In a study titled “Effect of Compliance Counseling on Brace Use and Success in Patients with Adolescent Idiopathic Scoliosis” in The Journal of Bone & Joint Surgery, Dr. Lori Karol and colleagues demonstrated that counseling adolescents about their compliance with the use of a scoliosis brace improved their use of the brace and also decreased the chance of scoliosis curve progression. The authors were able to validate the amount of brace wear for each patient in the study by using a sensor embedded within the scoliosis brace. For the counseling group, patients were informed at each visit about the data from the compliance monitor. For the comparison group, the physician, orthotist, and patient were not given access to the data about compliance. At the end of the study, comparison of data between groups showed that patients who were counseled wore their brace 3 hours more per day than the group that was not aware of the data. In addition, 36% of patients in that group progressed to curves greater than or equal to 50 degrees or to surgery, compared with only 25% of patients in the group with access about compliance data. The authors recommend that this type of compliance monitoring be incorporated into standard brace management protocols.
Hillard T. Spencer, MD 