Adherence and Wearing Time of Prescribed Footwear among People at Risk of Diabetes-Related Foot Ulcers: Which Measure to Use?

Adherence to prescribed footwear is essential to prevent diabetes-related foot ulcers. The aim was to compare different measures of adherence and wearing time of prescribed footwear with a reference adherence measure, among people with diabetes at high risk of foot ulceration. We followed 53 partici...

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Main Authors: Gustav Jarl, Chantal M. Hulshof, Tessa E. Busch-Westbroek, Sicco A. Bus, Jaap J. van Netten
Format: Article
Language:English
Published: MDPI AG 2023-02-01
Series:Sensors
Subjects:
Online Access:https://www.mdpi.com/1424-8220/23/3/1648
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author Gustav Jarl
Chantal M. Hulshof
Tessa E. Busch-Westbroek
Sicco A. Bus
Jaap J. van Netten
author_facet Gustav Jarl
Chantal M. Hulshof
Tessa E. Busch-Westbroek
Sicco A. Bus
Jaap J. van Netten
author_sort Gustav Jarl
collection DOAJ
description Adherence to prescribed footwear is essential to prevent diabetes-related foot ulcers. The aim was to compare different measures of adherence and wearing time of prescribed footwear with a reference adherence measure, among people with diabetes at high risk of foot ulceration. We followed 53 participants for 7 consecutive days. A temperature sensor measured wearing time of prescribed footwear and a triaxial accelerometer assessed weight-bearing activities. Subjective wearing time was self-reported. Reference adherence measure was proportion of weight-bearing time prescribed footwear was worn. We calculated Spearman’s correlation coefficients, kappa coefficients, and areas under the curve (AUC) for the association between the reference measure and other measures of adherence and wearing time. Proportion of daily steps with prescribed footwear worn had a very strong association (r = 0.96, Κ = 0.93; AUC: 0.96–1.00), objective wearing time had a strong association (r = 0.91, Κ = 0.85, AUC: 0.89–0.99), and subjective wearing time had a weak association (r = 0.42, Κ = 0.38, AUC: 0.67–0.81) with the reference measure. Objectively measured proportion of daily steps with prescribed footwear is a valid measure of footwear adherence. Objective wearing time is reasonably valid, and may be used in clinical practice and for long-term measurements. Subjective wearing time is not recommended to be used.
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spelling doaj.art-779cd2cee1a14e0ca59e7b08fb823f332023-11-16T18:04:11ZengMDPI AGSensors1424-82202023-02-01233164810.3390/s23031648Adherence and Wearing Time of Prescribed Footwear among People at Risk of Diabetes-Related Foot Ulcers: Which Measure to Use?Gustav Jarl0Chantal M. Hulshof1Tessa E. Busch-Westbroek2Sicco A. Bus3Jaap J. van Netten4Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, SwedenDepartment of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The NetherlandsDepartment of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The NetherlandsDepartment of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The NetherlandsDepartment of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The NetherlandsAdherence to prescribed footwear is essential to prevent diabetes-related foot ulcers. The aim was to compare different measures of adherence and wearing time of prescribed footwear with a reference adherence measure, among people with diabetes at high risk of foot ulceration. We followed 53 participants for 7 consecutive days. A temperature sensor measured wearing time of prescribed footwear and a triaxial accelerometer assessed weight-bearing activities. Subjective wearing time was self-reported. Reference adherence measure was proportion of weight-bearing time prescribed footwear was worn. We calculated Spearman’s correlation coefficients, kappa coefficients, and areas under the curve (AUC) for the association between the reference measure and other measures of adherence and wearing time. Proportion of daily steps with prescribed footwear worn had a very strong association (r = 0.96, Κ = 0.93; AUC: 0.96–1.00), objective wearing time had a strong association (r = 0.91, Κ = 0.85, AUC: 0.89–0.99), and subjective wearing time had a weak association (r = 0.42, Κ = 0.38, AUC: 0.67–0.81) with the reference measure. Objectively measured proportion of daily steps with prescribed footwear is a valid measure of footwear adherence. Objective wearing time is reasonably valid, and may be used in clinical practice and for long-term measurements. Subjective wearing time is not recommended to be used.https://www.mdpi.com/1424-8220/23/3/1648diabetic footfoot ulcertreatment adherence and compliancepatient compliancefootwearshoes
spellingShingle Gustav Jarl
Chantal M. Hulshof
Tessa E. Busch-Westbroek
Sicco A. Bus
Jaap J. van Netten
Adherence and Wearing Time of Prescribed Footwear among People at Risk of Diabetes-Related Foot Ulcers: Which Measure to Use?
Sensors
diabetic foot
foot ulcer
treatment adherence and compliance
patient compliance
footwear
shoes
title Adherence and Wearing Time of Prescribed Footwear among People at Risk of Diabetes-Related Foot Ulcers: Which Measure to Use?
title_full Adherence and Wearing Time of Prescribed Footwear among People at Risk of Diabetes-Related Foot Ulcers: Which Measure to Use?
title_fullStr Adherence and Wearing Time of Prescribed Footwear among People at Risk of Diabetes-Related Foot Ulcers: Which Measure to Use?
title_full_unstemmed Adherence and Wearing Time of Prescribed Footwear among People at Risk of Diabetes-Related Foot Ulcers: Which Measure to Use?
title_short Adherence and Wearing Time of Prescribed Footwear among People at Risk of Diabetes-Related Foot Ulcers: Which Measure to Use?
title_sort adherence and wearing time of prescribed footwear among people at risk of diabetes related foot ulcers which measure to use
topic diabetic foot
foot ulcer
treatment adherence and compliance
patient compliance
footwear
shoes
url https://www.mdpi.com/1424-8220/23/3/1648
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