{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:19:20Z","timestamp":1785410360969,"version":"3.56.0"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"unspecified","delay-in-days":167,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Wearable Technol."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Prolonged field care is increasingly important in military operations, where austere environments and delayed medical evacuations necessitate extended injury management. Tibia and fibula fractures are common, survivable battlefield injuries that demand such care. Current treatment options involve simple splints, which require the injured Service member to be carried on a litter, and exoskeletons, which are not suited for use in combat environments. The Intrepid Battlefield Exoskeleton (IBEX) was developed to address this critical gap in battlefield trauma care by stabilizing lower leg fractures and enabling independent mobility in prolonged care scenarios. This study evaluated the usability of two IBEX prototypes through sequential laboratory and field testing under two user conditions: medic and casualty. In laboratory testing, 20 participants completed a series of functional tasks with and without the IBEX and provided quantitative usability ratings and qualitative feedback via self-report measures and interviews. In field testing, 12 participants used the IBEX during a simulated mass casualty event and completed the same usability assessments. Quantitative results indicated high overall user satisfaction. Thematic analysis of qualitative feedback revealed recurring comments on usability, portability, comfort, security, and durability. Overall, results indicated moderate usability in both environments, with room to improve ease of fitting and adjustability. Findings highlight the value of a mixed-methods approach to device evaluation and underscore the importance of iterative design and testing. Ongoing work will compare the IBEX with the current standard of care and further refine the design for operational use.<\/jats:p>","DOI":"10.1017\/wtc.2025.10036","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T12:13:56Z","timestamp":1781698436000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Battlefield exoskeleton usability for lower-limb trauma in prolonged field care: A mixed-methods approach"],"prefix":"10.1017","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8825-7578","authenticated-orcid":false,"given":"Ciera A.","family":"Price","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00m1mwc36","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for the Intrepid, Brooke Army Medical Center"},{"id":[{"id":"https:\/\/ror.org\/04q9tew83","id-type":"ROR","asserted-by":"publisher"}],"name":"Henry M Jackson Foundation for the Advancement of Military Medicine Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharina C.","family":"Gaeth","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02gb0hd06","id-type":"ROR","asserted-by":"publisher"}],"name":"US Army Institute of Surgical Research"},{"name":"German Armed Forces Central Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia A.","family":"Gambill","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00m1mwc36","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for the Intrepid, Brooke Army Medical Center"},{"id":[{"id":"https:\/\/ror.org\/04q9tew83","id-type":"ROR","asserted-by":"publisher"}],"name":"Henry M Jackson Foundation for the Advancement of Military Medicine Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0023-104X","authenticated-orcid":false,"given":"William Brett","family":"Johnson","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00m1mwc36","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for the Intrepid, Brooke Army Medical Center"},{"name":"Extremity Trauma and Amputation Center of Excellence"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Pesquera","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00m1mwc36","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for the Intrepid, Brooke Army Medical Center"},{"name":"Extremity Trauma and Amputation Center of Excellence"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter Lee","family":"Childers","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00m1mwc36","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for the Intrepid, Brooke Army Medical Center"},{"name":"Extremity Trauma and Amputation Center of Excellence"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"S2631717625100364_r26","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e31802f78fb"},{"key":"S2631717625100364_r25","first-page":"537","volume-title":"Atlas of Amputations and Limb Deficiencies: Surgical, Prosthetic, and Rehabilitation Principles","volume":"Vol. 2","author":"Muller","year":"2016"},{"key":"S2631717625100364_r4","first-page":"29","article-title":"SUS: A retrospective","volume":"8","author":"Brooke","year":"2013","journal-title":"Journal of Usability Studies"},{"key":"S2631717625100364_r36","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/585837"},{"key":"S2631717625100364_r18","unstructured":"Johnson, WB , Pesquera, S , Shiels, SM and Childers, WL (2024a) Effectiveness of Fracture Stabilization Systems for Tibial Fractures [Conference abstract]. Military Health System Research Symposium, Kissimmee, FL, United States."},{"key":"S2631717625100364_r8","unstructured":"Childers, WL , Johnson, WB , Childress, JD , Harrison, D and Price, CA (2024). Battlefield Exoskeleton (Application No. 63.624,458). 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U.S. Army Natick Soldier Research, Development and Engineering Center. Available at https:\/\/apps.dtic.mil\/sti\/pdfs\/ADA611869.pdf (accessed on 2nd September 2021)."},{"key":"S2631717625100364_r20","doi-asserted-by":"crossref","first-page":"S135","DOI":"10.1016\/j.wem.2017.02.001","article-title":"Prolonged field care: Beyond the \u201cgolden hour\u201d","volume":"28","author":"Keenan","year":"2017","journal-title":"Wilderness and Environmental Medicine"},{"key":"S2631717625100364_r3","first-page":"189","volume-title":"Usability Evaluation in Industry","author":"Brooke","year":"1996"},{"key":"S2631717625100364_r7","doi-asserted-by":"crossref","first-page":"91","DOI":"10.55460\/QM3U-JZB1","article-title":"Mobility solutions after a lower extremity fracture and applicability to battlefield and wilderness medicine","volume":"23","author":"Childers","year":"2023","journal-title":"Journal of Special Operations Medicine"},{"key":"S2631717625100364_r15","unstructured":"Johnson, WB and Childers, WL (2025) Non-Invasive Fracture Stabilizing Orthosis (Application No. 19.066,693). 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Published by Cambridge University Press","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e9"}}