New Monitoring Technology to Objectively Assess Adherence to Prescribed Footwear and Assistive Devices During Ambulatory Activity
New Monitoring Technology to Objectively Assess Adherence to Prescribed Footwear and Assistive Devices During Ambulatory Activity
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DOI：
10.1016/j.apmr.2012.06.019
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发表时间：
2012-11-01
影响因子：
4.3
通讯作者：
Nolet, Frans
中科院分区：
文献类型：
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作者：
Bus, Sicco A.;Waaijman, Roelof;Nolet, Frans
Bus SA, Waaijman R, Nollet F.一种新的监测技术来客观地评估门诊活动中处方鞋类和辅助器具的依从性。中华医学杂志（英文版）；2012;33(3):391 - 391。目的：评估一种新型基于温度的粘附性监测鞋的有效性和可行性。设计：观察性研究。地点：大学医疗中心和参与者的家。参与者：方便样本：健康受试者（n=11）和足部溃疡高风险的神经性糖尿病患者（n=14）。干预措施：在健康受试者中，通过比较其在7天内穿鞋和脱鞋的记录与准确保存的日志记录，来调查鞋内附着性监测仪的有效性。在糖尿病患者中，使用7天的依从性监测仪与时间同步的踝关节步行活动监测仪来记录步行时规定的鞋类使用情况的可行性进行了评估。此外，还完成了可用性问卷调查。主要结果测量：对于效度，计算依从性监测仪记录的穿/脱鞋时刻与日志记录的平均时差和95%置信区间（Cl）。为了可行性，评估了技术性能、可用性和穿鞋的步数百分比（依从性）。结果：依从性监测与日志记录的平均时差为0.4分钟（95% CI, 0.2-0.6min）。糖尿病患者记录错误1例，记录不完整2例。3名患者报告对步活动监测仪感到不适，4名患者不赞成重复测试。患者走路的9%到99%都穿鞋。结论：依从性监测在测量是否穿鞋时具有良好的有效性，与步行活动仪器监测一起，是评估治疗依从性的一种可行、客观的方法。该方法可广泛应用于临床实践和研究处方鞋和其他身体穿戴辅助装置。
Bus SA, Waaijman R, Nollet F. New monitoring technology to objectively assess adherence to prescribed footwear and assistive devices during ambulatory activity. Arch Phys Med Rehabil 2012;93:2075-9.Objective: To assess the validity and feasibility of a new temperature-based adherence monitor to measure footwear use.Design: Observational study.Setting: University medical center and participants' homes.Participants: Convenience sample of healthy subjects (n=11) and neuropathic diabetic patients at high risk for foot ulceration (n=14).Interventions: In healthy subjects, the validity of the in-shoe attached adherence monitor was investigated by comparing its registrations of donning and doffing of footwear during 7 days to an accurately kept log registration. In diabetic patients, the feasibility of using the adherence monitor for 7 days in conjunction with a time-synchronized ankle-worn step activity monitor to register prescribed footwear use during walking was assessed. Furthermore, a usability questionnaire was completed.Main Outcome Measures: For validity, the mean time difference and 95% confidence interval (Cl) between moments of donning/doffing footwear recorded with the adherence monitor and in the log were calculated. For feasibility, technical performance, usability, and the percentage of steps that the footwear was worn (adherence) were assessed.Results: The mean time difference between the adherence monitor and log recordings was 0.4 minutes (95% CI, 0.2-0.6min). One erroneous recording and 2 incomplete recordings were obtained in diabetic patients. Three patients reported discomfort with the step activity monitor, and 4 patients would not favor repeated testing. Patients used their footwear for between 9% and 99% of their walking steps.Conclusions: The adherence monitor shows good validity in measuring when footwear is used or not, and is, together with instrumented monitoring of walking activity, a feasible and objective method to assess treatment adherence. This method can have wide application in clinical practice and research regarding prescribed footwear and other body-worn assistive devices.