{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:14:44Z","timestamp":1783509284148,"version":"3.55.0"},"reference-count":57,"publisher":"MDPI AG","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>Diabetes-related foot ulcers are a leading cause of global morbidity, mortality, and health-care costs. People with a history of foot ulcers have a diminished quality of life attributed to limited walking and mobility. One of the largest concerns is ulceration recurrence. Approximately 40% of patients with ulcerations will have a recurrent ulcer in the year after healing, and most occur in the first 3 months after wound healing. Hence, this period after ulceration is called \u201cremission\u201d due to this risk of reulceration. Promoting and fostering mobility is an integral part of everyday life and is important for maintaining good physical health and health-related quality of life for all people living with diabetes. In this short perspective, we provide recommendations on how to safely increase walking activity and facilitate appropriate off-loading and monitoring in people with a recently healed foot ulcer, foot reconstruction, or partial foot amputation. Interventions include monitored activity training, dosed out in steadily increasing increments and coupled with daily skin temperature monitoring, which can identify dangerous \u201chotspots\u201d prone to recurrence. By understanding areas at risk, patients are empowered to maximize ulcer-free days and to enable an improved quality of life. This perspective outlines a unified strategy to treat patients in the remission period after ulceration and aims to provide clinicians with appropriate patient recommendations based on best available evidence and expert opinion to educate their patients to ensure a safe transition to footwear and return to activity.<\/jats:p>","DOI":"10.7547\/20-166","type":"journal-article","created":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T08:59:13Z","timestamp":1617094753000},"source":"Crossref","is-referenced-by-count":16,"title":["Dosing Activity and Return to Preulcer Function in Diabetes-Related Foot Ulcer Remission"],"prefix":"10.3390","volume":"111","author":[{"given":"Malindu E.","family":"Fernando","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Woelfel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Perry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijan","family":"Najafi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanzim","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"DuBourdieu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Armstrong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"i8750-7315-111-5-Article_2-b01","series-title":"N Engl J Med","first-page":"2367","article-title":"Diabetic foot ulcers and their recurrence","volume":"376","author":"Armstrong","year":"2017","unstructured":"Armstrong\n              DG\n            \n            \n              Boulton\n              AJM\n            \n            \n              Bus\n              SA:\n            \n          \n          Diabetic foot ulcers and their recurrence.\n\t\t\t\t\tN Engl J Med376: \n\t\t\t\t\t2367,\n\t\t\t\t\t2017."},{"key":"i8750-7315-111-5-Article_2-b02","series-title":"Diabetes Care","first-page":"645","article-title":"Current challenges and opportunities in the prevention and management of diabetic foot ulcers","volume":"41","author":"Jeffcoate","year":"2018","unstructured":"Jeffcoate\n              WJ\n            \n            \n              Vileikyte\n              L\n            \n            \n              Boyko\n              EJ\n            \n            :\n          \n          Current challenges and opportunities in the prevention and management of diabetic foot ulcers.\n\t\t\t\t\tDiabetes Care41: \n\t\t\t\t\t645,\n\t\t\t\t\t2018."},{"key":"i8750-7315-111-5-Article_2-b03","series-title":"Diabet Med","first-page":"1297","article-title":"Diabetes-related lower-extremity complications are a leading cause of the global burden of disability","volume":"35","author":"Lazzarini","year":"2018","unstructured":"Lazzarini\n              PA\n            \n            \n              Pacella\n              RE\n            \n            \n              Armstrong\n              DG\n            \n            :\n          \n          Diabetes-related lower-extremity complications are a leading cause of the global burden of disability.\n\t\t\t\t\tDiabet Med35: \n\t\t\t\t\t1297,\n\t\t\t\t\t2018."},{"key":"i8750-7315-111-5-Article_2-b04","series-title":"N Engl J Med","first-page":"48","article-title":"Neuropathic diabetic foot ulcers","volume":"351","author":"Boulton","year":"2004","unstructured":"Boulton\n              AJM\n        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        DG\n            \n            \n              Lipsky\n              BA:\n            \n          \n          Preventing foot ulcers in patients with diabetes.\n\t\t\t\t\tJAMA293: \n\t\t\t\t\t217,\n\t\t\t\t\t2005."},{"key":"i8750-7315-111-5-Article_2-b07","series-title":"J Diabetes Complications","first-page":"400","article-title":"A longitudinal study of patients with diabetes and foot ulcers and their health-related quality of life: wound healing and quality-of-life changes","volume":"22","author":"Ribu","year":"2008","unstructured":"Ribu\n              L\n            \n            \n              Birkeland\n              K\n            \n            \n              Hanestad\n              BR\n            \n            :\n          \n          A longitudinal study of patients with diabetes and foot ulcers and their health-related quality of life: wound healing and quality-of-life changes.\n\t\t\t\t\tJ Diabetes Complications22: \n\t\t\t\t\t400,\n\t\t\t\t\t2008."},{"key":"i8750-7315-111-5-Article_2-b08","series-title":"J Diabetes Complications","first-page":"33","article-title":"Self-reported physical activity in community-dwelling adults with diabetes and its association with diabetes complications","volume":"33","author":"Johnson","year":"2019","unstructured":"Johnson\n              NA\n            \n            \n              Barwick\n              AL\n            \n            \n              Searle\n              A\n            \n            :\n          \n          Self-reported physical activity in community-dwelling adults with diabetes and its association with diabetes complications.\n\t\t\t\t\tJ Diabetes Complications33: \n\t\t\t\t\t33,\n\t\t\t\t\t2019."},{"key":"i8750-7315-111-5-Article_2-b09","series-title":"Sensors","first-page":"505","article-title":"Sensor-based daily physical activity: towards prediction of the level of concern about falling in peripheral neuropathy","volume":"20","author":"Kang","year":"2020","unstructured":"Kang\n              GE\n            \n            \n              Najafi\n              B:\n            \n          \n          Sensor-based daily physical activity: towards prediction of the level of concern about falling in peripheral neuropathy.\n\t\t\t\t\tSensors20: \n\t\t\t\t\t505,\n\t\t\t\t\t2020."},{"key":"i8750-7315-111-5-Article_2-b10","series-title":"Int Wound J","first-page":"1175","article-title":"Differences in the daily activity of patients with diabetic foot ulcers compared to controls in their free-living environments","volume":"14","author":"Sheahan","year":"2017","unstructured":"Sheahan\n              H\n            \n            \n              Canning\n              K\n            \n            \n              Refausse\n              N\n            \n            :\n          \n          Differences in the daily activity of patients with diabetic foot ulcers compared to controls in their free-living environments.\n\t\t\t\t\tInt Wound J14: \n\t\t\t\t\t1175,\n\t\t\t\t\t2017."},{"key":"i8750-7315-111-5-Article_2-b11","series-title":"Diabetes Care","first-page":"2065","article-title":"Physical activity\/exercise and diabetes: a position statement of the American Diabetes Association","volume":"39","author":"Colberg","year":"2016","unstructured":"Colberg\n              SR\n            \n            \n              Sigal\n              RJ\n            \n            \n              Yardley\n              JE\n            \n            :\n          \n          Physical activity\/exercise and diabetes: a position statement of the American Diabetes Association.\n\t\t\t\t\tDiabetes Care39: \n\t\t\t\t\t2065,\n\t\t\t\t\t2016."},{"issue":"(suppl 1)","key":"i8750-7315-111-5-Article_2-b12","series-title":"Diabetes Metab Res Rev","first-page":"e3266","article-title":"Practical guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update)","volume":"36","author":"Schaper","year":"2020","unstructured":"Schaper\n              NC\n            \n            \n              Netten\n              JJ\n            \n            \n              Apelqvist\n              J\n            \n            :\n          \n          Practical guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update).\n\t\t\t\t\tDiabetes Metab Res Rev36(suppl 1): \n\t\t\t\t\te3266,\n\t\t\t\t\t2020."},{"key":"i8750-7315-111-5-Article_2-b13","series-title":"J Diabetes Sci Technol","first-page":"1122","article-title":"Infrared thermal imaging for automated detection of diabetic foot complications","volume":"7","author":"van Netten","year":"2013","unstructured":"van Netten\n              JJ\n            \n            \n              van Baal\n              JG\n            \n            \n              Liu\n              C\n            \n            :\n          \n          Infrared thermal imaging for automated detection of diabetic foot complications.\n\t\t\t\t\tJ Diabetes Sci Technol7: \n\t\t\t\t\t1122,\n\t\t\t\t\t2013."},{"key":"i8750-7315-111-5-Article_2-b14","series-title":"Diabet Med","first-page":"1266","article-title":"Meta-analyses of randomized controlled trials reporting the effect of home foot temperature monitoring, patient education or offloading footwear on the incidence of diabetes-related foot ulcers","volume":"37","author":"Alahakoon","year":"2020","unstructured":"Alahakoon\n              C\n            \n            \n              Fernando\n              M\n            \n            \n              Galappaththy\n              C\n            \n            :\n          \n          Meta-analyses of randomized controlled trials reporting the effect of home foot temperature monitoring, patient education or offloading footwear on the incidence of diabetes-related foot ulcers.\n\t\t\t\t\tDiabet Med37: \n\t\t\t\t\t1266,\n\t\t\t\t\t2020."},{"key":"i8750-7315-111-5-Article_2-b15","series-title":"Am J Med","first-page":"1042","article-title":"Skin temperature monitoring reduces the risk for diabetic foot ulceration in high-risk patients","volume":"120","author":"Armstrong","year":"2007","unstructured":"Armstrong\n              DG\n            \n            \n              Holtz-Neiderer\n              K\n            \n            \n              Wendel\n              C\n            \n            :\n          \n          Skin temperature monitoring reduces the risk for diabetic foot ulceration in high-risk patients.\n\t\t\t\t\tAm J Med120: \n\t\t\t\t\t1042,\n\t\t\t\t\t2007."},{"key":"i8750-7315-111-5-Article_2-b16","series-title":"Diabetes Care","first-page":"2642","article-title":"Home monitoring of foot skin temperatures to prevent ulceration","volume":"27","author":"Lavery","year":"2004","unstructured":"Lavery\n              LA\n            \n            \n              Higgins\n              KR\n            \n            \n              Lanctot\n              DR\n            \n            :\n          \n          Home monitoring of foot skin temperatures to prevent ulceration.\n\t\t\t\t\tDiabetes Care27: \n\t\t\t\t\t2642,\n\t\t\t\t\t2004."},{"key":"i8750-7315-111-5-Article_2-b17","series-title":"J Diabetes Sci Technol","first-page":"1151","article-title":"A novel shear reduction insole effect on the thermal response to walking stress, balance, and gait","volume":"8","author":"Wrobel","year":"2014","unstructured":"Wrobel\n              JS\n            \n            \n              Ammanath\n              P\n            \n            \n              Le\n              T\n            \n            :\n          \n          A novel shear reduction insole effect on the thermal response to walking stress, balance, and gait.\n\t\t\t\t\tJ Diabetes Sci Technol8: \n\t\t\t\t\t1151,\n\t\t\t\t\t2014."},{"key":"i8750-7315-111-5-Article_2-b18","series-title":"J Diabetes Sci Technol","first-page":"678","article-title":"Lace up for healthy feet: the impact of shoe closure on plantar stress response","volume":"11","author":"Rahemi","year":"2017","unstructured":"Rahemi\n              H\n            \n            \n              Armstrong\n              DG\n            \n            \n              Enriquez\n              A\n            \n            :\n          \n          Lace up for healthy feet: the impact of shoe closure on plantar stress response.\n\t\t\t\t\tJ Diabetes Sci Technol11: \n\t\t\t\t\t678,\n\t\t\t\t\t2017."},{"key":"i8750-7315-111-5-Article_2-b19","series-title":"J Diabetes Sci Technol","first-page":"657","article-title":"Can't stand the pressure: the association between unprotected standing, walking, and wound healing in people with diabetes","volume":"11","author":"Najafi","year":"2017","unstructured":"Najafi\n              B\n            \n            \n              Grewal\n              GS\n            \n            \n              Bharara\n              M\n            \n            :\n          \n          Can't stand the pressure: the association between unprotected standing, walking, and wound healing in people with diabetes.\n\t\t\t\t\tJ Diabetes Sci Technol11: \n\t\t\t\t\t657,\n\t\t\t\t\t2017."},{"key":"i8750-7315-111-5-Article_2-b20","series-title":"Gerontology","first-page":"567","article-title":"Sensor-based interactive balance training with visual joint movement feedback for improving postural stability in diabetics with peripheral neuropathy: a randomized controlled trial","volume":"61","author":"Grewal","year":"2015","unstructured":"Grewal\n              GS\n            \n            \n              Schwenk\n              M\n            \n            \n              Lee-Eng\n              J\n            \n            :\n          \n          Sensor-based interactive balance training with visual joint movement feedback for improving postural stability in diabetics with peripheral neuropathy: a randomized controlled trial.\n\t\t\t\t\tGerontology61: \n\t\t\t\t\t567,\n\t\t\t\t\t2015."},{"key":"i8750-7315-111-5-Article_2-b21","series-title":"BMC Endocr Disord","first-page":"51","article-title":"Plantar pressures are higher in cases with diabetic foot ulcers compared to controls despite a longer stance phase duration","volume":"16","author":"Fernando","year":"2016","unstructured":"Fernando\n              ME\n            \n            \n              Crowther\n              RG\n            \n            \n              Lazzarini\n              PA\n            \n            :\n          \n          Plantar pressures are higher in cases with diabetic foot ulcers compared to controls despite a longer stance phase duration.\n\t\t\t\t\tBMC Endocr Disord16: \n\t\t\t\t\t51,\n\t\t\t\t\t2016."},{"key":"i8750-7315-111-5-Article_2-b22","series-title":"BMC Endocr Disord","first-page":"59","article-title":"Lower limb biomechanical characteristics of patients with neuropathic diabetic foot ulcers: the diabetes foot ulcer study protocol","volume":"15","author":"Fernando","year":"2015","unstructured":"Fernando\n              ME\n            \n            \n              Crowther\n              RG\n            \n            \n              Cunningham\n              M\n            \n            :\n          \n          Lower limb biomechanical characteristics of patients with neuropathic diabetic foot ulcers: the diabetes foot ulcer study protocol.\n\t\t\t\t\tBMC Endocr Disord15:\n\t\t\t\t\t59,\n\t\t\t\t\t2015."},{"key":"i8750-7315-111-5-Article_2-b23","series-title":"Diabetes Care","first-page":"2448","article-title":"Importance of time spent standing for those at risk of diabetic foot ulceration","volume":"33","author":"Najafi","year":"2010","unstructured":"Najafi\n              B\n            \n            \n              Crews\n              RT\n            \n            \n              Wrobel\n              JS:\n            \n          \n          Importance of time spent standing for those at risk of diabetic foot ulceration.\n\t\t\t\t\tDiabetes Care33: \n\t\t\t\t\t2448,\n\t\t\t\t\t2010."},{"key":"i8750-7315-111-5-Article_2-b24","series-title":"Phys Ther","first-page":"1602","article-title":"Gait in people with nonhealing diabetes-related plantar ulcers","volume":"99","author":"Fernando","year":"2019","unstructured":"Fernando\n              ME\n            \n            \n              Crowther\n              RG\n            \n            \n              Lazzarini\n              PA\n            \n            :\n          \n          Gait in people with nonhealing diabetes-related plantar ulcers.\n\t\t\t\t\tPhys Ther99: \n\t\t\t\t\t1602,\n\t\t\t\t\t2019."},{"key":"i8750-7315-111-5-Article_2-b25","series-title":"Clin Biomech","first-page":"157","article-title":"The impact of diabetic foot ulcers and unilateral offloading footwear on gait in people with diabetes","volume":"73","author":"Ling","year":"2020","unstructured":"Ling\n              E\n            \n            \n              Lepow\n              B\n            \n            \n              Zhou\n              H\n            \n            :\n          \n          The impact of diabetic foot ulcers and unilateral offloading footwear on gait in people with diabetes.\n\t\t\t\t\tClin Biomech73: \n\t\t\t\t\t157,\n\t\t\t\t\t2020."},{"key":"i8750-7315-111-5-Article_2-b26","series-title":"JAMA","first-page":"50","article-title":"Gait speed and survival in older adults","volume":"305","author":"Studenski","year":"2011","unstructured":"Studenski\n              S\n            \n            \n              Perera\n              S\n            \n            \n              Patel\n              K:\n            \n          \n          Gait speed and survival in older adults.\n\t\t\t\t\tJAMA305: \n\t\t\t\t\t50,\n\t\t\t\t\t2011."},{"key":"i8750-7315-111-5-Article_2-b27","series-title":"Diabetes Care","first-page":"2441","article-title":"Longitudinal predictors of reduced mobility and physical disability in patients with type 2 diabetes: the Fremantle Diabetes Study","volume":"28","author":"Bruce","year":"2005","unstructured":"Bruce\n              DG\n            \n            \n              Davis\n              WA\n            \n            \n              Davis\n              TME:\n            \n          \n          Longitudinal predictors of reduced mobility and physical disability in patients with type 2 diabetes: the Fremantle Diabetes Study.\n\t\t\t\t\tDiabetes Care28: \n\t\t\t\t\t2441,\n\t\t\t\t\t2005."},{"key":"i8750-7315-111-5-Article_2-b28","series-title":"Diabetologia","first-page":"2200","article-title":"Short-term strength and balance training does not improve quality of life but improves functional status in individuals with diabetic peripheral neuropathy: a randomised controlled trial","volume":"62","author":"Venkataraman","year":"2019","unstructured":"Venkataraman\n              K\n            \n            \n              Tai\n              BC\n            \n            \n              Khoo\n              EYH\n            \n            :\n          \n          Short-term strength and balance training does not improve quality of life but improves functional status in individuals with diabetic peripheral neuropathy: a randomised controlled trial.\n\t\t\t\t\tDiabetologia62: \n\t\t\t\t\t2200,\n\t\t\t\t\t2019."},{"key":"i8750-7315-111-5-Article_2-b29","series-title":"Phys Ther","first-page":"1385","article-title":"Effect of weight-bearing activity on foot ulcer incidence in people with diabetic peripheral neuropathy: feet first randomized controlled trial","volume":"88","author":"Lemaster","year":"2008","unstructured":"Lemaster\n              JW\n            \n            \n              Mueller\n              MJ\n            \n            \n              Reiber\n              GE\n            \n            :\n          \n          Effect of weight-bearing activity on foot ulcer incidence in people with diabetic peripheral neuropathy: feet first randomized controlled trial.\n\t\t\t\t\tPhys Ther88: \n\t\t\t\t\t1385,\n\t\t\t\t\t2008."},{"key":"i8750-7315-111-5-Article_2-b30","series-title":"Arch Phys Med Rehabil","first-page":"829","article-title":"Weight-bearing versus nonweight-bearing exercise for persons with diabetes and peripheral neuropathy: a randomized controlled trial","volume":"94","author":"Mueller","year":"2013","unstructured":"Mueller\n              MJ\n            \n            \n              Tuttle\n              LJ\n            \n            \n              Lemaster\n              JW\n            \n            :\n          \n          Weight-bearing versus nonweight-bearing exercise for persons with diabetes and peripheral neuropathy: a randomized controlled trial.\n\t\t\t\t\tArch Phys Med Rehabil94: \n\t\t\t\t\t829,\n\t\t\t\t\t2013."},{"key":"i8750-7315-111-5-Article_2-b31","series-title":"Phys Ther","first-page":"31","article-title":"Physical training and activity in people with diabetic peripheral neuropathy: paradigm shift","volume":"97","author":"Kluding","year":"2017","unstructured":"Kluding\n              PM\n            \n            \n              Bareiss\n              SK\n            \n            \n              Hastings\n              M\n            \n            :\n          \n          Physical training and activity in people with diabetic peripheral neuropathy: paradigm shift.\n\t\t\t\t\tPhys Ther97: \n\t\t\t\t\t31,\n\t\t\t\t\t2017."},{"key":"i8750-7315-111-5-Article_2-b32","series-title":"J Diabetes Sci Technol","first-page":"869","article-title":"Measuring plantar tissue stress in people with diabetic peripheral neuropathy: a critical concept in diabetic foot management","volume":"13","author":"Lazzarini","year":"2019","unstructured":"Lazzarini\n              PA\n            \n            \n              Crews\n              RT\n            \n            \n              van Netten\n              JJ\n            \n            :\n          \n          Measuring plantar tissue stress in people with diabetic peripheral neuropathy: a critical concept in diabetic foot management.\n\t\t\t\t\tJ Diabetes Sci Technol13: \n\t\t\t\t\t869,\n\t\t\t\t\t2019."},{"key":"i8750-7315-111-5-Article_2-b33","series-title":"Diabetes Res Clin Pract","first-page":"8190","article-title":"Physical activity and exercise on diabetic foot related outcomes: a systematic review","volume":"139","author":"Matos","year":"2018","unstructured":"Matos\n              M\n            \n            \n              Mendes\n              R\n            \n            \n              Silva\n              AB\n            \n            :\n          \n          Physical activity and exercise on diabetic foot related outcomes: a systematic review.\n\t\t\t\t\tDiabetes Res Clin Pract139: \n\t\t\t\t\t8190,\n\t\t\t\t\t2018."},{"key":"i8750-7315-111-5-Article_2-b34","series-title":"Plast Reconstr Surg","first-page":"669e","article-title":"A systematic review and meta-analysis of the pressure-induced vasodilation phenomenon and its role in the pathophysiology of ulcers","volume":"144","author":"Zwanenburg","year":"2019","unstructured":"Zwanenburg\n              PR\n            \n            \n              Backer\n              SFM\n            \n            \n              Obdeijn\n              MC\n            \n            :\n          \n          A systematic review and meta-analysis of the pressure-induced vasodilation phenomenon and its role in the pathophysiology of ulcers.\n\t\t\t\t\tPlast Reconstr Surg144: \n\t\t\t\t\t669e,\n\t\t\t\t\t2019."},{"key":"i8750-7315-111-5-Article_2-b35","series-title":"Med Sci Sports Exerc","first-page":"1093","article-title":"Daily weight-bearing activity does not increase the risk of diabetic foot ulcers","volume":"35","author":"Lemaster","year":"2003","unstructured":"Lemaster\n              JW\n            \n            \n              Reiber\n              GE\n            \n            \n              Smith\n              DG\n            \n            :\n          \n          Daily weight-bearing activity does not increase the risk of diabetic foot ulcers.\n\t\t\t\t\tMed Sci Sports Exerc35: \n\t\t\t\t\t1093,\n\t\t\t\t\t2003."},{"key":"i8750-7315-111-5-Article_2-b36","series-title":"Clin Biomech","first-page":"567","article-title":"Comparison of physical activity and cumulative plantar tissue stress among subjects with and without diabetes mellitus and a history of recurrent plantar ulcers","volume":"18","author":"Maluf","year":"2003","unstructured":"Maluf\n              KS\n            \n            \n              Mueller\n              MJ:\n            \n          \n          Comparison of physical activity and cumulative plantar tissue stress among subjects with and without diabetes mellitus and a history of recurrent plantar ulcers.\n\t\t\t\t\tClin Biomech18: \n\t\t\t\t\t567,\n\t\t\t\t\t2003."},{"issue":"(suppl 1)","key":"i8750-7315-111-5-Article_2-b37","series-title":"Diabetes Metab Res Rev","first-page":"e3239","article-title":"Leveraging smart technologies to improve the management of diabetic foot ulcers and extend ulcer-free days in remission","volume":"36","author":"Najafi","year":"2020","unstructured":"Najafi\n              B\n            \n            \n              Reeves\n              ND\n            \n            \n              Armstrong\n              DG:\n            \n          \n          Leveraging smart technologies to improve the management of diabetic foot ulcers and extend ulcer-free days in remission.\n\t\t\t\t\tDiabetes Metab Res Rev36(suppl 1): \n\t\t\t\t\te3239,\n\t\t\t\t\t2020."},{"key":"i8750-7315-111-5-Article_2-b38","series-title":"Diabetes Care","first-page":"1980","article-title":"Variability in activity may precede diabetic foot ulceration","volume":"27","author":"Armstrong","year":"2004","unstructured":"Armstrong\n              DG\n            \n            \n              Lavery\n              LA\n            \n            \n              Holtz-Neiderer\n              K\n            \n            :\n          \n          Variability in activity may precede diabetic foot ulceration.\n\t\t\t\t\tDiabetes Care27: \n\t\t\t\t\t1980,\n\t\t\t\t\t2004."},{"key":"i8750-7315-111-5-Article_2-b39","series-title":"Diabetes Care","first-page":"1697","article-title":"Risk factors for plantar foot ulcer recurrence in neuropathic diabetic patients","volume":"37","author":"Waaijman","year":"2014","unstructured":"Waaijman\n              R\n            \n            \n              de Haart\n              M\n            \n            \n              Arts\n              MLJ\n            \n            :\n          \n          Risk factors for plantar foot ulcer recurrence in neuropathic diabetic patients.\n\t\t\t\t\tDiabetes Care37: \n\t\t\t\t\t1697,\n\t\t\t\t\t2014."},{"key":"i8750-7315-111-5-Article_2-b40","series-title":"Diabetes Metab Res Rev","first-page":"791","article-title":"Physiological and psychological challenges of increasing physical activity and exercise in patients at risk of diabetic foot ulcers: a critical review","volume":"32","author":"Crews","year":"2016","unstructured":"Crews\n              RT\n            \n            \n              Schneider\n              KL\n            \n            \n              Yalla\n              SV\n            \n            :\n          \n          Physiological and psychological challenges of increasing physical activity and exercise in patients at risk of diabetic foot ulcers: a critical review.\n\t\t\t\t\tDiabetes Metab Res Rev32: \n\t\t\t\t\t791,\n\t\t\t\t\t2016."},{"issue":"(suppl 1)","key":"i8750-7315-111-5-Article_2-b41","series-title":"Diabetes Metab Res Rev","first-page":"e3275","article-title":"Effectiveness of offloading interventions to heal foot ulcers in persons with diabetes: a systematic review","volume":"36","author":"Lazzarini","year":"2020","unstructured":"Lazzarini\n              PA\n            \n            \n              Jarl\n              G\n            \n            \n              Gooday\n              C\n            \n            :\n          \n          Effectiveness of offloading interventions to heal foot ulcers in persons with diabetes: a systematic review.\n\t\t\t\t\tDiabetes Metab Res Rev36(suppl 1): \n\t\t\t\t\te3275,\n\t\t\t\t\t2020."},{"issue":"(suppl 1)","key":"i8750-7315-111-5-Article_2-b42","series-title":"Diabetes Metab Res Rev","first-page":"e3269","article-title":"Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)","volume":"36","author":"Bus","year":"2020","unstructured":"Bus\n              SA\n            \n            \n              Lavery\n              LA\n            \n            \n              Monteiro-Soares\n              M\n            \n            :\n          \n          Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update).\n\t\t\t\t\tDiabetes Metab Res Rev36(suppl 1): \n\t\t\t\t\te3269,\n\t\t\t\t\t2020."},{"key":"i8750-7315-111-5-Article_2-b43","series-title":"Curr Diab Rep","first-page":"109","article-title":"Psychological and biomechanical aspects of patient adaptation to diabetic neuropathy and foot ulceration","volume":"17","author":"Vileikyte","year":"2017","unstructured":"Vileikyte\n              L\n            \n            \n              Crews\n              RT\n            \n            \n              Reeves\n              ND:\n            \n          \n          Psychological and biomechanical aspects of patient adaptation to diabetic neuropathy and foot ulceration.\n\t\t\t\t\tCurr Diab Rep17: \n\t\t\t\t\t109,\n\t\t\t\t\t2017."},{"key":"i8750-7315-111-5-Article_2-b44","series-title":"J Foot Ankle Res","first-page":"30","article-title":"Footwear and insole design features that reduce neuropathic plantar forefoot ulcer risk in people with diabetes: a systematic literature review","volume":"13","author":"Ahmed","year":"2020","unstructured":"Ahmed\n              S\n            \n            \n              Barwick\n              A\n            \n            \n              Butterworth\n              P\n            \n            :\n          \n          Footwear and insole design features that reduce neuropathic plantar forefoot ulcer risk in people with diabetes: a systematic literature review.\n\t\t\t\t\tJ Foot Ankle Res13: \n\t\t\t\t\t30,\n\t\t\t\t\t2020."},{"key":"i8750-7315-111-5-Article_2-b45","series-title":"J Foot Ankle Res","first-page":"1","article-title":"Ulcer metastasis? anatomical locations of recurrence for patients in diabetic foot remission","volume":"13","author":"Petersen","year":"2020","unstructured":"Petersen\n              BJ\n            \n            \n              Rothenberg\n              GM\n            \n            \n              Lakhani\n              PJ\n            \n            :\n          \n          Ulcer metastasis? anatomical locations of recurrence for patients in diabetic foot remission.\n\t\t\t\t\tJ Foot Ankle Res13: \n\t\t\t\t\t1,\n\t\t\t\t\t2020."},{"key":"i8750-7315-111-5-Article_2-b46","series-title":"J Diabetes Sci Technol","first-page":"577","article-title":"Health sensors, smart home devices, and the internet of medical things: an opportunity for dramatic improvement in care for the lower extremity complications of diabetes","volume":"12","author":"Basatneh","year":"2018","unstructured":"Basatneh\n              R\n            \n            \n              Najafi\n              B\n            \n            \n              Armstrong\n              DG:\n            \n          \n          Health sensors, smart home devices, and the internet of medical things: an opportunity for dramatic improvement in care for the lower extremity complications of diabetes.\n\t\t\t\t\tJ Diabetes Sci Technol12: \n\t\t\t\t\t577,\n\t\t\t\t\t2018."},{"key":"i8750-7315-111-5-Article_2-b47","series-title":"Lancet Digit Health","first-page":"e308","article-title":"Innovative intelligent insole system reduces diabetic foot ulcer recurrence at plantar sites: a prospective, randomised, proof-of-concept study","volume":"1","author":"Abbott","year":"2019","unstructured":"Abbott\n              CA\n            \n            \n              Chatwin\n              KE\n            \n            \n              Foden\n              P\n            \n            :\n          \n          Innovative intelligent insole system reduces diabetic foot ulcer recurrence at plantar sites: a prospective, randomised, proof-of-concept study.\n\t\t\t\t\tLancet Digit Health1: \n\t\t\t\t\te308,\n\t\t\t\t\t2019."},{"issue":"(suppl 1)","key":"i8750-7315-111-5-Article_2-b48","series-title":"Diabetes Metab Res Rev","first-page":"221","article-title":"Innovations in plantar pressure and foot temperature measurements in diabetes","volume":"32","author":"Bus","year":"2016","unstructured":"Bus\n              SA:\n            \n          \n          Innovations in plantar pressure and foot temperature measurements in diabetes.\n\t\t\t\t\tDiabetes Metab Res Rev32(suppl 1): \n\t\t\t\t\t221,\n\t\t\t\t\t2016."},{"key":"i8750-7315-111-5-Article_2-b49","series-title":"Sensors","first-page":"4527","article-title":"The potential role of sensors, wearables and telehealth in the remote management of diabetes-related foot disease","volume":"20","author":"Golledge","year":"2020","unstructured":"Golledge\n              J\n            \n            \n              Fernando\n              M\n            \n            \n              Lazzarini\n              P\n            \n            :\n          \n          The potential role of sensors, wearables and telehealth in the remote management of diabetes-related foot disease.\n\t\t\t\t\tSensors20: \n\t\t\t\t\t4527,\n\t\t\t\t\t2020."},{"key":"i8750-7315-111-5-Article_2-b50","series-title":"Clin Biomech","first-page":"52","article-title":"Calf muscle stretching is ineffective in increasing ankle range of motion or reducing plantar pressures in people with diabetes and ankle equinus: a randomised controlled trial","volume":"69","author":"Searle","year":"2019","unstructured":"Searle\n              A\n            \n            \n              Spink\n              MJ\n            \n            \n              Oldmeadow\n              C\n            \n            :\n          \n          Calf muscle stretching is ineffective in increasing ankle range of motion or reducing plantar pressures in people with diabetes and ankle equinus: a randomised controlled trial.\n\t\t\t\t\tClin Biomech69: \n\t\t\t\t\t52,\n\t\t\t\t\t2019."},{"key":"i8750-7315-111-5-Article_2-b51","series-title":"Am J Phys Med Rehabil","first-page":"103","article-title":"Effect of exercise on risk factors of diabetic foot ulcers: a systematic review and meta-analysis","volume":"98","author":"Liao","year":"2019","unstructured":"Liao\n              F\n            \n            \n              An\n              R\n            \n            \n              Pu\n              F\n            \n            :\n          \n          Effect of exercise on risk factors of diabetic foot ulcers: a systematic review and meta-analysis.\n\t\t\t\t\tAm J Phys Med Rehabil98: \n\t\t\t\t\t103,\n\t\t\t\t\t2019."},{"key":"i8750-7315-111-5-Article_2-b52","series-title":"J Appl Physiol","first-page":"1","article-title":"Physiology in medicine: neuromuscular consequences of diabetic neuropathy","volume":"121","author":"Allen","year":"2016","unstructured":"Allen\n              MD\n            \n            \n              Doherty\n              TJ\n            \n            \n              Rice\n              CL\n            \n            :\n          \n          Physiology in medicine: neuromuscular consequences of diabetic neuropathy.\n\t\t\t\t\tJ Appl Physiol121: \n\t\t\t\t\t1,\n\t\t\t\t\t2016."},{"key":"i8750-7315-111-5-Article_2-b53","series-title":"JAPMA","first-page":"309","article-title":"Society for Vascular Surgery, American Podiatric Medical Association: The role of interdisciplinary team approach in the management of the diabetic foot: a joint statement from the Society for Vascular Surgery and the American Podiatric Medical Association","volume":"100","author":"Sumpio","year":"2010","unstructured":"Sumpio\n              BE\n            \n            \n              Armstrong\n              DG\n            \n            \n              Lavery\n              LA\n            \n            ;\n          \n          Society for Vascular Surgery, American Podiatric Medical Association: The role of interdisciplinary team approach in the management of the diabetic foot: a joint statement from the Society for Vascular Surgery and the American Podiatric Medical Association.\n\t\t\t\t\tJAPMA100: \n\t\t\t\t\t309,\n\t\t\t\t\t2010."},{"key":"i8750-7315-111-5-Article_2-b54","series-title":"J Vasc Surg","first-page":"738","article-title":"Functional ambulatory status as a potential adjunctive decision-making tool following wound, level of ischemia, and severity of foot infection assessment","volume":"72","author":"Khan","year":"2020","unstructured":"Khan\n              T\n            \n            \n              Plotkin\n              A\n            \n            \n              Magee\n              GA\n            \n            :\n          \n          Functional ambulatory status as a potential adjunctive decision-making tool following wound, level of ischemia, and severity of foot infection assessment.\n\t\t\t\t\tJ Vasc Surg72: \n\t\t\t\t\t738,\n\t\t\t\t\t2020."},{"key":"i8750-7315-111-5-Article_2-b55","article-title":"Do you prescribe thermometry for your diabetic foot patients? here's a printable daily diary for them","year":"2020","unstructured":"Do you prescribe thermometry for your diabetic foot patients? here's a printable daily diary for them.\n\t\t\t\t\tAvailable at: https:\/\/diabeticfootonline.com\/2015\/09\/09\/do-you-prescribe-thermometry-for-your-diabetic-foot-patients-heres-a-printable-daily-diary-for-them\/. Accessed July 10,2020."},{"key":"i8750-7315-111-5-Article_2-b56","series-title":"Cardiovasc Diabetol","first-page":"11","article-title":"The association between diabetes and dermal microvascular dysfunction non-invasively assessed by laser Doppler with local thermal hyperemia: a systematic review with meta-analysis","volume":"16","author":"Fuchs","year":"2017","unstructured":"Fuchs\n              D\n            \n            \n              Dupon\n              PP\n            \n            \n              Schaap\n              LA\n            \n            :\n          \n          The association between diabetes and dermal microvascular dysfunction non-invasively assessed by laser Doppler with local thermal hyperemia: a systematic review with meta-analysis.\n\t\t\t\t\tCardiovasc Diabetol16: \n\t\t\t\t\t11,\n\t\t\t\t\t2017."},{"key":"i8750-7315-111-5-Article_2-b57","series-title":"BMJ Open Diabetes Res Care","first-page":"e000235","article-title":"Peripheral sensory neuropathy is associated with altered postocclusive reactive hyperemia in the diabetic foot","volume":"4","author":"Barwick","year":"2016","unstructured":"Barwick\n              AL\n            \n            \n              Tessier\n              JW\n            \n            \n              Janse de Jonge\n              X\n            \n            :\n          \n          Peripheral sensory neuropathy is associated with altered postocclusive reactive hyperemia in the diabetic foot.\n\t\t\t\t\tBMJ Open Diabetes Res Care4: \n\t\t\t\t\te000235,\n\t\t\t\t\t2016."}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/111\/5\/20-166.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/japma\/article-pdf\/doi\/10.7547\/20-166\/2975145\/i8750-7315-111-5-article_2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/111\/5\/20-166.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/111\/5\/20-166.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:18:28Z","timestamp":1783505908000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/111\/5\/20166"}},"subtitle":["Patient Recommendations and Guidance from the Limb Preservation Consortium at USC and the Rancho Los Amigos National Rehabilitation Center"],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":57,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.7547\/20-166","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2021,9]]}}}