title: Electronic monitoring improves brace-wearing compliance in patients with adolescent idiopathic scoliosis: a randomized clinical trial.
abstract: METHODS
  Randomized controlled trial.
  
  
  OBJECTIVE
  To assess whether monitoring increases brace-wearing compliance in patients with adolescent idiopathic scoliosis (AIS).
  
  
  BACKGROUND
  Noncompliance is a barrier to brace treatment of AIS. Studies have demonstrated that monitoring improves medication compliance; however, this has not been investigated in spinal braces.
  
  
  METHODS
  Twenty-one patients (mean age = 12.4 ± 2.0 years) with AIS were prescribed treatment with a custom-made Thoraco-Lumbo-Sacral-Orthosis for 18 hours a day using a standardized script. Before beginning treatment, 10 patients were randomized to be informed that their compliance was monitored, whereas 11 patients were unaware. Compliance was measured via a temperature probe embedded within the Thoraco-Lumbo-Sacral-Orthosis hidden from view.
  
  
  RESULTS
  Patients who were notified that they had a monitor in their brace demonstrated significantly increased compliance during the first 14 weeks of treatment compared with those who were uninformed (85.7% vs. 56.5%, P = 0.029), corresponding to a mean difference of 5.24 hours of daily brace wear.
  
  
  CONCLUSIONS
  Electronic monitoring can improve compliance with orthoses in patients with spinal deformity during a short observation period.
authors.affiliation: Division of Pediatric Orthopaedic Surgery, Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY 10032, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Miller
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Franzone
authors.forename: Hiroko
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Jaime A
authors.initials: JA
authors.lastname: Gomez
authors.forename: Javier
authors.initials: J
authors.lastname: Avendaño
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Hyman
authors.forename: David P
authors.initials: DP
authors.lastname: Roye
authors.forename: Michael G
authors.initials: MG
authors.lastname: Vitale
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D001915:Braces; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods*; D009519:New York City; D010349:Patient Compliance; D012600:Scoliosis / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D013821:Thermometers; D013997:Time Factors; D016896:Treatment Outcome