Affiliation:
1. Department of Prosthetics and Orthotics Faculty of Medicine and Health Örebro University Örebro Sweden
2. University Health Care Research Center Faculty of Medicine and Health Örebro University Örebro Sweden
3. Department of Rehabilitation Medicine Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands
4. Amsterdam Movement Sciences, Rehabilitation & Development Amsterdam The Netherlands
Abstract
AbstractIntroductionAdherence to wearing prescribed footwear is paramount in reducing the risk of developing diabetes‐related foot ulcers, but adherence is often lower than optimal. This study aimed to investigate predictors of footwear adherence and variations in adherence and activity in people at risk of diabetes‐related foot ulceration.MethodsSixty people at high foot ulcer risk were included. We measured the proportion of weight‐bearing acitivity time the prescribed footwear was worn for seven days. Multiple linear regression and analysis of variance were used.ResultsMean overall adherence was 63%. Adherence was lower at home than away from home (59% vs. 74%), while activity was higher at home (2.2 vs. 1.2 h/day). Adherence was similar across activities (61%–63%). No variable predicted the overall adherence. Higher Hba1c predicted lower adherence at home (β = −0.34, p = 0.045, R2 = 11.6%). More daily steps predicted lower adherence away from home (β = −0.30, p = 0.033, R2 = 9.3%). Adherence and activity were highest in mornings (71%, 1.1 h) and afternoons (71%, 1.5 h), and lower in evenings (40%, 0.8 h) and at nights (9%, 0.1 h). Adherence was similar on weekdays and weekend days (63% vs. 60%), but activity was higher on weekdays (3.4 vs. 3.0 h).ConclusionAdherence levels and predictors thereof differed between adherence at home and away from home, so we suggest to treat them as different concepts. Due to the low explained variance, future studies should focus on other predictors such as psychological variables.