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“Smart Boots Hold Promise for Improving Adherence to Diabetic Foot Ulcer Treatment– Especially Among Underserved Populations, New Study Shows”
A recent study entitle “Taking a Load Off” published in the journal Sensors has shown that the use of smart offloading walkers for diabetic foot ulcers (DFUs) could help promote adherence to prescribed use, particularly among underserved populations. The study, led by co-senior authors David G. Armstrong, Professor of Surgery at the University of Southern California, and Bijan Najafi, Professor in Surgery at Baylor College of Medicine, and funded by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases Award Number 1R01124789-01A1, aimed to examine user perspectives of offloading walkers to gain insight into ways to promote adherence and ultimately aid in ulcer healing.
Participants in the study were randomized to wear one of three types of walkers: irremovable, removable, or smart removable walkers (smart boot) that provided feedback on adherence and daily walking. The researchers used a 15-item questionnaire based on the Technology Acceptance Model (TAM) to assess user perspectives of the walkers. The study found that smart boot users reported that learning how to use the boot was easy, and that people who identified as Hispanic or Latino were more likely to like using the smart boot and would use it in the future.
According to co-senior author Bijan Najafi, “Our study provides important evidence that smart offloading walkers could help improve adherence to prescribed use among underserved populations, ultimately leading to better outcomes for patients with DFUs. By understanding user perspectives and preferences, we can work towards optimizing the design and implementation of this technology in clinical practice, with the goal of improving access to care and reducing health disparities.”
Further research in this area could help optimize the design and implementation of this technology in clinical practice. Co-senior author David G. Armstrong, Professor of Surgery at the University of Southern California, concluded, “We were surprised – pleasantly – by these initial results. We think that it is pointing the way to merging precision health and technology to help our patients move through the world a little bit better and ultimately prevent unecessary amputations in our patients with diabetes.”
Taking a Load Off: User Perceptions of Smart Offloading Walkers for Diabetic Foot Ulcers Using the Technology Acceptance Model
by
M. G. Finco 1,
Gozde Cay 1,
Jason Garcia 2,
Elia Salazar 2,
Tze-Woei Tan 2,
David G. Armstrong 2 and
Bijan Najafi 1,*
Abstract
People with diabetic foot ulcers (DFUs) are commonly prescribed offloading walkers, but inadequate adherence to prescribed use can be a barrier to ulcer healing. This study examined user perspectives of offloading walkers to provide insight on ways to help promote adherence. Participants were randomized to wear: (1) irremovable, (2) removable, or (3) smart removable walkers (smart boot) that provided feedback on adherence and daily walking. Participants completed a 15-item questionnaire based on the Technology Acceptance Model (TAM). Spearman correlations assessed associations between TAM ratings with participant characteristics. Chi-squared tests compared TAM ratings between ethnicities, as well as 12-month retrospective fall status. A total of 21 adults with DFU (age 61.5 ± 11.8 years) participated. Smart boot users reported that learning how to use the boot was easy (ρ =−0.82, p ≤≤ 0.001). Regardless of group, people who identified as Hispanic or Latino, compared to those who did not, reported they liked using the smart boot (p = 0.05) and would use it in the future (p = 0.04). Non-fallers, compared to fallers, reported the design of the smart boot made them want to wear it longer (p = 0.04) and it was easy to take on and off (p = 0.04). Our findings can help inform considerations for patient education and design of offloading walkers for DFUs.
Keywords:
diabetic foot; smart offloading; remote patient monitoring; adherence; foot care; foot ulcer; wearable; digital health; telehealth
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