Adaptive Technology to Optimize Rehabilitation of Lower Extremity Musculoskeletal Injuries throughout Recovery

The DoD lacks capability to optimally and rapidly rehabilitate injured Warfighters to duty. Over 1 million medical encounters and roughly 10 million days of limited duty occur annually as a result of injuries and injury-related musculoskeletal conditions, affecting over half of Soldiers each year (U.S. Army Public Health Center. 2018. 2018 Health of the Force, https://phc.amedd.army.mil/topics/campaigns/hof). Military recruits engaged in training are at a higher risk of suffering an injury, with the majority of injuries occurring in the lower limb (Andersen, KA, et al. 2016. Musculoskeletal Lower Limb Injury Risk in Army Populations. Sports medicine - open, 2, 22.). Specifically, injuries to the ankle-foot complex account for one the highest proportions of musculoskeletal injuries in conventional and special warfare combatants (Teyhen, DS, et al. 2018, Incidence of Musculoskeletal Injury in US Army Unit Types: A Prospective Cohort Study. Journal of Orthopaedic and Sports Physical Therapy, 48, 749). Depending on the severity of the injury, rehabilitation times can extend across weeks, months, and even years. The rehabilitation needs of the Warfighter change during this time, to include the level of support, stabilization, assistance, and/or resistance of essential exoskeleton or bracing technology. The DoD is limited in available technology that is responsive or can be tuned to meet these changing needs of the Warfighter throughout the rehabilitation process to facilitate return to duty. A solution is sought that is clinically accessible, easy to use for both clinicians and patients, and has the potential to be applicable across various ankle injuries to promote Warfighter return to duty.