Preliminary Findings of Low-Cost Interventions to Increase Physical Activity in Adults at Risk for a Diabetic Foot Ulcer

Purpose: Physical activity (PA) is not contraindicated for those at risk for diabetic foot ulcers (DFU) and increasing PA may actually reduce DFU risk. However, supervised interventions are typically not reimbursable and can be burdensome. The present study tests the feasibility of lowcost PA strategies for adults at risk for DFUs. Methods: Five moderate/high risk patients have completed the study. DFU preventative measures of plantar pressure customized insoles, diabetic shoes, and an infrared foot thermometer were provided to participants. Participants completed four 1-hour supervised PA sessions including training in safely increasing PA and strategies for increasing PA over a 2-week period. Then participants completed 8 weeks of low-cost behavioral and technological (commercial activity monitorFitbit, online social network & text messaging) PA interventions. Baseline and end of study location-specific PA was measured for 1 week by syncing a GPS monitor and tri-axial accelerometer (Figure 1). End of study key informant interviews were conducted. Results: Three females and 2 males aged 63.4 year (range: 56-74 year) with a BMI of 36.8 (range: 30.4-46.4) participated. Four of the subjects completed all 4 supervised PA sessions and the fifth completed 2 sessions. Subjects met their weekly step count goals 66.7% of the weeks they were given (range: 33.3-100%). Baseline and end of study PA metrics are presented in Table 1. Subjects reduced their baseline Hba1c of 7.80 (range: 7.0-8.4) to 7.65 (range: 6.7-8.8) at end of study. Initial results of key-informant interviews suggest that the use of in-person physical activity sessions, the text messages, and the commercial activity monitor were the most preferred aspects of the intervention. Participants rarely accessed the online social network due to limitations in its functionality. Discussion: These preliminary findings suggest low-cost behavioral and technological interventions may potentially be able to improve PA profiles of at-risk individuals. In addition to benefiting glycemic control, improvements in 763635 DSTXXX10.1177/1932296818763635Journal of Diabetes Science and Technology Editorial editorial2018 2017 Diabetic Foot Conference Abstracts Figure 1. Minutes spent on weight bearing activities (WBA) at out-of-home stops by subject 01 preintervention. 860 Journal of Diabetes Science and Technology 12(4) PA may also reduce DFU risk as previous studies of at-risk patients have associated low average PA levels with higher DFU risk.