Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
J Foot Ankle Res. 2024 Sep;17(3):e70002. doi: 10.1002/jfa2.70002.
Adherence 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.
Sixty 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.
Mean 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, R = 11.6%). More daily steps predicted lower adherence away from home (β = -0.30, p = 0.033, R = 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).
Adherence 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.
坚持穿规定的鞋子对于降低糖尿病相关足部溃疡的风险至关重要，但依从性往往低于最佳水平。本研究旨在调查预测因素与易患糖尿病性足部溃疡人群的鞋类依从性和活动度变化。
共纳入 60 名足部溃疡高风险患者。我们测量了在一周内规定的鞋子穿着时的承重活动时间占比。采用多元线性回归和方差分析进行分析。
总体依从率平均为 63%。在家中穿着的依从性低于离家时（59%比 74%），而在家中的活动量更高（2.2 小时/天比 1.2 小时/天）。各种活动中的依从性相似（61%-63%）。没有变量可以预测总体依从性。HbA1c 越高，在家中的依从性越低（β=-0.34，p=0.045，R²=11.6%）。每天的步数越多，离家时的依从性越低（β=-0.30，p=0.033，R²=9.3%）。在早晨（71%，1.1 小时）和下午（71%，1.5 小时），依从性和活动量最高，而在晚上（40%，0.8 小时）和夜间（9%，0.1 小时）最低。工作日和周末的依从性相似（63%比 60%），但工作日的活动量更高（3.4 小时比 3.0 小时）。
在家中与离家时的依从性水平及其预测因素不同，因此我们建议将它们视为不同的概念。由于解释方差较低，未来的研究应重点关注其他预测因素，如心理变量。
