that explored peer support as an intervention; they 

measured outcomes related to physical, social, 

psychological, and quality of life domains. The benefits of 

peer-support interventions were highlighted in all articles, 

which included physical or psychosocial benefits. 

Conversely, there were few articles examining the barriers 

to peer support, which included organizational, individual, 

and group dynamic barriers.  

Limited studies defined peer support, but the prevailing 

agreement among these studies was that peer support 

involves the sharing of experiences among individuals with 

major limb loss.21-24,26  The lack of clarity in defining peer 

support for major limb loss resonates with similar 

observations across other healthcare contexts.43,44 The 

inconsistency in definitions might be attributed to the 

diverse nature of peer support interventions and the 

contextual variations in their implementation. Comparable 

challenges in defining peer support have been identified in 

studies focusing on peer support for mental health and 

chronic disease populations.43,44 This may be due to the 

more recent introduction of peer support as an integral part 

of the healthcare system. This discrepancy underscores the 

need for standardized terminology to facilitate effective 

communication and comprehension among researchers, 

practitioners, and participants. 

Peer support groups were positively reported by all studies 

included in this scoping review. The perceived benefit with 

the greatest amount of evidence was social support and 

connectedness. This was achieved through sharing 

experiences and giving or receiving advice from other group 

members.22 In a previous integrated review, Reichmann et 

al.45 similarly identified that peer support interventions 

benefited psychosocial outcomes during rehabilitation. The 

unique value of peer support provides participants with the 

opportunity to obtain reassurance from others in a similar 

position as themselves.34 For instance, peers with major 

limb losses reported that they were able to provide others 

with feelings of optimism and hope for the future.21 Similar 

claims were reported in peer support studies for individuals 

with diabetes, stating that sharing experiences enabled 

participants to receive validation from others when 

expressing their frustrations and concerns about their 

diabetes management.46 Significant emphasis on 

knowledge exchange and education facilitated in peer 

support groups was also positively highlighted throughout 

the review.21,24-28,34,35,37,40 According to Wasilewski et al.16  

this is attributed to participants finding educational 

information more informative and engaging when delivered 

by a peer, as they were able to resonate better due to 

shared experiences. In addition, peer support led to the 

building of friendships and a community for individuals with 

major limb loss.20,22,24,31,39-41 Peers were able to share 

advice amongst each other, which inspired them to engage 

more in the community, in daily activities, and build a life 

outside their family and non-amputee friends.16,42,47 

In this review, findings suggest participants expressed 

concerns regarding inaccessibility (e.g., geographical 

distance) and the inconvenience of attending peer support 

meetings.26,48 Flexible communication options, like 

telephone or online platforms, have been proposed as 

solutions and proven effective in increasing attendance 

frequency and participation.20,39,46 A meta-analysis of 

patients with diabetes found that support groups offered 

through telephone-based communications were equally 

effective as in person.16 Additionally, barriers to participation 

or engagement occurred due to a lack of peer mentor 

training, which resulted in poor leadership skills and self-

doubt among participants and mentors.22,26   

The review underscores the potential benefits of peer 

support, particularly in terms of social support, 

connectedness, knowledge exchange, and community-

building. However, research on the effectiveness of peer 

support interventions from RCTs is limited. Moreover, this 

research highlighted challenges to participation and 

engagement, such as accessibility and group dynamics. 

Future research should focus on developing and evaluating 

flexible communication options, like online platforms, to 

overcome geographical barriers. Additionally, 

comprehensive mentor training, mentor-mentee 

relationship-building, and tailored group categorization 

should be further explored to enhance engagement and 

address dynamics within peer support groups.  

Strengths and Limitations 

The strength of this scoping review is in the methodological 

rigour of the approach. This review followed Arksey and 

O’Malley’s methodological framework and was guided by a 

university-affiliated scientific librarian. As a result, this 

review provides a comprehensive summary of existing 

literature on the topic of peer support specific to individuals 

with amputations. This scoping review had some limitations. 

First, most of the articles included in this study did not 

explore peer support as their primary objective. This and the 

lack of RCTs made it difficult for the authors to understand 

the direct impact of peer support on health outcomes, as 

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9 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

most studies only focused on its perceived benefits. This 

limited our study objective to understanding the impact of 

peer support as an intervention. 

CONCLUSION 

This scoping review provided an understanding of what is 

known in the literature about peer support and people with 

major limb amputations. For this population, studies have 

shown that there are many perceived benefits to the 

provision of peer support. However, given the small number 

of studies in this field, future research is needed to explore 

the implementation process and evaluate the effectiveness 

of peer support for this population. 

ACKNOWLEDGEMENTS 

The authors of this article would like to express appreciation to 

Katie Merriman (academic librarian at the University of Toronto), for 

her assistance with the development of the literature search 

strategy. 

DECLARATION OF CONFLICTING INTERESTS 

The authors report that there are no conflicts of interest to declare. 

AUTHORS CONTRIBUTION 

• Annamaria Costa-Parke: responsible for researching and 

reviewing all included articles and co-writing manuscript. 

• Anna Maria Di Lella: responsible for researching and 

reviewing all included articles and co-writing manuscript.  

• Ashley Walker: responsible for editing and co-writing 

manuscript. 

• Lee Verweel: conceptualizing project, responsible for editing, 

co-writing manuscript, project supervision. 

• Crystal MacKay: conceptualizing project, responsible for 

editing, co-writing manuscript, project supervision. 

 

SOURCES OF SUPPORT 

No funding was provided for this review. 

REFERENCES 

1.Mulindwa B, Nalwoga RP, Nakandi BT, Mwaka ES, Kenney LPJ, 

Ackers L, et al. Evaluation of the current status of prosthetic 

rehabilitation services for major limb loss: a descriptive study in 

Ugandan Referral hospitals. Disabil Rehabil. 2023;1–10. DOI: 

10.1080/09638288.2023.2188266 

2.Jo S-H, Kang S-H, Seo W-S, Koo B-H, Kim H-G, Yun S-H. Psychiatric 

understanding and treatment of patients with amputations. Yeungnam 

Univ J Med. 2021;38(3):194–201. DOI: 10.12701/yujm.2021.00990 

3.Caddick N, Cullen H, Clarke A, Fossey M, Hill M, McGill G, et al. 

Ageing, limb-loss and military veterans: a systematic review of the 

literature. Ageing Soc. 2019;39(8):1582–1610. DOI: 10.1017/ 

S0144686X18000119 

4.Desmond D, MacLachlan M. Psychological issues in prosthetic and 

orthotic practice. Prosthet Orthot Int. 2002;26(3):182–188. DOI: 

10.1080/03093640208726646 

5.Khan M, Dogar SF, Masroor U. Family relations, quality of life and 

post-traumatic stress among amputees and prosthetics. Amputees and 

Prosthetics. 2018;68(1).  

6.Roșca AC, Baciu CC, Burtăverde V, Mateizer A. Psychological 

consequences in patients with amputation of a limb. an interpretative-

phenomenological analysis. Front Psychol. 2021;12. DOI: 10.3389/ 

fpsyg.2021.537493 

7.Luza LP, Ferreira EG, Minsky RC, Pires GKW, Silva R da. 

Psychosocial and physical adjustments and prosthesis satisfaction in 

amputees: a systematic review of observational studies. Disabil Rehabil 

Assist Technol. 2020;15(5):582–589. DOI:10.1080/17483107.2019. 

1602853 

8.Fitzpatrick MC. The psychologic assessment and psychosocial 

recovery of the patient with an amputation. Clin Orthop Relat Res. 

1999;361:98-107. DOI: 10.1097/00003086-199904000-00014 

9.Horgan O, MacLachlan M. Psychosocial adjustment to lower-limb 

amputation: a review. Disabil Rehabil. 2004;26(14–15):837–850. DOI: 

10.1080/09638280410001708869 

10.Bryant C, Gustafsson L, Aplin T, Setchell J. Supporting sexuality 

after spinal cord injury: a scoping review of non-medical approaches. 

Disabil Rehabil. 2022;44(19):5669–5682.DOI: 10.1080/09638288. 

2021.1937339 

11.Hoey LM, Ieropoli SC, White VM, Jefford M. Systematic review of 

peer-support programs for people with cancer. Patient Educ Couns. 

2008;70(3):315–337. DOI: 10.1016/j.pec.2007.11.016 

12.Boisvert RA, Martin LM, Grosek M, Clarie AJ. Effectiveness of a 

peer-support community in addiction recovery: participation as 

intervention. Occup Ther Int. 2008;15(4):205–220. DOI: 10.1002/oti.257 

13.Fortuna KL, DiMilia PR, Lohman MC, Bruce ML, Zubritsky CD, 

Halaby MR, et al. Feasibility, acceptability, and preliminary 

effectiveness of a peer-delivered and technology supported self-

management intervention for older adults with serious mental illness. 

Psychiatric Quarterly. 2018;89(2):293–305. DOI: 10.1007/ s11126-017-

9534-7 

14.Proudfoot J, Parker G, Manicavasagar V, Hadzi-Pavlovic D, Whitton 

A, Nicholas J, et al. Effects of adjunctive peer support on perceptions of 

illness control and understanding in an online psychoeducation program 

for bipolar disorder:  a randomised controlled trial. J Affect Disord. 

2012;142(1–3):98–105. DOI: 10.1016/j.jad.2012.04.007  

15.Lorig K, Ritter PL, Villa FJ, Armas J. Community-based peer-led 

diabetes self-management. Diabetes Educ. 2009;35(4):641–651. DOI: 

10.1177/0145721709335006 

16.Wasilewski MB, Rios J, Simpson R, Hitzig SL, Gotlib Conn L, 

MacKay C, et al. Peer support for traumatic injury survivors: a scoping 

review. Disabil Rehabil. 2023;45(13):2199–2232. DOI: 10.1080/ 

09638288.2022.2083702 

17.Imam B, Miller WC, Finlayson HC, Eng JJ, Jarus T. Incidence of 

lower limb amputation in Canada. Can J Public Health. 2017; 

108(4):374–380. DOI: 10.17269/cjph.108.6093 

18.Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris 

E. Systematic review or scoping review? Guidance for authors when 

choosing between a systematic or scoping review approach. BMC Med 

Res Methodol. 2018;18(1):143. DOI: 10.1186/s12874-018-0611-x 

19.Arksey H, O’Malley L. Scoping studies: towards a methodological 

framework. Int J Soc Res Methodol. 2005;8(1):19–32. DOI: 

10.1080/1364557032000119616 

20.Anderson SP, Barnett CT, Rusaw DF. Exploring the perspectives of 

prosthetic and orthotic users: past and present experiences and insights 

https://doi.org/10.33137/cpoj.v6i1.42170


 

10 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

for the future. Disabil Rehabil. 2022;44(18):5284–5290. DOI: 

10.1080/09638288.2021. 1928777 

21.Amorelli C, Yancosek K, Morris R. Amputees unanimous. Prosthet 

Orthot Int. 2019;43(3):293–300. DOI: 10.1177/ 0309364619836027 

22.Richardson L-J, Molyneaux V, Murray CD. Being a peer support 

mentor for individuals who have had a lower limb amputation: an 

interpretative phenomenological analysis. Disabil Rehabil. 

2020;42(26):3850–3857. DOI: 10.1080/09638288.2019.1611954 

23.Valizadeh S, Dadkhah B, Mohammadi E, Hassankhani H. The 

perception of trauma patients from social support in adjustment to lower-

limb amputation: a qualitative study. Indian J Palliat Care. 

2014;20(3):229. DOI: 10.4103/0973-1075.138401 

24.Anderson S, Chaffey L, Dillon M. 'It's . . . forward-focused': 

experiences of a mobility clinic for people with limb loss. Prosthet Orthot 

Int. 2019;43(6):601–608. DOI: 10.1177/0309364619882126 

25.MacBride A, Rogers J, Whylie B, Freeman SJJ. Psychosocial factors 

in the rehabilitation of elderly amputees. Psychosomatics. 

1980;21(3):258–265. DOI: 10.1016/S0033-3182(80)73701-5 

26.Nathan EP, Winkler SL. Amputees’ attitudes toward participation in 

amputee support groups and the role of virtual technology in supporting 

amputees: survey study. JMIR Rehabil Assist Technol. 

2019;6(2):14887. DOI: 10.2196/14887 

27.Brusco NK, Foster S, Noonan M, Waugh F, Warren N. What is the 

cost, impact, and willingness to pay for an Amputee Peer Support 

Program? Prosthet Orthot Int. 2023;47(2):137–146. DOI: 10.1097/ 

PXR.0000000000000193 

28.Mortimer CM. Patient information on phantom limb pain: a focus 

group study of patient experiences, perceptions and opinions. Health 

Educ Res. 2002;17(3):291–304. DOI: 10.1093/her/17.3.291 

29.Turner AP, Wegener ST, Williams RM, Ehde DM, Norvell DC, Yanez 

ND, et al. Self-management to improve function after amputation: a 

randomized controlled trial of the VETPALS intervention. Arch Phys 

Med Rehabil. 2021;102(7):1274–1282. DOI: 10.1016/j.apmr.2021. 

02.027 

30.Wegener ST, Mackenzie EJ, Ephraim P, Ehde D, Williams R. Self-

management improves outcomes in persons with limb loss. Arch Phys 

Med Rehabil. 2009;90(3):373–380. DOI: 10.1016/ j.apmr.2008.08.222 

31.Liu F, Williams RM, Liu H-E, Chien N-H. The lived experience of 

persons with lower extremity amputation. J Clin Nurs. 2010;19(15–

16):2152–2161. DOI: 10.1111/j.1365-2702.2010.03256.x 

32.Messinger S, Bozorghadad S, Pasquina P. Social relationships in 

rehabilitation and their impact on positive outcomes among amputees 

with lower limb loss at Walter Reed National Military Medical Center. J 

Rehabil Med 2018;50(1):86–93. DOI: 10.2340/16501977-2274 

33.Radenovic M, Aguilar K, Wyrough AB, Johnson CL, Luong S, Everall 

AC, et al. Understanding transitions in care for people with major lower 

limb amputations from inpatient rehabilitation to home: a descriptive 

qualitative study. Disabil Rehabil. 2022;44(16):4211–4219. DOI: 

10.1080/09638288.2021.1882009 

34.Dillon MP, Anderson SP, Duke EJ, Ozturk HE, Stuckey R. The lived 

experience of sequential partial foot and transtibial amputation. Disabil 

Rehabil. 2020;42(15):2106–2114. DOI: 10.1080/09638288.2018. 

1555288 

35.Stutts LA, Bills SE, Erwin SR, Good JJ. Coping and posttraumatic 

growth in women with limb amputations. Psychol Health Med 

2015;20(6):742–752. DOI: 10.1080/13548506.2015. 1009379 

36.Andersen I, Rossi R, Kahorha Mukubirho C, Ragazzoni L, Hubloue 

I. Mental health and psychosocial support during physical rehabilitation 

in Eastern Democratic Republic of Congo: a retrospective cohort study. 

Disabil Rehabil. 2023;45(17):2777–2786. DOI: 10.1080/09638288. 

2022.2107093 

37.Lehavot K, Young JP, Thomas RM, Williams RM, Turner AP, Norvell 

DC, et al. Voices of women veterans with lower limb prostheses: a 

qualitative study. J Gen Intern Med.2022;37(S3):799–805. DOI: 

10.1007/s11606-022-07572-8 

38.Keeves J, Hutchison A, D’Cruz K, Anderson S. Social and 

community participation following traumatic lower limb amputation: an 

exploratory qualitative study. Disabil Rehabil. 2022;1–9. DOI: 

10.1080/09638288. 2022.2152114 

39.MacKay C, Cimino SR, Guilcher SJT, Mayo AL, Devlin M, Dilkas S, 

et al. A qualitative study exploring individuals’ experiences living with 

dysvascular lower limb amputation. Disabil Rehabil. 2022;44(10):1812–

1820. DOI: 10.1080/09638288.2020.1803999 

40.Mayo AL, Fung V, Hitzig SL, Gould S, Posa S, Summers deLuca L, 

et al. Exploring the psychosocial needs of persons with lower extremity 

amputation and feasibility of internet cognitive behavioural therapy: a 

qualitative study. Disabil Rehabil. 2022;1–10. DOI: 10.1080/ 

09638288.2022.2144492 

41.McGill G, Wilson G, Caddick N, Forster N, Kiernan MD. 

Rehabilitation and transition in military veterans after limb-loss. Disabil 

Rehabil. 2021;43(23):3315–3322. DOI: 10.1080/09638288.2020. 

1734875 

42.Richardson L-J, Molyneaux V, Murray CD. Being a peer support 

mentor for individuals who have had a lower limb amputation: an 

interpretative phenomenological analysis. Disabil Rehabil. 

2020;42(26):3850–3857. DOI: 10.1080/09638288.2019.1611954 

43.Doull M, O’Connor AM, Welch V, Tugwell P, Wells GA. Peer support 

strategies for improving the health and well-being of individuals with 

chronic diseases. Cochrane Database Syst Rev. 2017. DOI: 

10.1002/14651858.CD005352. 

44.Shalaby RAH, Agyapong VIO. Peer support in mental health: 

literature review. JMIR Ment Health. 2020;7(6):e15572. DOI: 

10.2196/15572 

45.Reichmann JP, Bartman KR. An integrative review of peer support 

for patients undergoing major limb amputation. J Vasc Nurs. 

2018;36(1):34–39. DOI: 10.1016/j.jvn.2017.10.002 

46.Gavrila V, Garrity A, Hirschfeld E, Edwards B, Lee JM. Peer support 

through a diabetes social media community. J Diabetes Sci Technol. 

2019;13(3):493–497. DOI: 10.1177/1932296818818828 

47.Magasi S, Papadimitriou C. Peer support interventions in physical 

medicine and rehabilitation: a framework to advance the field. Arch Phys 

Med Rehabil. 2022;103(7). DOI: 10.1016/j.apmr. 2020.09.400 

48.Matthias MS, Kukla M, McGuire AB, Damush TM, Gill N, Bair MJ. 

Facilitators and barriers to participation in a peer support intervention 

for veterans with chronic pain. Clin J Pain. 2016;32(6):534–540. 

DOI: 10.1097/AJP.0000000000000297 

 

 

 

 

 

 

 

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Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

 APPENDICIES  

 Legend 

 

 

  Appendix A: Ovid MEDLINE (Timeline: 1946 to 2023) 

 

 

 

 

 

 

 

 

Operator Meaning 

.tw title or abstract  

.kf word in author provided keyword  

.tw,kf the term is found in the title, abstract or in an author provided keyword 

* or $ truncation (E.g., support OR supports OR supporting)  

or/#-# 
Refers to the lines that include words related to the search term (eg. or/1-10 [amputation] means that lines 1 or 2 or 3 or 4 or 5 or 6 or 7 
or 8 or 9 or 10 include terms related to amputation) 

adj# 
the search term is within a specified number of words of the term (E.g. peer adj2 is within 2 words of the term support* (e.g., peer 
support OR supporting a peer)) 

# Searches Results 

1 amputation/ or disarticulation/ or hemipelvectomy/ 23917 

2 
Amputation, Traumatic/ or leg amputation/ or above knee amputation/ or below knee amputation/ or knee amputation/ or arm 
amputation/ or amputation/ or foot amputation/ or hand amputation/ or limb amputation/ 

27952 

3 (Major limb amputat* or major limb loss or limb absence or limb loss).tw,kf. 2524 

4 (Lower limb amputation* or Upper limb amputation*).tw,kf. 2801 

5 Amputation Stumps/ 3218 

6 Amputation, Surgical/ 182 

7 Artificial Limbs.tw,kf. 587 

8 amputat* stump*.tw,kf. 1095 

9 Artificial Limbs/ 7930 

10 ((leg or knee or arm or foot or hand or wrist or ankle or limb) adj3 amputat*).tw,kf. 12980 

11 or/1-10 [Amputation] 42690 

12 Social support/ 78053 

13 (peer adj2 (group* or support* or coach* or mentor*)).tw,kf. 13117 

14 peer group/ 23804 

15 Mentoring/ 3699 

16 (social adj2 support).tw,kf. 54253 

17 (lay$ adj2 (led or run or help$ or support$ or visit$ or based or deliver$ or worker? or person$)).tw,kf. 8855 

18 (user$ adj2 (led or run or help$ or support$ or visit$ or based or deliver$)).tw,kf. 7513 

19 (voluntary adj2 (work$ or care or involvement or help$ or counsel$)).tw,kf. 2660 

20 (volunteer adj2 (work$ or care or involvement or help$ or counsel$)).tw,kf. 1240 

21 (community adj2 (person$ or based or visit$ or worker?)).tw,kf. 88377 

22 (support adj2 (person$ or worker?)).tw,kf. 7020 

23 (mutual adj2 (aid or support?)).tw,kf. 1512 

24 (expert adj2 patient?).tw,kf. 1268 

25 (non adj2 (professional? or medical)).tw,kf. 12426 

26 (supportive adj2 relationship).tw,kf. 310 

27 (health adj2 coach$).tw,kf. 1438 

28 peer* to peer* support.tw,kf. 200 

29 patient* to patient* support.tw,kf. 29 

30 survivor* network*.tw,kf. 51 

31 or/12-30 [Peer Support] 260846 

32 11 and 31 300 

https://doi.org/10.33137/cpoj.v6i1.42170


 

12 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

 Appendix B: EMBASE (Timeline: 1947 to 2023) 

 

 

 

 

 

 

 

 

 

 

 

 

 

# Searches Results 

1 amputation/ or disarticulation/ or hemipelvectomy/ 35000 

2 
Amputation, Traumatic/ or leg amputation/ or above knee amputation/ or below knee amputation/ or knee amputation/ or arm 
amputation/ or amputation/ or foot amputation/ or hand amputation/ or limb amputation/ 

59817 

3 (Major limb amputat* or major limb loss or limb absence or limb loss).tw,kf. 3357 

4 (Lower limb amputation* or Upper limb amputation*).tw,kf. 3860 

5 Amputation Stumps/ 7003 

6 Amputation, Surgical/ 0 

7 Artificial Limbs.tw,kf. 594 

8 amputat* stump*.tw,kf. 1193 

9 Artificial Limbs/ 4445 

10 ((leg or knee or arm or foot or hand or wrist or ankle or limb) adj3 amputat*).tw,kf. 18335 

11 or/1-10 [Amputation] 73823 

12 Social support/ 109599 

13 (peer adj2 (group* or support* or coach* or mentor*)).tw,kf. 17481 

14 peer group/ 29351 

15 Mentoring/ 6087 

16 (social adj2 support).tw,kf. 66633 

17 (lay$ adj2 (led or run or help$ or support$ or visit$ or based or deliver$ or worker? or person$)).tw,kf. 9821 

18 (user$ adj2 (led or run or help$ or support$ or visit$ or based or deliver$)).tw,kf. 9109 

19 (voluntary adj2 (work$ or care or involvement or help$ or counsel$)).tw,kf. 3125 

20 (volunteer adj2 (work$ or care or involvement or help$ or counsel$)).tw,kf. 1615 

21 (community adj2 (person$ or based or visit$ or worker?)).tw,kf. 111367 

22 (support adj2 (person$ or worker?)).tw,kf. 9212 

23 (mutual adj2 (aid or support?)).tw,kf. 1877 

24 (expert adj2 patient?).tw,kf. 2312 

25 (non adj2 (professional? or medical)).tw,kf. 19072 

26 (supportive adj2 relationship).tw,kf. 406 

27 (health adj2 coach$).tw,kf. 2084 

28 peer* to peer* support.tw,kf. 328 

29 patient* to patient* support.tw,kf. 51 

30 survivor* network*.tw,kf. 78 

31 or/12-30 [Peer Support] 322841 

32 11 and 31 514 

https://doi.org/10.33137/cpoj.v6i1.42170


 

13 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

 Appendix C: PsycInfo (Timeline: 1806 to 2023) 

 

 

 

 

 

 

 

 

 

 

 

# Searches Results 

1 amputation/ or disarticulation/ or hemipelvectomy/ 1109 

2 "Amputation, Traumatic"/ or "leg amputation"/ or "above knee amputation"/ or "below knee amputation"/ or "knee amputation"/ 

or "arm amputation"/ or amputation/ or "foot amputation"/ or "hand amputation"/ or "limb amputation"/ 
1109 

3 ("Major limb amputat*" or "major limb loss" or "limb absence" or "limb loss").ti,ab,id. 154 

4 ("Lower limb amputation*" or "Upper limb amputation*").ti,ab,id. 251 

5 "Amputation Stumps"/ 0 

6 "Amputation, Surgical"/ 0 

7 "Artificial Limbs".ti,ab,id. 41 

8 "amputat* stump*".ti,ab,id. 22 

9 "Artificial Limbs"/ 1121 

10 ((leg or knee or arm or foot or hand or wrist or ankle or limb) adj3 amputat*).ti,ab,id. 762 

11 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 [Amputation] 2387 

12 "Social support"/ 42141 

13 (peer adj2 (group* or support* or coach* or mentor*)).ti,ab,id. 15696 

14 "peer group"/ 0 

15 Mentoring/ 0 

16 (social adj2 support).ti,ab,id. 61395 

17 (lay# adj2 (led or run or help# or support# or visit# or based or deliver# or worker? or person#)).ti,ab,id. 4 

18 (user# adj2 (led or run or help# or support# or visit# or based or deliver#)).ti,ab,id. 850 

19 (voluntary adj2 (work# or care or involvement or help# or counsel#)).ti,ab,id. 228 

20 (volunteer adj2 (work# or care or involvement or help# or counsel#)).ti,ab,id. 208 

21 (community adj2 (person# or based or visit# or worker?)).ti,ab,id. 38917 

22 (support adj2 (person# or worker?)).ti,ab,id. 2600 

23 (mutual adj2 (aid or support?)).ti,ab,id. 1911 

24 (expert adj2 patient?).ti,ab,id. 260 

25 (non adj2 (professional? or medical)).ti,ab,id. 4077 

26 (supportive adj2 relationship).ti,ab,id. 528 

27 (health adj2 coach#).ti,ab,id. 2 

28 "peer* to peer* support".ti,ab,id. 115 

29 "patient* to patient* support".ti,ab,id. 7 

30 "survivor* network*".ti,ab,id. 30 

31 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25 or 26 or 27 or 28 or 29 or "30 [Peer 

Support]".mp. [mp=title, abstract, heading word, table of contents, key concepts, original title, tests & measures, mesh word] 
132455 

32 11 and 31 82 

https://doi.org/10.33137/cpoj.v6i1.42170


 

14 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

Appendix D: CINAHL (Timeline: 1991 to 2023) 
               Appendix D: CINAHL (Timeline: 1991 to 2023) 

# Query 
Limiters/ 

Expanders 
Last Run Via Results 

S32 S11 AND S31 Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced 

Search 

Database - CINAHL 

187 

S31 

S12 OR S13 OR S14 OR S15 OR S16 OR S17 OR S18 

OR S19 OR S20 OR S21 OR S22 OR S23 OR S24 OR 

S25 OR S26 OR S27 OR S28 OR S29 OR S30 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced 

Search 

Database - CINAHL 

131,387 

S30 
(TI "survivor* network*" OR AB "survivor* network*" OR SU 

"survivor* network*") 
Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced 

Search 

Database - CINAHL 

34 

S29 
(TI "patient* to patient* support" OR AB "patient* to patient* 

support" OR SU "patient* to patient* support") 
Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced 

Search 

Database - CINAHL 

1 

S28 
(TI "peer* to peer* support" OR AB "peer* to peer* support" 

OR SU "peer* to peer* support") 
Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced 

Search 

Database - CINAHL 

106 

S27 
((TI health OR AB health OR SU health) N2 (TI coach? OR 

AB coach? OR SU coach?)) 
Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced 

Search 

Database - CINAHL 

461 

S26 
((TI supportive OR AB supportive OR SU supportive) N2 (TI 

relationship OR AB relationship OR SU relationship)) 
Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced 

Search 

Database - CINAHL 

1,276 

S25 

((TI non OR AB non OR SU non) N2 ((TI professional# OR 

AB professional# OR SU professional#) OR (TI medical OR 

AB medical OR SU medical))) 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced 

Search 

Database - CINAHL 

6,442 

S24 
((TI expert OR AB expert OR SU expert) N2 (TI patient# 

OR AB patient# OR SU patient#)) 
Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced 

Search 

Database - CINAHL 

1,843 

S23 

((TI mutual OR AB mutual OR SU mutual) N2 ((TI aid OR 

AB aid OR SU aid) OR (TI support# OR AB support# OR 

SU support#))) 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced 

Search 

Database - CINAHL 

1,175 

S22 

((TI support OR AB support OR SU support) N2 ((TI 

person? OR AB person? OR SU person?) OR (TI worker# 

OR AB worker# OR SU worker#))) 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced 

Search 

Database - CINAHL 

5,168 

 

https://doi.org/10.33137/cpoj.v6i1.42170


 

15 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

 
                Appendix D (Continued): CINAHL (Timeline: 1991 to 2023) 

S21 

((TI community OR AB community OR SU community) N2 ((TI 

person? OR AB person? OR SU person?) OR (TI based OR AB 

based OR SU based) OR (TI visit? OR AB visit? OR SU visit?) 

OR (TI worker# OR AB worker# OR SU worker#))) 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

53,178 

S20 

((TI volunteer OR AB volunteer OR SU volunteer) N2 ((TI work? 

OR AB work? OR SU work?) OR (TI care OR AB care OR SU 

care) OR (TI involvement OR AB involvement OR SU 

involvement) OR (TI help? OR AB help? OR SU help?) OR (TI 

counsel? OR AB counsel? OR SU counsel?))) 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

1,411 

S19 

((TI voluntary OR AB voluntary OR SU voluntary) N2 ((TI work? 

OR AB work? OR SU work?) OR (TI care OR AB care OR SU 

care) OR (TI involvement OR AB involvement OR SU 

involvement) OR (TI help? OR AB help? OR SU help?) OR (TI 

counsel? OR AB counsel? OR SU counsel?))) 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

655 

S18 

((TI user? OR AB user? OR SU user?) N2 ((TI led OR AB led 

OR SU led) OR (TI run OR AB run OR SU run) OR (TI help? OR 

AB help? OR SU help?) OR (TI support? OR AB support? OR 

SU support?) OR (TI visit? OR AB visit? OR SU visit?) OR (TI 

based OR AB based OR SU based) OR (TI deliver? OR AB 

deliver? OR SU deliver?))) 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

3,951 

S17 

((TI lay? OR AB lay? OR SU lay?) N2 ((TI led OR AB led OR SU 

led) OR (TI run OR AB run OR SU run) OR (TI help? OR AB 

help? OR SU help?) OR (TI support? OR AB support? OR SU 

support?) OR (TI visit? OR AB visit? OR SU visit?) OR (TI 

based OR AB based OR SU based) OR (TI deliver? OR AB 

deliver? OR SU deliver?) OR (TI worker# OR AB worker# OR 

SU worker#) OR (TI person? OR AB person? OR SU person?))) 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

1,128 

S16 
((TI social OR AB social OR SU social) N2 (TI support OR AB 

support OR SU support)) 
Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

38,938 

S15 (MH Mentoring) Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

0 

S14 (MH "peer group") Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

15,928 

S13 

((TI peer OR AB peer OR SU peer) N2 ((TI group* OR AB 

group* OR SU group*) OR (TI support* OR AB support* OR SU 

support*) OR (TI coach* OR AB coach* OR SU coach*) OR (TI 

mentor* OR AB mentor* OR SU mentor*))) 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

23,113 

S12 (MH "Social support") Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

0 

S11 
S1 OR S2 OR S3 OR S4 OR S5 OR S6 OR S7 OR S8 OR S9 

OR S10 
Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

12,972 

S10 

(((TI leg OR AB leg OR SU leg) OR (TI knee OR AB knee OR 

SU knee) OR (TI arm OR AB arm OR SU arm) OR (TI foot OR 

AB foot OR SU foot) OR (TI hand OR AB hand OR SU hand) 

OR (TI wrist OR AB wrist OR SU wrist) OR (TI ankle OR AB 

ankle OR SU ankle) OR (TI limb OR AB limb OR SU limb)) N3 

(TI amputat* OR AB amputat* OR SU amputat*)) 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

6,306 

 

https://doi.org/10.33137/cpoj.v6i1.42170


 

16 

Costa-Parke A, Di Lella A.M, Walker A, Verweel L, MacKay C. Peer support for individuals with major limb loss: A scoping review. Canadian Prosthetics & Orthotics 
Journal. 2023; Volume 6, Issue 1, No.6. https://doi.org/10.33137/cpoj.v6i1.42170 

CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 

ISSN: 2561-987X PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS  

 

Costa-Parke et al., 2023 

 

 

 

 

                Appendix D (Continued): CINAHL (Timeline: 1991 to 2023) 

S9 (MH "Artificial Limbs") Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

0 

S8 
(TI "amputat* stump*" OR AB "amputat* stump*" OR SU 

"amputat* stump*") 
Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

553 

S7 
(TI "Artificial Limbs" OR AB "Artificial Limbs" OR SU "Artificial 

Limbs") 
Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

56 

S6 (MH "Amputation, Surgical") Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

0 

S5 (MH "Amputation Stumps") Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

498 

S4 

((TI "Lower limb amputation*" OR AB "Lower limb amputation*" 

OR SU "Lower limb amputation*") OR (TI "Upper limb 

amputation*" OR AB "Upper limb amputation*" OR SU "Upper 

limb amputation*")) 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

1,480 

S3 

((TI "Major limb amputat*" OR AB "Major limb amputat*" OR 

SU "Major limb amputat*") OR (TI "major limb loss" OR AB 

"major limb loss" OR SU "major limb loss") OR (TI "limb 

absence" OR AB "limb absence" OR SU "limb absence") OR 

(TI "limb loss" OR AB "limb loss" OR SU "limb loss")) 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

1,010 

S2 

(MH "Amputation, Traumatic") OR (MH "leg amputation") OR 

(MH "above knee amputation") OR (MH "below knee 

amputation") OR (MH "knee amputation") OR (MH "arm 

amputation") OR (MH amputation) OR (MH "foot amputation") 

OR (MH "hand amputation") OR (MH "limb amputation") 

Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

8,309 

S1 
(MH amputation) OR (MH disarticulation) OR (MH 

hemipelvectomy) 
Search modes - Boolean/Phrase 

Interface - EBSCOhost Research 

Databases 

Search Screen - Advanced Search 

Database - CINAHL 

7,738 

 

https://doi.org/10.33137/cpoj.v6i1.42170

