{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:29:04Z","timestamp":1787027344031,"version":"build-2736575974"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate clinical improvement in persons with severe musculoskeletal injuries following a 4-week high intensity sports-based return to run rehabilitation therapy program (RTR) combined with use of an Intrepid Dynamic Exoskeletal Orthosis (IDEO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>41 persons (37 male and 4 female) with lower limb musculoskeletal injuries undergoing treatment and rehabilitation at the Center for the Intrepid were included in the retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Retrospective analysis of clinical data was used to identify changes in Two Minute Walk Test (2MWT) outcomes in patients with lower limb musculoskeletal injuries without the IDEO, with the IDEO alone and after IDEO\u2009+\u2009RTR. A repeated measures ANOVA was used to examine differences in distance walked across the three groups (NO IDEO, IDEO alone, and IDEO\u2009+\u2009RTR). Bonferroni\n                      <jats:italic>post-hoc<\/jats:italic>\n                      analysis was performed, and a level of significance was set at 0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A statistically significant difference in distance walked between all groups was observed (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Patients' mean distance walked using the IDEO alone (179\u2005m,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and IDEO\u2009+\u2009RTR (208\u2005m,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) increased significantly compared to NO IDEO (152\u2005m,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). These differences surpass the Minimal Clinically Important Difference (37.2\u2005m) and the Minimal Detectable Change (34.3\u2005m) for the 2MWT in the limb loss population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These data suggest the potential benefit of the combination of IDEO\u2009+\u2009RTR improved walking in patients with lower limb musculoskeletal injuries and suggest the 2MWT may be a meaningful, simple measure to detect improvement in function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fresc.2025.1602110","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T05:40:19Z","timestamp":1759902019000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical outcome of Two Minute Walk Test after return to run program in IDEO users: a retrospective study"],"prefix":"10.3389","volume":"6","author":[{"given":"Michelle D.","family":"Lockwood","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher F.","family":"Hovorka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly E.","family":"Baumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Lee","family":"Childers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1089\/wound.2016.0714","article-title":"Impact of traumatic lower extremity injuries beyond acute care: movement-based considerations for resultant Longer term secondary health conditions","volume":"6","author":"Butowicz","year":"2017","journal-title":"Adv Wound Care (New Rochelle)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1097\/00005373-199607000-00002","article-title":"Long-term outcomes after lower extremity trauma","volume":"41","author":"Butcher","year":"1996","journal-title":"J Trauma"},{"key":"B3","doi-asserted-by":"publisher","first-page":"182","DOI":"10.5435\/00124635-199607000-00002","article-title":"The mangled extremity: when should it be amputated?","volume":"4","author":"Dirschl","year":"1996","journal-title":"J Am Acad Orthop Surg"},{"key":"B4","first-page":"8","article-title":"Can an ankle-foot orthosis change hearts and minds?","volume":"20","author":"Patzkowski","year":"2011","journal-title":"J Surg Orthop Adv"},{"key":"B5","doi-asserted-by":"publisher","first-page":"3505","DOI":"10.1016\/j.injury.2021.07.023","article-title":"IDEO energy-storing orthosis: effects on lower extremity function and preservation","volume":"52","author":"Hoyt","year":"2021","journal-title":"Injury"},{"key":"B6","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.suc.2023.10.006","article-title":"Management of the mangled extremity","volume":"104","author":"Farrelly","year":"2024","journal-title":"Surg Clin North Am"},{"key":"B7","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1097\/PXR.0000000000000252","article-title":"Short-term effect of a carbon fiber custom dynamic orthosis and integrated rehabilitation on self-reported physical function, pain, speed, and agility in civilians","volume":"47","author":"Williamson","year":"2023","journal-title":"Prosthet Orthot Int"},{"key":"B8","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1097\/PXR.0000000000000291","article-title":"Changes in functional outcomes in people with high-energy ankle trauma after the use of the ReAktiv posterior dynamic element orthosis and a rehabilitation program: a case series","volume":"48","author":"Gardner","year":"2024","journal-title":"Prosthet Orthot Int"},{"key":"B9","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1519\/00139143-200932020-00002","article-title":"White paper: \u201cwalking speed: the sixth vital sign\u201d","volume":"32","author":"Fritz","year":"2009","journal-title":"J Geriatr Phys Ther"},{"key":"B10","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1123\/japa.2013-0236","article-title":"Walking speed: the functional vital sign","volume":"23","author":"Middleton","year":"2015","journal-title":"J Aging Phys Act"},{"key":"B11","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1001\/jama.2010.1923","article-title":"Gait speed and survival in older adults","volume":"305","author":"Studenski","year":"2011","journal-title":"JAMA"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.1111\/j.1532-5415.2005.53501.x","article-title":"Prognostic value of usual gait speed in well-functioning older people\u2013results from the health, aging and body composition study","volume":"53","author":"Cesari","year":"2005","journal-title":"J Am Geriatr Soc"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1093\/gerona\/60.10.1304","article-title":"Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older","volume":"60","author":"Montero-Odasso","year":"2005","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e70","DOI":"10.1097\/BOT.0000000000000006","article-title":"Return to duty after integrated orthotic and rehabilitation initiative","volume":"28","author":"Blair","year":"2014","journal-title":"J Orthop Trauma"},{"key":"B15","doi-asserted-by":"publisher","first-page":"3017","DOI":"10.1007\/s11999-014-3609-7","article-title":"Can an integrated orthotic and rehabilitation program decrease pain and improve function after lower extremity trauma?","volume":"472","author":"Bedigrew","year":"2014","journal-title":"Clin Orthop Relat Res"},{"key":"B16","doi-asserted-by":"publisher","first-page":"2224","DOI":"10.1589\/jpts.29.2224","article-title":"Normative reference values for the two-minute walk test derived by meta-analysis","volume":"29","author":"Bohannon","year":"2017","journal-title":"J Phys Ther Sci"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e1913123","DOI":"10.1001\/jamanetworkopen.2019.13123","article-title":"Association of neurocognitive and physical function with gait speed in midlife","volume":"2","author":"Rasmussen","year":"2019","journal-title":"JAMA Netw Open"},{"key":"B18","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1097\/JSA.0000000000000259","article-title":"Advanced functional bracing in lower extremity trauma: bracing to improve function","volume":"27","author":"Franklin","year":"2019","journal-title":"Sports Med Arthrosc Rev"},{"key":"B19","doi-asserted-by":"publisher","first-page":"555","DOI":"10.2522\/ptj.20100287","article-title":"Reliability of outcome measures for people with lower-limb amputations: distinguishing true change from statistical error","volume":"91","author":"Resnik","year":"2011","journal-title":"Phys Ther"},{"key":"B20","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/j.gaitpost.2021.06.001","article-title":"Minimal clinically important difference in walking velocity, gait profile score and two minute walk test for individuals with lower limb amputation","volume":"88","author":"Carse","year":"2021","journal-title":"Gait Posture"},{"key":"B21","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1179\/2042618614Y.0000000076","article-title":"Manual physical therapy combined with high-intensity functional rehabilitation for severe lower extremity musculoskeletal injuries: a case series","volume":"24","author":"Crowell","year":"2016","journal-title":"J Man Manip Ther"},{"key":"B22","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1007\/978-3-031-10355-1_42","article-title":"Orthotics","volume-title":"Blast Injury Science and Engineering: A Guide for Clinicians and Researchers","author":"Anderson","year":"2022"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/B978-0-323-60913-5.00001-5","article-title":"Orthotics and prosthetics in rehabilitation: multidisciplinary approach","author":"Jorge","year":"2020"},{"key":"B24","doi-asserted-by":"publisher","first-page":"S5","DOI":"10.1016\/j.injury.2020.03.047","article-title":"Current concepts in rehabilitation protocols to optimize patient function following musculoskeletal trauma","volume":"51","author":"You","year":"2020","journal-title":"Injury"},{"key":"B25","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1097\/PXR.0000000000000217","article-title":"Carbon fiber ankle-foot orthoses in impaired populations: a systematic review","volume":"47","author":"Grunst","year":"2023","journal-title":"Prosthet Orthot Int"}],"container-title":["Frontiers in Rehabilitation Sciences"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fresc.2025.1602110\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T05:40:20Z","timestamp":1759902020000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fresc.2025.1602110\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":25,"alternative-id":["10.3389\/fresc.2025.1602110"],"URL":"https:\/\/doi.org\/10.3389\/fresc.2025.1602110","relation":{},"ISSN":["2673-6861"],"issn-type":[{"value":"2673-6861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,8]]},"article-number":"1602110"}}