Taking a Load Off: User Perceptions of Smart Offloading Walkers for Diabetic Foot Ulcers Using the Technology Acceptance Model

M. G. Finco, Gozde Cay, Myeounggon Lee, Jason Garcia, Elia Salazar, Tze Woei Tan, David G. Armstrong, Bijan Najafi

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


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 ± 11.8 years) participated. Smart boot users reported that learning how to use the boot was easy (ρ =−0.82, p (Formula presented.) 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.

Original languageEnglish (US)
Article number2768
Issue number5
StatePublished - Mar 2023
Externally publishedYes


  • adherence
  • diabetic foot
  • digital health
  • foot care
  • foot ulcer
  • remote patient monitoring
  • smart offloading
  • telehealth
  • wearable

ASJC Scopus subject areas

  • Analytical Chemistry
  • Information Systems
  • Instrumentation
  • Atomic and Molecular Physics, and Optics
  • Electrical and Electronic Engineering
  • Biochemistry

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