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Continuous Activity Monitoring in Persons at High Risk for Diabetes-Related Lower-Extremity Amputation

David G. Armstrong, DPM^*, Patricia L. Abu-Rumman, DPM, Brent P. Nixon, DPM and Andrew J.M. Boulton, MD

^* Director of Research and Education, Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, Tucson, AZ; Visiting Senior Lecturer of Medicine, Department of Medicine, Manchester Royal Infirmary, Manchester, UK. Mailing address: Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, 3601 S Sixth Ave, Tucson, AZ 85723.
Submitted during second-year residency, Department of Surgery, Podiatry Service, Southern Arizona Veterans Affairs Health Care System, Tucson, AZ.
Chief of Podiatry Service, Department of Surgery, Podiatry Service, Southern Arizona Veterans Affairs Health Care System, Tucson, AZ.
Professor, University Department of Medicine, Manchester Royal Infirmary, Manchester, UK.

Abstract

This study evaluated the magnitude and location of activity of diabetic patients at high risk for foot amputation. Twenty subjects aged 64.6 ± 1.8 years with diabetes, neuropathy, deformity, or a history of lower-extremity ulceration or partial foot amputation were dispensed a continuous activity monitor and a log book to record time periods spent in and out of their homes for 1 week. The results indicate that patients took more steps per hour outside their home, but took more steps per day inside their homes. Although 85% of the patients wore their physician-approved shoes most or all of the time while they were outside their homes, only 15% continued to wear them at home. Focusing on protection of the foot during in-home ambulation may be an important factor on which to focus future multidisciplinary efforts to reduce the incidence of ulceration and amputation. The ability to continuously monitor the magnitude, duration, and time of activity ultimately may assist clinicians in dosing activity just as they dose drugs. (J Am Podiatr Med Assoc 91(9): 451-455, 2001)

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