{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:58:37Z","timestamp":1787320717911,"version":"build-2736575974"},"reference-count":33,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health","award":["1R01124789-01A1"],"award-info":[{"award-number":["1R01124789-01A1"]}]},{"DOI":"10.13039\/100000002","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["1R01124789-01A1"],"award-info":[{"award-number":["1R01124789-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>People with diabetic foot ulcers (DFUs) are commonly prescribed offloading walkers, but inadequate adherence to prescribed use can be a barrier to ulcer healing. This study examined user perspectives of offloading walkers to provide insight on ways to help promote adherence. Participants were randomized to wear: (1) irremovable, (2) removable, or (3) smart removable walkers (smart boot) that provided feedback on adherence and daily walking. Participants completed a 15-item questionnaire based on the Technology Acceptance Model (TAM). Spearman correlations assessed associations between TAM ratings with participant characteristics. Chi-squared tests compared TAM ratings between ethnicities, as well as 12-month retrospective fall status. A total of 21 adults with DFU (age 61.5 \u00b1 11.8 years) participated. Smart boot users reported that learning how to use the boot was easy (\u03c1 =\u22120.82, p\u2264 0.001). Regardless of group, people who identified as Hispanic or Latino, compared to those who did not, reported they liked using the smart boot (p = 0.05) and would use it in the future (p = 0.04). Non-fallers, compared to fallers, reported the design of the smart boot made them want to wear it longer (p = 0.04) and it was easy to take on and off (p = 0.04). Our findings can help inform considerations for patient education and design of offloading walkers for DFUs.<\/jats:p>","DOI":"10.3390\/s23052768","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T02:03:08Z","timestamp":1677808988000},"page":"2768","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Taking a Load Off: User Perceptions of Smart Offloading Walkers for Diabetic Foot Ulcers Using the Technology Acceptance Model"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0637-2772","authenticated-orcid":false,"given":"M. G.","family":"Finco","sequence":"first","affiliation":[{"name":"Interdisciplinary Consortium for Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1985-1772","authenticated-orcid":false,"given":"Gozde","family":"Cay","sequence":"additional","affiliation":[{"name":"Interdisciplinary Consortium for Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8546-5613","authenticated-orcid":false,"given":"Myeounggon","family":"Lee","sequence":"additional","affiliation":[{"name":"Interdisciplinary Consortium for Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Garcia","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7979-5015","authenticated-orcid":false,"given":"Elia","family":"Salazar","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6658-9482","authenticated-orcid":false,"given":"Tze-Woei","family":"Tan","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0320-8101","authenticated-orcid":false,"given":"Bijan","family":"Najafi","sequence":"additional","affiliation":[{"name":"Interdisciplinary Consortium for Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/nyas.13569","article-title":"Update on Management of Diabetic Foot Ulcers","volume":"1411","author":"Everett","year":"2018","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"153","DOI":"10.4239\/wjd.v7.i7.153","article-title":"Diabetic Foot Disease: From the Evaluation of the \u201cFoot at Risk\u201d to the Novel Diabetic Ulcer Treatment Modalities","volume":"7","author":"Amin","year":"2016","journal-title":"World J. 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Available online: https:\/\/iwgdfguidelines.org\/wp-content\/uploads\/2019\/05\/03-IWGDF-offloading-guideline-2019.pdf.","DOI":"10.1002\/dmrr.3274"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"108733","DOI":"10.1016\/j.diabres.2021.108733","article-title":"Should Weight-Bearing Activity Be Reduced during Healing of Plantar Diabetic Foot Ulcers, Even When Using Appropriate Offloading Devices?","volume":"175","author":"Jarl","year":"2021","journal-title":"Diabetes Res. Clin. 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