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Clinical outcome of Two Minute Walk Test after return to run program in IDEO users: a retrospective study
Michelle D Lockwood1,2,3, Christopher F Hovorka3,4, Molly E Baumann1,2,3
1Research and Surveillance Division, Extremity Trauma and Amputation Center of Excellence, Falls Church, VA, United States.
Frontiers in Rehabilitation Sciences
|October 24, 2025
Summary
The combination of the Intrepid Dynamic Exoskeletal Orthosis (IDEO) and a return-to-run (RTR) program significantly improved walking distance in patients with lower limb injuries. The Two Minute Walk Test (2MWT) effectively measured this functional improvement.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Sports Medicine
Background:
- Severe musculoskeletal injuries, particularly in the lower limbs, present significant challenges for patient recovery and return to function.
- Traditional rehabilitation programs may not always suffice for individuals with complex injuries requiring advanced assistive devices.
Purpose of the Study:
- To evaluate the clinical effectiveness of a high-intensity, sports-based return-to-run (RTR) rehabilitation program combined with the Intrepid Dynamic Exoskeletal Orthosis (IDEO) in patients with severe lower limb musculoskeletal injuries.
- To assess changes in functional mobility using the Two Minute Walk Test (2MWT) following this combined intervention.
Main Methods:
- A retrospective cohort study involving 41 patients (37 male, 4 female) with lower limb musculoskeletal injuries was conducted.
- Clinical data were analyzed to compare walking distances from the 2MWT across three conditions: no orthosis (NO IDEO), IDEO alone, and IDEO combined with the RTR program (IDEO + RTR).
- A repeated measures ANOVA and Bonferroni post-hoc tests were employed to determine statistically significant differences in walking distance (p < 0.05).
Main Results:
- A statistically significant increase in walking distance was observed across all conditions (p < 0.001).
- Patients demonstrated significantly greater walking distances with the IDEO alone (179m) and the IDEO + RTR program (208m) compared to NO IDEO (152m).
- The observed improvements in walking distance surpassed the Minimal Clinically Important Difference (37.2m) and Minimal Detectable Change (34.3m) for the 2MWT in the limb loss population.
Conclusions:
- The combined approach of the IDEO and RTR program shows potential for enhancing walking function in individuals with lower limb musculoskeletal injuries.
- The 2MWT appears to be a sensitive and clinically meaningful tool for detecting functional improvements in this patient population.
