UA Department of Surgery Researchers Receive $1.2M to Monitor Activity of Individuals with Diabetes to Heal Wounds, Prevent Amputations

Contact: Jo Marie Gellerman, (520) 626-7219 Sept. 8, 2010

TUCSON, Ariz. – Researchers in the University of Arizona Department of Surgery have been awarded a $1.2 million grant to use cutting-edge technology in the form of a simple computerized undershirt to monitor activity among diabetics with foot wounds. The study will determine the role activity plays in the formation of sores to better understand how to prevent wounds from occurring.

David G. Armstrong, DPM, MD, PhD, professor of surgery and co-founder of the UA Department of Surgery’s Southern Arizona Limb Salvage Alliance (SALSA), an internationally renowned center for diabetic wound treatment and amputation prevention, is taking a lead role in the international collaborative. Dr. Armstrong hopes the study, funded by the Qatar National Research Foundation, ultimately will result in fewer infections and amputations.

“This is potentially game changing,” Dr. Armstrong said. “The kind of data we’re going to collect on a large scale will help us better tailor activity for a broad spectrum of patients that go beyond this one disease.”

The technology being used is a body-worn sensor that for the first time allows researchers to accurately monitor activity. Over the course of the three-year study, 112 individuals with diabetes who are suffering from foot wounds will be enrolled at the UA and at Hamad Medical Corporation in Doha, Qatar, and monitored through a comfortable undershirt. Partnering in the collaboration is the Center for Lower Extremity Ambulatory Research (CLEAR) in Chicago.

“It doesn’t cramp your style at all,” Dr. Armstrong said of the device. “It can assess not just the steps that we take, but many other things. It can measure if you are standing or sitting, jumping or running, lying down on your stomach or your back. We are able to gauge, with highly sensitive equipment, what’s going on with the foot and rest of the body based on subtle movements that occur in the trunk.

“We used to think that it was the number of steps that people took that might predict whether they got a wound or not,” Dr. Armstrong said. “The more steps you took, the more likely you were to get a blister, which would become a wound.”

But Dr. Armstrong now believes that other movements may be responsible and walking in short bursts around the home actually may be more dangerous than walking a mile outdoors. “It might not be occurring during the walking, but during the starting and stopping. The great news about this is that these problems are preventable. And one of the ways they are preventable is in better assessing activity levels in patients.”

Dr. Armstrong hopes sensors ultimately will be available to all people with diabetes, possibly embedded in cell phones. If an individual is moving in a manner that is more likely to cause a wound, the person and his or her physician will be alerted electronically.

“This could be like a home security system for your body,” Dr. Armstrong said.

The study aims to help researchers determine the most effective forms of exercise and activity for people with diabetes.

“We want people to be as active as they can be, but we don’t want them to be active in a way that hurts them,” Dr. Armstrong said. “We think there’s a happy medium. We want to get people back to living their lives.”

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