1. Introduction
DFUs, diabetic foot ulcer, diabetic foot ulcers, ulcer, diabetes
DIABETES, ULCER, DIABETIC FOOT ULCER, DIABETIC FOOT ULCERS
People with diabetic foot ulcers (DFUs) are commonly prescribed offloading walkers, but inadequate adherence to prescribed use can be a barrier to ulcer healing. This study examined user perspectives of offloading walkers to provide insight on ways to help promote adherence. Participants were randomized to wear: (1) irremovable, (2) removable, or (3) smart removable walkers (smart boot) that provided feedback on adherence and daily walking. Participants completed a 15-item questionnaire based on the Technology Acceptance Model (TAM). Spearman correlations assessed associations between TAM ratings with participant characteristics. Chi-squared tests compared TAM ratings between ethnicities, as well as 12-month retrospective fall status. A total of 21 adults with DFU (age 61.5 ± 11.8 years) participated. Smart boot users reported that learning how to use the boot was easy (ρ =−0.82, Of the estimated 30 million people in the US with diabetes, 34% will develop a diabetic foot ulcer (DFU) in their lifetime [However, inadequate adherence to the prescribed use of offloading devices could be a potential barrier to ulcer healing. Irremovable knee-high offloading devices are recommended for offloading intervention [Despite adherence being a barrier to ulcer healing, few studies have investigated patient perceptions of offloading devices to help inform ways to improve adherence [With advances in wearables, digital health, and remote patient monitoring technology, new solutions have emerged to help actively engage patients in caring for their wound, rather being passive recipients of wound care. However, patients’ acceptance of these solutions, as well as factors that may influence perceptions, are still unknown. Park et al. proposed the concept of smart offloading to reinforce adherence in using offloading devices and tested its proof of concept validity, comfort level, and ease of use in healthy adults without DFUs [This study is the first to explore perceptions surrounding smart offloading with real-time feedback in people with DFUs, and what participant characteristics may be associated with acceptability. The objective of this study was to examine user perspectives of irremovable, removable, and sensorized offloading walkers to provide insight on ways to help promote adherence. This study also sought to gain insight about factors associated with the acceptance of a smart offloading device with a remote patient monitoring component. Research outcomes were user perspectives on offloading boots, which were expressed through a questionnaire based on the Technology Acceptance Model.