Measuring 24‐h use of time in people with a diabetes‐related foot ulcer: A feasibility study

Abstract Background Physical activity (PA), sleep and sedentary time are now recognised as mutually exclusive and exhaustive parts of the 24‐h day—if PA decreases, time spent sleeping, being sedentary or both must increase so that all components equate to 24 h. Recent advances in time‐use epidemiology suggest that we should not consider time‐use domains (PA, sleep and sedentary time) in isolation from each other, but in terms of a composition—the mix of time‐use domains across the 24‐h day. While interrelated daily activities are known to be important in the management of diabetes mellitus, few studies have investigated the interrelated daily activities in people with an active diabetes‐related foot ulcer (DFU) and their impact on important outcomes such as wound severity, blood glucose control and health‐related quality of life (HRQoL). This feasibility study aims to determine the acceptability and practicality of measuring 24‐h use of time data in people with a DFU and its associations on important outcome measures for this population. Methods Participants wore a wrist‐worn accelerometer for two weeks and completed demographic and HRQoL questionnaires. Outcomes were participant engagement, reported levels of study burden and value and compositional data analysis as a methodological approach for evaluating 24‐h use of time data. Results Twenty‐six participants reported low levels of study burden and rated the study value highly. The protocol appears feasible in terms of recruitment (81%) and retention rate (86%). On average, participants were relatively sedentary spending 747, 172 and 18 min in sedentary time, light physical activity and moderate‐to‐vigorous activity, respectively. Sleep appeared adequate with participants obtaining an average of 485 min, but quality of sleep was notably poor with average sleep efficiency of 75%. Compositional data analysis was able to quantify the integrated associations of 24‐h use of time with HRQoL. Conclusion The protocol provides an acceptable method to collect 24‐h use of time data in people with a DFU. Efforts to consider and analyse PA as part of a 24‐h activity composition may provide holistic and realistic understandings of PA in this clinical population.