Smart Boot Use to Measure Offloading Adherence

NCT ID: NCT04460573

Last Updated: 2026-01-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

210 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-19

Study Completion Date

2026-03-31

Brief Summary

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The purpose of this study is to help people with diabetes who develop neuropathic diabetic foot ulcers (DFUs). These ulcers, or sores, if left untreated can increase the chance of amputation. Part of the treatment is to have the person wear a diabetic shoe or boot to help their foot heal. Sometimes people don't wear the boot like they are told. The investigators want to compare three different kinds of diabetic boots to see if they can help make it easier for people to wear their boots as instructed.

The investigators will look at three groups of participants: the first group will use removable offloading with reinforced education emphasizing continuous wear, including during rest and sleep, and not to remove it at any time. The second group will use removable offloading consistent with standard of care and receive education on recommended wear during walking or standing, with permission to remove the device during rest and sleep. The third group will use a smart removable offloading device that provides real-time adherence feedback via a smartwatch and smartphone, with additional personalized education informed by remotely monitored adherence data.

The investigators will also be looking at how much physical activity, like walking, the participants do. And they will compare how well participants sleep and rate their quality of life in the three different boots. The investigators think that giving participants information about how much they are wearing their boot using readily available technology will help them to follow the doctor's directions better, and help their wounds heal faster.

Detailed Description

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Conditions

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Diabetic Foot Ulcer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

prospective, comparative randomized trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Group 1: Reference Group

The group 1 will receive above-standard of care intervention, which includes wearing a standard removable boot and enhanced eductaion with weekly adherence reinforcement. In this group, participants are interviewed weekly, adherence is reviewed, and education is reinforced at each visit. Participants are instructed to wear the offloading device at all times, including during rest and at night, and not to remove it at any time.

Group Type ACTIVE_COMPARATOR

Offloading Boot

Intervention Type DEVICE

Removable offloading boot in one of three configurations provided to participants

Group 2: Control Group

The control group uses removable offloading and represents the standard of care. These participants receive education at baseline and are advised to wear the offloading device during walking or standing; however, they are allowed to remove it during rest and sleep.

Group Type ACTIVE_COMPARATOR

Offloading Boot

Intervention Type DEVICE

Removable offloading boot in one of three configurations provided to participants

Group 3: SmartBoot

The SmartBoot group follows a similar protocol to the control group, but adherence to wearing offloading during weight-bearing activities is reinforced using a smartwatch. The smartwatch provides real-time reminders when participants walk without the offloading device. In addition, data from remote patient monitoring may help personalize education during weekly clinic visits conducted by the research coordinator.

Group Type EXPERIMENTAL

Offloading Boot

Intervention Type DEVICE

Removable offloading boot in one of three configurations provided to participants

Interventions

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Offloading Boot

Removable offloading boot in one of three configurations provided to participants

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Male or female
* ≥18 years old
* Non-infected, non-ischemic DFU requiring offloading
* Ambulatory at home with or without assistance
* Willing and able to provide written informed consent

Exclusion Criteria

* Wound present for \> 1 year
* HbA1c \> 12%
* ABI of index limb \< 0.6 or non-detectable Doppler, and/or patient being considered for revascularization during the course of the study
* Acute Charcot neuropathy or a major foot deformity that doesn't allow them to wear the smart boot
* Amputation proximal to the rearfoot on the affected extremity
* Any clinically significant medical or psychiatric condition
* Laboratory abnormality that would interfere with the ability to participate in the study
* Concurrently participating in exercise training
* Changes in psychotropic or sleep medication in the last 6 weeks
* Ulcer involves bone
* Ulcer not of diabetic origin
* Unable or unwilling to attend prescribed clinic visits or comply with protocol
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of California, Los Angeles

OTHER

Sponsor Role collaborator

University of Southern California

OTHER

Sponsor Role lead

Responsible Party

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David Armstrong

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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David G Armstrong, DPN, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Professor of Surgery, Keck School of Medicine of USC

Locations

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Rancho Los Amigos National Rehabilitation Center

Downey, California, United States

Site Status RECRUITING

Verdugo Hills Hospital of USC

Glendale, California, United States

Site Status RECRUITING

Clemente Clinical Research

Los Angeles, California, United States

Site Status RECRUITING

Keck Medical Center of USC

Los Angeles, California, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Fabiola Rodriguez, MD

Role: CONTACT

3235162332

Bijan Najafi, PHD

Role: CONTACT

5244677127

Facility Contacts

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Fabiola Rodriguez, MD

Role: primary

3235162332

Fabiola Rodriguez

Role: primary

3235162332

Scott Mathis

Role: primary

3233304287

Fabiola A Rodriguez, MD

Role: primary

3235162332

Other Identifiers

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HS-20-00526

Identifier Type: -

Identifier Source: org_study_id

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