Ryan T Crews1, David G Armstrong, Andrew J M Boulton. 1. Scholl's Center for Lower Extremity Ambulatory Research (CLEAR) at Rosalind Franklin University of Medicine and Science, Chicago, IL 60064, USA. ryan.crews@rosalindfranklin.edu
Abstract
BACKGROUND: Off-loading excessive pressure is essential to healing diabetic foot ulcers. However, many patients are not compliant in using prescribed footwear or off-loading devices. We sought to validate a method of objectively measuring off-loading compliance via activity monitors. METHODS: For 4 days, a single subject maintained a written compliance diary concerning use of a removable cast walker. He also wore a hip-mounted activity monitor during all waking hours. An additional activity monitor remained mounted on the cast walker at all times. At the conclusion of the 4 days, the time-stamped hip activity data were independently coded for walker compliance by the compliance diary and by using the time-stamped walker activity data. RESULTS: An intraclass reliability of 0.93 was found between diary-coded and walker monitor-coded activity. CONCLUSIONS: These results support the use of this dual activity monitor approach for assessing off-loading compliance. An advantage of this approach versus a patient-maintained diary is that the monitors are not susceptible to incorrect patient recall or a patient's desire to please a caregiver by reporting inflated compliance. Furthermore, these results seem to lend support to existing reports in the literature using similar methods.
BACKGROUND: Off-loading excessive pressure is essential to healing diabetic foot ulcers. However, many patients are not compliant in using prescribed footwear or off-loading devices. We sought to validate a method of objectively measuring off-loading compliance via activity monitors. METHODS: For 4 days, a single subject maintained a written compliance diary concerning use of a removable cast walker. He also wore a hip-mounted activity monitor during all waking hours. An additional activity monitor remained mounted on the cast walker at all times. At the conclusion of the 4 days, the time-stamped hip activity data were independently coded for walker compliance by the compliance diary and by using the time-stamped walker activity data. RESULTS: An intraclass reliability of 0.93 was found between diary-coded and walker monitor-coded activity. CONCLUSIONS: These results support the use of this dual activity monitor approach for assessing off-loading compliance. An advantage of this approach versus a patient-maintained diary is that the monitors are not susceptible to incorrect patientrecall or a patient's desire to please a caregiver by reporting inflated compliance. Furthermore, these results seem to lend support to existing reports in the literature using similar methods.
Authors: Ryan T Crews; Biing-Jiun Shen; Laura Campbell; Peter J Lamont; Andrew J M Boulton; Mark Peyrot; Robert S Kirsner; Loretta Vileikyte Journal: Diabetes Care Date: 2016-06-06 Impact factor: 19.112