Activity Patterns of Patients With Diabetic Foot Ulceration
Abstract
OBJECTIVE: To evaluate the activity of patients with diabetic foot ulcerations and their adherence to their pressure off-loading device. RESEARCH DESIGN AND METHODS: We enrolled 20 subjects treated for neuropathic diabetic foot wounds corresponding to University of Texas grade 1 stage A. All were off-loaded using a removable cast walker (RCW). We recorded the total activity (measured in activity steps per day) taken on a waist-worn computerized accelerometer. We subsequently correlated this to activity recorded on an RCW-mounted accelerometer, which was not readily accessible to the patient. RESULTS: There were a mean 1219.1 +/- 821.2 activity units (steps) taken per patient per day. Patients logged significantly more daily activity units with the protective RCW off than with it on (873.7 +/- 828.0 vs. 345.3 +/- 219.1, P = 0.01). This amounts to only 28% of total daily activity recorded while patients were wearing their RCW. Although a total of 30% of the patients in the study recorded more daily activity units while wearing the device, this subset most adherent to their off-loading regimen still only wore the device for a total of 60% of their total daily activity. CONCLUSIONS: Subjects with diabetic foot ulcerations appear to wear their off-loading devices for only a minority of steps taken each day. This may partially explain the poor results reported from many trials of agents designed to help speed the healing of these wounds. Control of this important aspect of care with less easily removable devices may increase the prevalence of healing.
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One study of 154 644 patients with chronic wounds treated at 525 US-based centers (19.0% with diabetic foot ulcers) reported a significant increase in healing (55% vs 28%) in people who had weekly debridement vs those who had less frequent debridement.
“One study of 154 644 patients with chronic wounds treated at 525 US-based centers (19.0% with diabetic foot ulcers) reported a significant increase in healing (55% vs 28%;P < .001)inpeople who had weekly debridement vs those who had less frequent debridement.54”
From Diabetic Foot Ulcers (2023) · cites this paper as [54]
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Diabetic Foot Ulcer Off-loading
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- Authors
- Armstrong, D. G., Lavery, L. A., Kimbriel, H. R., Nixon, B. P., & Boulton, A. J. M.
- Affiliations
- Manchester Royal Infirmary (GB)
- Scott & White Memorial Hospital (US)
- Southern Arizona VA Health Care System (US)
- University of Miami (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2003-09-01
- Volume
- 26
- Issue
- 9
- Pages
- 2595-2597
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2107085531
- Cited by
- 306
- References
- 17
- Citations by year
- 2026: 10 · 2025: 6 · 2024: 12 · 2023: 24 · 2022: 25 · 2021: 7 · 2020: 18 · 2019: 10 · 2018: 13 · 2017: 11 · 2016: 17 · 2015: 17 · 2014: 17 · 2013: 8 · 2012: 12
- FWCI
- 8.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Foot and Ankle Surgery
- Keywords
- diabetic foot ulcer, device adherence, physical activity, step count, accelerometer, wound healing
- MeSH terms
- Aged, Diabetic Neuropathies, Female, Humans, Longitudinal Studies, Male, Motor Activity, Patient Compliance, Walkers, Wounds and Injuries, Weight-Bearing, Age of Onset, Diabetic Foot
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