Schneider Kristin L, Crews Ryan T, Subramanian Vasanth, Moxley Elizabeth, Hwang Sungsoon, DiLiberto Frank E, Aylward Laura, Bean Jermaine, Yalla Sai
1 Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
2 Northern Illinois University, Dekalb, IL, USA.
J Diabetes Sci Technol. 2019 Sep;13(5):857-868. doi: 10.1177/1932296818822538. Epub 2019 Jan 18.
Among adults with diabetes, 19-34% will develop a diabetic foot ulcer (DFU), which increases amputation risk and health care costs, and worsens quality of life. Regular physical activity, when increased gradually, may help prevent DFUs. In this mixed-methods study, we examined the feasibility of a low-intensity, technology-based behavioral intervention to increase activity in adults at risk for DFUs.
Participants at risk for a DFU (n = 12; 66% female; mean age = 59.9 years) received four in-person exercise and behavioral counseling sessions over 2-3 weeks, supplemented with use of an activity monitor (to track steps) and text messages (to reinforce behavioral strategies) for an added 8 weeks. Pre- and postintervention assessments of accelerometer measured activity, daily mobility, and glycemic control (A1C) were completed. Treatment acceptability was assessed by questionnaire and via key informant interview.
The program appears feasible since all but one participant attended all four sessions, all used the activity monitor and all responded to text messages. Treatment acceptability (scale: 1 = very dissatisfied, 5 = extremely satisfied) was high; average item ratings were 4.79 (SD = 0.24). Participants increased their steps by an average of 881.89 steps/day ( = 0.66). A1C decreased on average by 0.33% ( = 0.23). Daily mobility did not change. Interview results suggest that participants perceived benefits from the intervention. Participant recommended improvements included providing more physical activity information, addressing pain, and intervention delivery in a podiatry clinic.
Individuals at risk for a DFU might benefit from a minimally intensive, technology-based intervention to increase their physical activity. Future research comparing the intervention to usual care is warranted.
在成年糖尿病患者中，19%至34%会发生糖尿病足溃疡（DFU），这会增加截肢风险和医疗成本，并降低生活质量。逐渐增加规律的体育活动可能有助于预防糖尿病足溃疡。在这项混合方法研究中，我们检验了一种基于技术的低强度行为干预措施在增加糖尿病足溃疡高危成年人身体活动方面的可行性。
12名糖尿病足溃疡高危参与者（66%为女性；平均年龄59.9岁）在2至3周内接受了4次面对面的运动和行为咨询课程，并在接下来的8周内辅以使用活动监测器（追踪步数）和短信（强化行为策略）。完成了干预前后通过加速度计测量的身体活动、日常活动能力和血糖控制（糖化血红蛋白）评估。通过问卷调查和关键信息提供者访谈评估治疗的可接受性。
该项目似乎可行，因为除一名参与者外，所有参与者都参加了全部4次课程，所有人都使用了活动监测器，并且所有人都回复了短信。治疗可接受性较高（量表：1 = 非常不满意，5 = 极其满意）；平均项目评分是4.79（标准差 = 0.24）。参与者平均每天增加881.89步（ = 0.66）。糖化血红蛋白平均下降0.33%（ = 0.23）。日常活动能力没有变化。访谈结果表明参与者认为该干预有好处。参与者建议的改进包括提供更多体育活动信息、解决疼痛问题以及在足病诊所提供干预。
糖尿病足溃疡高危个体可能会从这种最低强度的基于技术的干预中受益，以增加他们的身体活动。有必要开展未来研究，将该干预与常规护理进行比较。
