Compliance Monitoring of Brace Treatment for Patients with Idiopathic Scoliosis

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Abstract

Study Design.

Prospective, blinded study to evaluate compliance with treatment.

Objective.

To evaluate objectively idiopathic scoliosis patients’ compliance with Wilmington brace treatment.

Summary of Background Data.

Patients’ compliance with brace treatment for idiopathic scoliosis traditionally has been determined from patient or parent interviews or both; however, the hours reported by patients are subjective and consequently are not accurate.

Methods.

Study participants were 61 consecutive patients with idiopathic scoliosis: 54 girls and 7 boys. Inclusion criteria were curvature of more than 20° and less than 45° of Cobb angle before brace treatment. Actual hours worn per day were measured using a compliance monitor, and compliance was determined by the percentage of actual hours worn in accordance with the prescribed regimen. Accuracy of compliance from hours reported by patients was compared with actual hours measured by the monitor. Correlations between compliance and prescribed regimen and age were analyzed.

Results.

The overall compliance measured by the monitor was 75 ± 27% (mean ± S.D.), and the frequency distribution was similar to a Gaussian distribution. The compliance determined from hours reported by patients was 85 ± 24%, which was higher than that from actual hours measured by the monitor (P = 0.01). There was a negative correlation between age and compliance (ρ = −0.30, P = 0.025); 10-, 12-, and 14-year-old patients had 84, 77, and 60% average compliance, respectively. Compliance among patients with different prescribed regimens (8, 12, 16, or 23 hours of wear) showed no statistical difference (P = 0.361).

Conclusions.

Patients with idiopathic scoliosis complied with 75% of prescribed regimen on average and overreported their hours of brace wear to their physician. Age affected compliance. There was no statistical difference in compliance among patients with different prescribed regimens. The present study confirms the need for a compliance monitor to accurately evaluate use and outcome of brace treatment.

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