Thijs Lutjeboer, Jaap J. van Netten, Klaas Postema, Juha M. Hijmans
University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, 9700 RB Groningen, The Netherlands: E-mail: t.lutjeboer@umcg.nl
DOI: 10.2340/16501977-2759

Objective: To investigate the effect of awareness of being monitored on wearing time and adherence to wearing orthopaedic footwear. Quantitative assessment of wearing time was made using direct measurement with temperature sensors during the first 3 months after provision of footwear.
Design: Randomized controlled trial.
Intervention: Awareness that the temperature sensor is used for measuring wearing time.
Methods: All 55 participants had a temperature sensor built into the medial arch of the left insole of their orthopaedic footwear. Participants were assigned randomly to either an “awareness group” (n = 25, mean age 67 years) and knew they were being monitored for wearing time, or a “no awareness group” (n = 30, mean age 65 years) and only knew their shoe temperature was being measured. Differences were assessed with a linear mixed model.
Results: Mean (standard deviation; SD) wearing time in the intervention group was 7. 32 h/day (SD 4. 2), and 6. 11 h/day (SD 4. 1) in the control group (p = 0. 017). A significant interaction effect was found between awareness and pathology group on wearing time (p = 0. 036). The difference was especially large (7. 0 (SD 4. 7) vs 2. 4 (SD 2. 2) h/day) in the subgroup of people with diabetes.
Conclusion: Awareness of being monitored increases wearing time and wearing of orthopaedic footwear.

Orthopaedic footwear is prescribed for people with a wide variety of foot problems. This footwear helps people to prevent (diabetic) foot ulcers, to reduce pain, and to support their feet when of a different shape. Even if the or-thopaedic shoes are technically perfect, they need to be worn to be effective. Temperature sensors, placed in the inlays, can be used to measure wearing time of ortho-paedic footwear. This study investigated the effect of awareness of being monitored on wearing time and wearing of orthopaedic footwear. Participants in the “Awareness group” (intervention) knew they were being monitored for wearing time. The control group only knew their shoe temperature was being measured. The results showed that having awareness of being monitored increases wearing time and wearing of orthopaedic footwear by 1 h per day. The increase was especially large (4 h per day) in the subgroup of people with diabetes.