The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.
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%;P < .001)inpeople who had weekly debridement vs those who had less frequent debridement.54”
From Diabetic Foot Ulcers: A Review (2023) · cites this paper as [54]
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Cites
Armstrong, D. G., Lavery, L. A., & Harkless, L. B. (1998) · Diabetes Care · doi:10.2337/diacare.21.5.855 · Cited by 1,142
Self-citationVeves, A., Falanga, V., Armstrong, D. G., Sabolinski, M. L., & Study, T. A. D. F. U. (2001) · Diabetes Care · doi:10.2337/diacare.24.2.290 · Cited by 769
Self-citationSteed, D. L., & the Diabetic Ulcer Study Group * (1995) · Journal of Vascular Surgery · doi:10.1016/s0741-5214(95)70245-8 · Cited by 610
Off-Loading the Diabetic Foot Wound
Armstrong, D. G., Nguyen, H. C., Lavery, L. A., van Schie, C. H. M., Boulton, A. J. M., & Harkless, L. B. (2001) · Diabetes Care · doi:10.2337/diacare.24.6.1019 · Cited by 602
Self-citationAmerican Diabetes Association (1999) · Diabetes Care · doi:10.2337/diacare.22.8.1354 · Cited by 496
Quantitative Assessment of Walking Activity after Total Hip or Knee Replacement*
Schmalzried, T. P., Szuszczewicz, E. S., NORTHFIELD, M. R., Akizuki, K. H., FRANKEL, R. E., BELCHER, G., & Amstutz, H. C. (1998) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-199801000-00010 · Cited by 434
Healing of diabetic neuropathic foot ulcers receiving standard treatment. A meta-analysis.
Margolis, D. J., Kantor, J., & Berlin, J. A. (1999) · Diabetes Care · doi:10.2337/diacare.22.5.692 · Cited by 422
Use of Dermagraft, a Cultured Human Dermis, to Treat Diabetic Foot Ulcers
Gentzkow, G. D., Iwasaki, S. D., Hershon, K. S., Mengel, M. C., Prendergast, J. J., Ricotta, J. J., Steed, D. P., & Lipkin, S. (1996) · Diabetes Care · doi:10.2337/diacare.19.4.350 · Cited by 414
Veves, A. (2002) · Archives of Surgery · doi:10.1001/archsurg.137.7.822 · Cited by 388
Diabetic foot disorders: A clinical practice guideline
Frykberg, R. G., Armstrong, D. G., Giurini, J. M., Edwards, A. L., Kravette, M. A., Kravitz, S. R., Ross, C. W., Stavosky, J. W., Stuck, R. M., & Vanore, J. (2000) · The Journal of Foot & Ankle Surgery · Cited by 367
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Items 301–306 of 306
Niemiec, S. L. S., Styer, L., Chapman, J., Myong, E., Moshtael, R., Lopez, C., Arteaga, J., Wong, E., Morales, D. M., Kumar, N. K., et al. (2026) · Translational Behavioral Medicine · doi:10.1093/tbm/ibag030
Yalla, S. V., Jhaveri, S. N., NEGRON-FERNANDEZ, N., Crews, R. T., & Rosenblatt, N. J. (2026) · Journal of Foot and Ankle Research · doi:10.1002/jfa2.70170
Offloading Adherence for Appearance’s Sake?
Crews, R. T., NEGRON-FERNANDEZ, N., Yalla, S. V., Fleischer, A. E., Boulton, A. J. M., Reeves, N. D., Vileikytė, L., & Rosenblatt, N. J. (2026) · Journal of the American Podiatric Medical Association · doi:10.3390/japma116030041
Self-citationDurability and offloading performance of 3D-printed multilayer lattice for accommodative insoles
Nagle-Christensen, A. Y., Heino, D. J., Nickerson, K. A., Ledoux, W. R., Telfer, S., & Muir, B. C. (2026) · Journal of the mechanical behavior of biomedical materials/Journal of mechanical behavior of biomedical materials · doi:10.1016/j.jmbbm.2026.107515
Internal Off-Loading Surgeries In The Management Of Diabetic Foot Ulcers
Bhoyar, S. (2026) · PAIN JOINTS SPINE · doi:10.1922/pjs.16.5s.2026.846
Digital Technologies and Diabetic Footcare
Brown, S. J., Reeves, N. D., & Boulton, A. J. M. (2026) · Springer eBooks · doi:10.1007/978-3-032-24854-1_22
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Metadata
- 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 › Surgery › 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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