The Long-term Effects of a Personalized Multimodal Intervention on Plantar Pressure, Physical Activity, and Footwear Adherence in People with Diabetes at High Ulcer Risk: a preliminary analysis

This study evaluated changes in factors contributing to foot mechanical loading - plantar pressure, physical activity, and footwear adherence - over 12 months in 23 participants with diabetes from a larger randomized control trial. Participants received either usual or enhanced care (pressure-optimized footwear, custom-made indoor shoes, temperature monitoring, tailored education). No statistically significant differences were found between groups or over time for any outcomes, including in-shoe pressure, step count, and adherence. However, the intervention group showed more stable trends. These preliminary results suggest potential benefits of enhanced care, warranting further investigation in the full study cohort to assess long-term effects on ulcer prevention and mechanical loading.