January 2014

Compliance with prescribed footwear depends on perceived clinical benefit

In the moment: Diabetes

By Emily Delzell

Practitioners should educate patients with diabetes about benefits of custom therapeutic footwear to encourage its use, according to a usability survey conducted by Dutch investigators.

Researchers in the departments of rehabilitation at the University of Amsterdam and two Dutch hospitals recruited 153 patients with diabetes, peripheral neuropathy, prior plantar foot ulceration, and newly prescribed custom-made footwear.

Patients answered questions about their perception of weight, appearance, comfort, durability, donning and doffing, stability, benefit, and overall appreciation of footwear. Patients also reported on usability and footwear use priorities.

The overall appreciation score was 8.3 on a 10-point visual analog scale. Other scores ranged from 6.5 for weight to 9.6 for donning/doffing. Footwear comfort was most commonly listed (33.3%) as the highest priority. More than half (58%) of patients wore footwear less than 60% of daytime hours (defined as 16 hours/day). Only the perceived benefit of the footwear was a significant determinant of its use.

The researchers epublished the results on December 19 in the Journal of Rehabilitation Medicine.


Arts MLJ, de Haart M, Bus SA, et al. Perceived usability and use of custom-made footwear in diabetic patients at high risk for foot ulceration. J Rehabil Med 2013 Dec 19. [Epub ahead of print.]

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