Article

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.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS