Return to Work After Lower Limb Amputation: A Critical Challenge in Jordan's Socioeconomic and Healthcare Context

After lower limb amputation (LLA), return to work (RTW) is an essential step, signifying the economic stability of people with amputation, psychological recovery, and social reintegration. While RTW is well-studied in high-income countries, the experiences of people with amputation in low- and middle-income countries like Jordan remain poorly characterized within contexts of prominent systemic barriers.

This study aimed to quantify the RTW rate after LLA in Jordan and identify the facilitators and barriers to vocational reintegration.

In a cross-sectional study, 119 male participants with amputation of working age participated in structured face-to-face interviews. Data collected included demographic and clinical variables (e.g., amputation level), clinical-outcome measures (socket comfort score, SIGAM mobility scale, London Handicap Scale), and employability, which was assessed using a validated employment questionnaire (EQ) to quantify work status and identify barriers to employment.

The RTW rate was 34.5%. Employed individuals reported significantly greater mobility, socket comfort, and lower perceived handicap. For all participants, higher education and better functional outcomes predicted greater employability. A critical divergence emerged in that for employed people with amputation, clinical factors like socket comfort were significantly associated with their work experience (p = 0.03), whereas for unemployed participants, these factors showed no association.

The low RTW rate (34.4%) highlights an urgent need for systemic change. The finding suggests that for most people with amputation, RTW may be impeded not by their medical condition alone, but by external barriers likely including inaccessible workplaces and the absence of vocational rehabilitation. To unlock the potential of people with amputation, rehabilitation must evolve into a comprehensive socio-medical system that integrates vocational training, advanced prosthetic care, and equitable policies.