Scoliosis Brace Compliance Sensor

Investigators:

• Tariq Rahman, PhD
• J. Richard Bowen, MD

Spinal bracing has been the mainstay of conservative treatment of idiopathic scoliosis. It has been shown to be effective in halting the progression of moderate idiopathic curves in most skeletally immature patients. The efficacy of the spinal orthoses is, however, dependent upon excellent patient compliance with the prescribed brace-wearing schedule.Spinal bracing has been the mainstay of conservative treatment of idiopathic scoliosis. It has been shown to be effective in halting the progression of moderate idiopathic curves in most skeletally immature patients. The efficacy of the spinal orthoses is, however, dependent upon excellent patient compliance with the 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 project is to prospectively and accurately document the brace wear compliance of patients with idiopathic scoliosis 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 patient’s subjective reports.

Sixty-one subjects with juvenile or adolescent idiopathic scoliosis who were braced with the Wilmington jacket were monitored with the compliance sensor. 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. The compliance sensor was very effective and reliable in providing an objective measure of compliance. Patient compliance was measured to be 75% of prescribed time. This figure decreased as the child grew older.

The lab has developed an improved compliance sensor called the Cricket. The sensor is self contained, sealed and can be obtained with a small screen that gives the patient information on average hours the brace is worn. The Cricket was manufactured in partnership with Creative MicroDesigns  and is being sold commercially by Boston Brace .

References

Rahman T, Bowen J.R, Takemitsu M, Scott C. “The Association Between Brace Compliance and Outcomes for Patients with Idiopathic Scoliosis”. J Pediatr Orthop 2005:25(4): 420-422

Takemitsu M, Bowen JR, Rahman T, Glutting JJ, Scott C. “Compliance monitoring of brace treatment for patients with idiopathic scoliosis” Spine 2004:29:2070-2074.