Teresa J. Kelechi, PhD, RN, CWCN, College of Nursing, Medical University of South Carolina, Charleston.
Mohan Madisetti, MS, College of Nursing, Medical University of South Carolina, Charleston.
J Wound Ostomy Continence Nurs. 2020 Mar/Apr;47(2):173-181. doi: 10.1097/WON.0000000000000631.
The purpose of this study was to investigate the use of an mHealth application (app), self-management physical activity intervention FOOTFIT with an added patient-provider connectivity feature (FOOTFIT+), that was designed to strengthen the lower extremities of minimally ambulatory individuals with venous leg ulcers (VLUs).
Randomized controlled trial.
Twenty-four adults 18 years and older with VLUs being treated in 2 wound clinics in the Southeastern United States participated in this study.
Preliminary estimates and 95% confidence intervals for the medians of short-term functional impacts on foot function, strength, ankle range of motion, walking capacity, depression, and physical functioning were obtained pre- and postassessment after the 6-week intervention trial.
There were negligible changes in either group for foot function. It is noted that both groups experienced substantial foot and ankle impairment at baseline. The greatest improvement in range of motion was noted in the FOOTFIT group for dorsiflexion of the right ankle (4.6 ± 5.22 lb/in over baseline) whereas strength decreased in both ankles for dorsiflexion and plantar flexion in the FOOTFIT+ group. No improvements were noted in walking distance or physical health for FOOTFIT (slight decrease -2.9 ± 5.6) and FOOTFIT+ (slight increase 3.0 ± 6.6) during the 6-week study period.
In a minimally ambulatory population with VLUs, our mHealth FOOTFIT intervention composed of progressive exercise "boosts" demonstrated minimal short-term effects. We recommend engagement with the app for a longer period to determine longer-term outcomes of lower extremity function.
本研究旨在调查移动医疗应用程序（app）的使用情况，该应用程序名为 FOOTFIT，是一种自我管理的体育活动干预措施，增加了患者与提供者的连接功能（FOOTFIT+），旨在增强下肢活动能力较弱的静脉溃疡（VLU）患者的下肢功能。
随机对照试验。
本研究纳入了 24 名 18 岁及以上在美国东南部 2 家伤口诊所接受 VLU 治疗的成年人。
在 6 周干预试验前后进行预评估和后评估，获得短期功能对足部功能、力量、踝关节活动范围、步行能力、抑郁和身体功能的中位数的初步估计和 95%置信区间。
两组在足部功能方面几乎没有变化。需要注意的是，两组在基线时都有严重的足部和踝关节损伤。FOOTFIT 组在右踝关节背屈时的活动范围改善最大（4.6±5.22 磅/英寸，高于基线），而 FOOTFIT+组在两个踝关节的背屈和跖屈时力量都下降。在 6 周的研究期间，FOOTFIT（轻微减少-2.9±5.6）和 FOOTFIT+（轻微增加 3.0±6.6）在步行距离或身体健康方面均未得到改善。
在下肢活动能力较弱且患有 VLU 的患者中，我们的由渐进性运动“增强”组成的移动医疗 FOOTFIT 干预措施显示出最小的短期效果。我们建议患者使用该应用程序更长时间，以确定下肢功能的长期结果。
