Monitoring scoliosis patients’ brace use prevents curve progression, surgery

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Adolescent scoliosis patients who used a brace with embedded sensors which monitored use wore their brace for longer than those who were not told the purpose of the monitors.

In the study, published in the Journal of Bone and Joint Surgery, 93 patients in one group were told about the existence and purpose of the monitors, and data and time spent wearing the brace were discussed at follow-up visits. The 78 patients in the second group were not told about the purpose of the monitors, nor did they receive data on brace compliance.

“Patients who were aware that their device measured brace use, wore their brace, on average, an additional three hours each day,” says orthopaedic surgeon and lead study author Lori Karol. The study also found that patients who wore their brace were less likely to require surgery, by 11%, due to less spinal progression.

The average curve magnitude at the start of bracing was comparable at the start of the study: 33.2 degrees in the counselled group and 33.9 in the non-counselled group. Among the specific findings:

  • Daily brace wear during the initial 180-day time period averaged 15 hours in the counselled group and 12.5 hours in the non-counselled group
  • Counselled patients who completed bracing averaged 13.8 hours per day of orthotic wear during the entire course of bracing, compared with 10.8 hours per day for patients who did not receive compliance reports
  • The spinal curve did not progress more than 6 degrees between the start of bracing and brace termination in 59% of patients in the counselled group, and 36% of patients in the non-counselled group
  • Children who did not need surgery wore their brace 2.1 hours more per day on average

“Shared information between the teen, parents, orthotist (who oversees the creation and fit of the custom brace), and physician resulted in improved brace compliance,” says Karol. “These findings emphasise the role that open doctor-patient communication plays in encouraging treatment effectiveness in the adolescent age group.”

 

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