{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:46:36Z","timestamp":1787064396699,"version":"build-2736575974"},"reference-count":27,"publisher":"American Diabetes Association","issue":"6","license":[{"start":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T00:00:00Z","timestamp":1630108800000},"content-version":"vor","delay-in-days":3027,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Prescription custom-made footwear can only be effective in preventing diabetic foot ulcers if worn by the patient. Particularly, the high prevalence of recurrent foot ulcers focuses the attention on adherence, for which objective data are nonexisting. We objectively assessed adherence in patients with high risk of ulcer recurrence and evaluated what determines adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>In 107 patients with diabetes, neuropathy, a recently healed plantar foot ulcer, and custom-made footwear, footwear use was measured during 7 consecutive days using a shoe-worn, temperature-based monitor. Daily step count was measured simultaneously using an ankle-worn activity monitor. Patients logged time away from home. Adherence was calculated as the percentage of steps that prescription footwear was worn. Determinants of adherence were evaluated in multivariate linear regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Mean \u00b1 SD adherence was 71 \u00b1 25%. Adherence at home was 61 \u00b1 32%, over 3,959 \u00b1 2,594 steps, and away from home 87 \u00b1 26%, over 2,604 \u00b1 2,507 steps. In 35 patients with low adherence (&amp;lt;60%), adherence at home was 28 \u00b1 24%. Lower BMI, more severe foot deformity, and more appealing footwear were significantly associated with higher adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The results show that adherence to wearing custom-made footwear is insufficient, particularly at home where patients exhibit their largest walking activity. This low adherence is a major threat for reulceration. These objective findings provide directions for improvement in adherence, which could include prescribing specific off-loading footwear for indoors, and they set a reference for future comparative research on footwear adherence in diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc12-1330","type":"journal-article","created":{"date-parts":[[2013,1,16]],"date-time":"2013-01-16T00:03:08Z","timestamp":1358294588000},"page":"1613-1618","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":125,"title":["Adherence to Wearing Prescription Custom-Made Footwear in Patients With Diabetes at High Risk for Plantar Foot Ulceration"],"prefix":"10.2337","volume":"36","author":[{"given":"Roelof","family":"Waaijman","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renske","family":"Keukenkamp","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"de Haart","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojtek P.","family":"Polomski","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Spaarne Hospital, Hoofddorp, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans","family":"Nollet","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sicco A.","family":"Bus","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Department of Surgery, Hospital Group Twente, Almelo, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2013,5,15]]},"reference":[{"key":"2022031222454926800_B1","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1002\/dmrr.2253","article-title":"Practical guidelines on the management and prevention of the diabetic foot 2011","volume":"28","author":"Bakker","year":"2012","journal-title":"Diabetes Metab Res Rev"},{"key":"2022031222454926800_B2","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1002\/(SICI)1096-9136(199710)14:10<867::AID-DIA475>3.0.CO;2-L","article-title":"Factors contributing to the presentation of diabetic foot ulcers","volume":"14","author":"Macfarlane","year":"1997","journal-title":"Diabet Med"},{"key":"2022031222454926800_B3","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1007\/BF00400259","article-title":"The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study","volume":"35","author":"Veves","year":"1992","journal-title":"Diabetologia"},{"key":"2022031222454926800_B4","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.1002\/dmrr.435","article-title":"Therapeutic footwear for people with diabetes","volume":"20","author":"Cavanagh","year":"2004","journal-title":"Diabetes Metab Res Rev"},{"key":"2022031222454926800_B5","doi-asserted-by":"crossref","first-page":"441","DOI":"10.2337\/diacare.26.2.441","article-title":"The influence of shoe design on plantar pressures in neuropathic feet","volume":"26","author":"Praet","year":"2003","journal-title":"Diabetes Care"},{"key":"2022031222454926800_B6","doi-asserted-by":"crossref","first-page":"1542","DOI":"10.1111\/j.1464-5491.2012.03700.x","article-title":"Pressure-reduction and preservation in custom-made footwear of patients with diabetes and a history of plantar ulceration","volume":"29","author":"Waaijman","year":"2012","journal-title":"Diabet Med"},{"key":"2022031222454926800_B7","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1002\/dmrr.446","article-title":"Repetitive ulceration in neuropathic patients","volume":"20","author":"Connor","year":"2004","journal-title":"Diabetes Metab Res Rev"},{"key":"2022031222454926800_B8","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1111\/j.1464-5491.1990.tb01404.x","article-title":"How effective is cushioned therapeutic footwear in protecting diabetic feet? 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