The Objective Determination of Compliance in Treatment of Adolescent Idiopathic Scoliosis With Spinal Orthoses

Abstract

Long-term logging of temperature within a spinal orthosis is a reliable and simple way to measure objectively the compliance. Thus, comparison of full-time and part-time bracing is made possible on an objective basis. Furthermore, knowing the bracing pattern provides a better focus on other variables of spinal bracing, such as the force distribution within the brace. This knowledge may help to improve further the shape and effectiveness of bracing.

Objective compliance of adolescent girls with idiopathic scoliosis in a dynamic SpineCor brace

“…4 The distribution of the data points of all patients indicates the clear cut-off between brace-on temperatures over the 30°C threshold and brace-off temperatures between 21 and 26°C 1 20 0 22 14 47 58 50 57 49 48 34 38 10 49 2 30 0 24 18 49 49 28 23 60 39 63 20 24 44 3 7 2 20 10 67 45 50 52 37 0 26 20 20 40 4 7 0 3 0 2 2 5 2 2 6 0 0 0 0 4 7 5 1 2 5 29 3 24 34 58 64 43 49 53 58 75 21 37 57 6 2 0 2 correction [21]. We, therefore, focused on the objective assessment of compliance, which is reliably accomplished with temperature recording at the brace/skin interface [2,5,6,8,9,22]. Since all parts of SpineCor are less than 1.5-mm thick and flexible, the logger needs to be thin and bendable.…”

“…According to a previous similar study on rigid braces, a logging period of 2 weeks is sufficient to reveal the wearing pattern [5]. We programmed the device at 30-min intervals (672 data/2 weeks).…”

“…Though their interaction has not been clearly quantified yet, the most commonly prescribed regimen is 20-23 h daily brace wear [3][4][5][6][7][8]. However, subjective assessments by questionnaires, diaries and interviews revealed overestimation of the time in brace [6,8,9] compared to valid data yielded by load and temperature measurements in rigid braces: compliance (wearing time in brace divided by advised hours) only reached fairly consistent averages of 62-67.5% [5,7,8]. A psychological profile with low self-esteem, anxiety, poor social support and limited success expectations seems predictive for low compliance [3].…”

Electronic monitoring of scoliosis brace wear compliance

“…The number of wear hours reported in these studies was subjective and difficult to verify due to reliance on patient recall, with the possibility of false reporting. Others have looked at developing objective ways of measuring brace wear compliance by using pressure monitoring [5][6][7] or temperature sensing [8][9][10][11][12]. These sensors worked; however, they were bulky.…”

No effect of osteopathic treatment on trunk morphology and spine flexibility in young women with adolescent idiopathic scoliosis

“…At least 50% in-brace Cobb angle correction and adherence to a 20-23 h per day wear regimen are mandatory for success [36][37][38][39]. However, the use of bracing is controversial: compliance (hours in brace/prescribed brace regimen) has been found to be as low as 62-67.5% in rigid braces [6,40,41] and pooled data in meta-analysis on observation, exercises and bracing did not provide evidence to recommend one approach over the other [42,43]. This may reflect the physical and psychosocial impacts of a rigid, visible and warm orthosis.…”