A Retrospective Review of High-level Performance After the Return to Run Clinical Pathway in Patients Using the Intrepid Dynamic Exoskeletal Orthosis.

BACKGROUND: Severe ankle and foot injuries in the U.S. military can result in high-level functional limitation, lost duty days and medical discharge.

OBJECTIVE: To assess the effectiveness of the Return to Run Clinical Pathway (RTR) in returning patients with lower extremity fractures who utilize the Intrepid Dynamic Exoskeletal Orthosis (IDEO) to high-level mobility.

METHODS: Thirty service members with lower extremity fractures who utilized the IDEO unilaterally and completed the RTR at Naval Medical Center San Diego were included. The Comprehensive High-Level Activity Mobility Predictor (CHAMP) and all sub-tests were completed prior to and after completion of RTR as part of routine clinical care. An ANCOVA was utilized to compare CHAMP scores before and after RTR.

RESULTS: Significant improvements [mean change (95% Confidence Interval)] were found in the T-Test [-5.3 seconds (3.6 - 7.1), p=.03] and total CHAMP score [4.2 (3.0 - 5.3), p<.05]. No significant changes were noted in single legged stance subtest, the Edgren Side Step Test, or the Illinois Agility Test.

CONCLUSIONS: The RTR led to improvements in high-level, multi-directional mobility in IDEO users with history of fractures. Applicability of the intervention used in this study requires further validation before widespread use.

LEVEL OF EVIDENCE: Level 4. J Orthop Sports Phys Ther, Epub 13 Feb 2019. doi:10.2519/jospt.2019.8763.