Study | Participants | DFU | Aim | Interventions | Activity Monitor | Follow Up | Activity Outcomes | Other Outcomes | Findings |
---|---|---|---|---|---|---|---|---|---|
Ababneh et al. [28] Jordan | N = 57 M n = 45 F n = 12 Mean age 56 (SD 10) | Forefoot or midfoot plantar DFU | To investigate levels and factors/ psychosocial factors, associated with adherence to RCW | RCW | i) Wrist band activity monitor (Fitbit Flex) ii) Boot worn activity monitor Data downloaded after 7 days. | 1 week | Total steps/day Activity units = correlated at least 50% of time | Device adherence | Activity Total median 2758 (IQR 1729–4726) daily steps RCW device worn 34% (SD 17%) of total weight-bearing activity. Ulcer healing Not reported |
Armstrong et al. [25] USA | N = 20 M n = 14 F n = 6 Mean age 65 (SD 7.6) | Non-infected, non-ischaemic superficial Texas grade 1A. | To evaluate activity and adherence to RCW | RCW | i) Waist worn accelerometer/pedometer (Biotrainer Pro; IM Systems, Boston, MA). ii) Boot-worn accelerometer /pedometer (Biotrainer Pro; IM Systems, Boston, MA). Data recorded 24 hours/day | 1 week | Total activity (steps/day). ‘Active use’ = correlated between devices. | Device adherence | Activity Total mean 1219 (SD 821) steps/ day. RCW off 873.7 (SD 828) RCW on 345.3 (SD 219); p = 0.01 28% of total daily activity occurred while RCW worn. Ulcer healing Not reported |
Saltzman et al. [26] USA | N = 40 M n = 25 F n = 15 Median age 52 | Active Wagner Grade I plantar DFU | To evaluate compliance with recommended non-weight-bearing and rate of ulcer healing | TCC | StepWatch monitor (Cyma, Seattle, Washington) incorporated into TCC. Data capture during device change every 1 to 2 weeks | 13 weeks | Steps per 24, 48 hours and over remaining 13 weeks. | Ulcer healing by 13 weeks | Activity 24 hours: median 523 steps 48 hours: median 808 steps Median 2083 steps over remaining weeks Ulcer healing 32/40 (80%) healed (median 6 weeks) |
Crews et al. [27] USA/UK | N = 79 with adherence data from larger cohort of n = 118 N = 46 UK N = 33 USA M n = 66 F n = 13 Mean age 56.5 (9.6) | Texas grade 1A up to 2D | To assess association between off-loading adherence and DFU healing (Secondary analysis) | RCW n = 61 Sandal n = 13 Other n = 5 | i) Waist worn activity monitor (Lifecorder Plus, Suzuken) ii) Lifecoder Plus (Suzuken) device concealed in off-loading device. Data uploaded by clinician. Adherence = boot device correlated > 50% of waist device activity. | 6 weeks | Physical activity (hours/day) | Change in ulcer area; Device adherence (days); Not reported Hospital Anxiety Depression Scale; NeuroQOL; IPQ-R. | Activity Mean hours/day active 6.7 (SD 3.8) Device adherence mean 35 (SD 10) days or 59% of time active. Ulcer Healing 19/79 (24%) Mean ulcer size reduction 230 mm2 to 106mm2; p = 0.001. |