Sicco A Bus1, Roelof Waaijman, Frans Nollet. 1. Human Performance Laboratory, Department of Rehabilitation, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. s.a.bus@amc.uva.nl
Abstract
OBJECTIVE: To assess the validity and feasibility of a new temperature-based adherence monitor to measure footwear use. DESIGN: Observational study. SETTING: University medical center and participants' homes. PARTICIPANTS: Convenience sample of healthy subjects (n=11) and neuropathic diabetic patients at high risk for foot ulceration (n=14). INTERVENTIONS: In healthy subjects, the validity of the in-shoe attached adherence monitor was investigated by comparing its registrations of donning and doffing of footwear during 7 days to an accurately kept log registration. In diabetic patients, the feasibility of using the adherence monitor for 7 days in conjunction with a time-synchronized ankle-worn step activity monitor to register prescribed footwear use during walking was assessed. Furthermore, a usability questionnaire was completed. MAIN OUTCOME MEASURES: For validity, the mean time difference and 95% confidence interval (CI) between moments of donning/doffing footwear recorded with the adherence monitor and in the log were calculated. For feasibility, technical performance, usability, and the percentage of steps that the footwear was worn (adherence) were assessed. RESULTS: The mean time difference between the adherence monitor and log recordings was 0.4 minutes (95% CI, 0.2-0.6min). One erroneous recording and 2 incomplete recordings were obtained in diabetic patients. Three patients reported discomfort with the step activity monitor, and 4 patients would not favor repeated testing. Patients used their footwear for between 9% and 99% of their walking steps. CONCLUSIONS: The adherence monitor shows good validity in measuring when footwear is used or not, and is, together with instrumented monitoring of walking activity, a feasible and objective method to assess treatment adherence. This method can have wide application in clinical practice and research regarding prescribed footwear and other body-worn assistive devices.
OBJECTIVE: To assess the validity and feasibility of a new temperature-based adherence monitor to measure footwear use. DESIGN: Observational study. SETTING: University medical center and participants' homes. PARTICIPANTS: Convenience sample of healthy subjects (n=11) and neuropathic diabeticpatients at high risk for foot ulceration (n=14). INTERVENTIONS: In healthy subjects, the validity of the in-shoe attached adherence monitor was investigated by comparing its registrations of donning and doffing of footwear during 7 days to an accurately kept log registration. In diabeticpatients, the feasibility of using the adherence monitor for 7 days in conjunction with a time-synchronized ankle-worn step activity monitor to register prescribed footwear use during walking was assessed. Furthermore, a usability questionnaire was completed. MAIN OUTCOME MEASURES: For validity, the mean time difference and 95% confidence interval (CI) between moments of donning/doffing footwear recorded with the adherence monitor and in the log were calculated. For feasibility, technical performance, usability, and the percentage of steps that the footwear was worn (adherence) were assessed. RESULTS: The mean time difference between the adherence monitor and log recordings was 0.4 minutes (95% CI, 0.2-0.6min). One erroneous recording and 2 incomplete recordings were obtained in diabeticpatients. Three patients reported discomfort with the step activity monitor, and 4 patients would not favor repeated testing. Patients used their footwear for between 9% and 99% of their walking steps. CONCLUSIONS: The adherence monitor shows good validity in measuring when footwear is used or not, and is, together with instrumented monitoring of walking activity, a feasible and objective method to assess treatment adherence. This method can have wide application in clinical practice and research regarding prescribed footwear and other body-worn assistive devices.
Authors: Peter A Lazzarini; Ryan T Crews; Jaap J van Netten; Sicco A Bus; Malindu E Fernando; Paul J Chadwick; Bijan Najafi Journal: J Diabetes Sci Technol Date: 2019-04-29
Authors: Marloes Tenten-Diepenmaat; Marike van der Leeden; Thea P M Vliet Vlieland; Leo D Roorda; Joost Dekker Journal: Rheumatol Int Date: 2018-03-20 Impact factor: 2.631
Authors: Sicco A Bus; Jaap J van Netten; Anke Ir Kottink; Erik A Manning; Maximilian Spraul; Arend-Jan Woittiez; Jeff G van Baal Journal: Int Wound J Date: 2017-10-23 Impact factor: 3.315
Authors: Roelof Waaijman; Renske Keukenkamp; Mirjam de Haart; Wojtek P Polomski; Frans Nollet; Sicco A Bus Journal: Diabetes Care Date: 2013-01-15 Impact factor: 19.112
Authors: Yvette L Kerkum; Jaap Harlaar; Annemieke I Buizer; Josien C van den Noort; Jules G Becher; Merel-Anne Brehm Journal: BMC Pediatr Date: 2013-02-01 Impact factor: 2.125
Authors: Sicco A Bus; Roelof Waaijman; Mark Arts; Mirjam de Haart; Tessa Busch-Westbroek; Jeff van Baal; Frans Nollet Journal: Diabetes Care Date: 2013-10-15 Impact factor: 19.112