Scoliosis Brace Compliance Sensor
Investigators:
Background:
Spinal bracing has been the mainstay of conservative treatment of idiopathic scoliosis. It has been shown to be effective in halting the natural history of progression of moderate idiopathic curves in most skeletally immature patients. The efficacy of the spinal orthoses is, however, dependent upon excellent patient compliance with a prescribed brace-wearing schedule.
Several studies on the effectiveness of these spinal orthoses have failed to address the issue of brace-wear compliance. Poor patient compliance with the prescribed brace-wear schedule has been well documented to be a major factor in brace failure and curve progression. Most studies were done retrospectively either by reviewing medical records or by telephone interviews of patients and parents. They relied on the patients reporting their average daily brace-wear time to determine their compliance.
The purpose of this study is to prospectively and accurately document the brace wear compliance of patients with idiopathic scoliosis being treated with the Wilmington brace by installing a monitor in the braces. The monitor records their actual brace-wear time and pattern of brace-wear, thus allowing the accurate assessment of brace-wear compliance without relying on the patients subjective reports.
What We're Doing:
Sixty-one subjects with juvenile or adolescent idiopathic scoliosis who were braced with the Wilmington jacket were monitored with the compliance sensor. Patients were followed throughout their brace-wearing period. The data were downloaded at every clinical visit and then analyzed. Brace compliance was measured and compared with factors such as age and progression of scoliosis.
Some of What We've Found:
The compliance sensor was very effective and reliable in providing an objective measure of compliance. Results further demonstrated that compliance decreased as the child grew older; compliance is routinely overestimated by the patient. The study also shows that compliance was significantly less in patients whose scoliosis got worse compared with those whose did not get worse.
