Impact of Removable Cast Walker Design on Usability for Patients With Diabetic Foot Ulcers

Inclusion Criteria: * presence of a full thickness plantar (forefoot) diabetic foot ulcer ≥1cm2 that is being treated on an outpatient basis with a University of Texas wound classification of 1A-C or 2 A-C; * self-reported ability to walk for at least two continuous minutes at a self-selected speed * confirmation of the presence of diabetic peripheral neuropathy as identified by failure to detect a 10 gram Semmes Weinstein Monofilament on either foot at one of four sites tested (1st, 3rd, 5th metatarsal heads, and plantar surface of hallux) OR a vibration perception threshold value of 25 or more at either hallux. Exclusion Criteria: * lower extremity amputation more proximal than transmetatarsal on either limb * chronic kidney disease stage 4 or higher (i.e., currently undergoing dialysis or eGFR\<30 within last 60 days) * active Charcot neuroarthropathy * severe peripheral arterial disease (non-palpable pulse at posterior tibia and dorsalis pedis arteries, and an ankle brachial index\<0.7) * gait/balance disturbance not attributable to diabetes (e.g. neuromuscular disease or cerebrovascular vascular accident) * current or previous (within past year) use of an ankle-high RCW or of a contralateral lift to offset an RCW-induced LLD