Can a custom Step-Count plan cool down diabetic feet?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age ≥18 years. * Type 1 or type 2 diabetes mellitus. * Loss of protective sensation demonstrated by standardized 10-g monofilament testing. * IWGDF risk category 3. * Previous diabetic foot ulceration and/or lower-extremity amputation consistent with IWGDF risk category 3. * Any previous ulcer on the relevant foot completely epithelialized and clinically healed for at least 4 weeks. * Confirmed plantar thermal hotspot, defined as an inter-foot temperature difference \>2.2°C at the same anatomically comparable plantar site on two consecutive days. * Intact skin at the index hotspot. * Community ambulatory. * Able to perform daily foot-temperature measurements independently or with caregiver assistance. * Able to reduce ambulatory activity temporarily if assigned to the experimental intervention. * At least five valid days of objectively recorded daily step-count data during Days -21 through -3 relative to the first positive thermal screening measurement. * Objective historical activity data available from a smartphone, smartwatch, activity tracker, pedometer with stored daily counts, or another verifiable device-based source. * Willing to continue objective activity measurement during randomized follow-up whenever technically possible. * Able to provide informed consent and complete study procedures. Exclusion Criteria: * Active diabetic foot ulcer or other open foot wound. * Blister, hemorrhagic callus, skin breakdown, or another pre-ulcerative lesion requiring immediate therapeutic management. * Active or suspected Charcot neuro-osteoarthropathy. * Clinical evidence of foot infection. * Critical limb-threatening ischaemia or another vascular condition requiring urgent management. * Recent acute foot trauma or surgery that could independently alter local foot temperature. * Predominantly non-ambulatory or wheelchair-dependent status. * Medical condition for which substantial temporary reduction in ambulatory activity would be unsafe. * Inability to provide the required pre-hotspot objective activity history. * Cognitive or functional impairment preventing study procedures without suitable caregiver assistance. * Absence of an anatomically valid contralateral comparison site for the proposed index hotspot.