The preliminary clinical application of a smart orthosis personalized management system for the treatment of patients with adolescent idiopathic scoliosis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHU Ce ¹ , WU Qiang ² , XIAO Bing ³ , WANG Juehan ¹ , LUO Chao ¹ , YU Quan ⁴ ,  LIU Limin ¹ , SONG Yueming ¹

1. Department of Orthopedics, Orthopedics Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;
2. Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;
3. Chengdu Spine Medical Technology Co., Ltd, Chengdu Sichuan, 610000, P.R.China;
4. Sichuan NeoSource BioTektronics Limited, Chengdu Sichuan, 610000, P.R.China;

Corresponding author：

LIU Limin, Email: liulimin_spine@163.com

Keywords：

Adolescent idiopathic scoliosis; orthosis treatment; real-time monitoring; compliance

DOI：

10.7507/1002-1892.202103163

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Objective To develop a smart orthosis personalized management system for the treatment of patients with adolescent idiopathic scoliosis (AIS) and to evaluate the feasibility and efficiency through clinical preliminary applications.Methods The smart orthosis personalized management system consists of a wireless force monitor, a WeChat Mini Program, a cloud-based storage system, and a website backstage management system. Twenty-two patients with AIS who underwent orthosis treatment and met the selection criteria between March 2020 and December 2020 were enrolled. The follow-up time was 4 months. The parameters used to evaluate patients’ compliance were as follows (back and lumbar): baseline force value, measured force value, force compliance (measured force value/baseline force value×100%), measured wearing time (wearing time of force value was more than 0 N), and time compliance (measured wearing time/prescribed wearing time×100%), in which the prescribed wearing time was 23 hours/day. The baseline force values were measured at initiation, while the measured force value, measured wearing time, force compliance, and time compliance were measured during follow-up. The differences of these parameters between back and lumbar, and the differences among these parameters at 1, 2, 3, and 4 months after orthosis wearing were analyzed.Results The average measured force value of 22 patients (back and lumbar) was (0.83±0.34) N, the average force compliance was 68.5%±17.9%, the average measured wearing time was (15.4±1.7) hours, and the average time compliance was 66.9%±7.7%. The baseline force value and measured force value of back were significantly higher than those of lumbar (P<0.05); the measured wearing time, force compliance, and time compliance between back and lumbar showed no significant difference (P>0.05). The measured force value, measured wearing time, force compliance, and time compliance at 1 month after wearing were significantly lower than those at 2, 3, and 4 months after orthosis wearing (P<0.05), no significant difference was found among 2, 3, and 4 months after orthosis wearing (P>0.05). At different time points after wearing, the measured force value of back were significantly higher than that of lumbar (P<0.05), while there was no significant difference between back and lumbar on the other parameters (P>0.05).Conclusion The smart orthosis personalized management system has high feasibility to treat AIS, and can improve the compliance of such patients with orthosis wearing.

Citation： ZHU Ce, WU Qiang, XIAO Bing, WANG Juehan, LUO Chao, YU Quan, LIU Limin, SONG Yueming. The preliminary clinical application of a smart orthosis personalized management system for the treatment of patients with adolescent idiopathic scoliosis. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(7): 801-806. doi: 10.7507/1002-1892.202103163 Copy

1.	邱勇, 朱丽华, 宋知非. 脊柱侧凸的临床病因学分类研究. 中华骨科杂志, 2000, 20(5): 265.
2.	孙超, 邱勇. 青少年特发性脊柱侧凸支具治疗的研究进展. 中国脊柱脊髓杂志, 2010, 20(5): 421-424.
3.	Rahimi S, Kiaghadi A, Fallahian N. Effective factors on brace compliance in idiopathic scoliosis: a literature review. Disabil Rehabil Assist Technol, 2020, 15(8): 917-923.
4.	Wiley JW, Thomson JD, Mitchell TM, et al. Effectiveness of the boston brace in treatment of large curves in adolescent idiopathic scoliosis. Spine (Phila Pa 1976), 2000, 25(18): 2326-2332.
5.	Karol LA. Effectiveness of bracing in male patients with idiopathic scoliosis. Spine (Phila Pa 1976), 2001, 26(18): 2001-2005.
6.	Nicholson GP, Ferguson-Pell MW, Smith K, et al. The objective measurement of spinal orthosis use for the treatment of adolescent idiopathic scoliosis. Spine (Phila Pa 1976), 2003, 28(19): 2243-2250.
7.	Donzelli S, Zaina F, Minnella S, et al. Consistent and regular daily wearing improve bracing results: a case-control study. Scoliosis Spinal Disord, 2018, 13: 16. doi: 10.1186/s13013-018-0164-0.
8.	Karol LA, Virostek D, Felton K, et al. Effect of compliance counseling on brace use and success in patients with adolescent idiopathic scoliosis. J Bone Joint Surg (Am), 2016, 98(1): 9-14.
9.	Miller DJ, Franzone JM, Matsumoto H, et al. Electronic monitoring improves brace-wearing compliance in patients with adolescent idiopathic scoliosis: a randomized clinical trial. Spine (Phila Pa 1976), 2012, 37(9): 717-721.
10.	Lou E, Hill DL, Raso JV. A wireless sensor network system to determine biomechanics of spinal braces during daily living. Med Biol Eng Comput, 2010, 48(3): 235-243.
11.	Lou E, Hill D, Hedden D, et al. An objective measurement of brace usage for the treatment of adolescent idiopathic scoliosis. Med Eng Phys, 2011, 33(3): 290-294.
12.	Lou E, Raso JV, Hill DL, et al. The daily force pattern of spinal orthoses in subjects with adolescent idiopathic scoliosis. Prosthet Orthot Int, 2002, 26(1): 58-63.
13.	王凯, 王胜利, 吴志宏, 等. 用于测量Boston支具表面压力的无线压力传感器研制. 中国骨与关节外科, 2014, (2): 142-145.
14.	易红蕾, 李明, 朱晓东, 等. 新型脊柱侧凸三维矩形支具的有限元分析、顺应性监测及临床应用初探. 上海: 第二军医大学, 2014.
15.	Chhabra HS, Sharma S, Verma S. Smartphone app in self-management of chronic low back pain: a randomized controlled trial. Eur Spine J, 2018, 27(11): 2862-2874.
16.	Debono B, Bousquet P, Sabatier P, et al. Postoperative monitoring with a mobile application after ambulatory lumbar discectomy: an effective tool for spine surgeons. Eur Spine J, 2016, 25(11): 3536-3542.
17.	Morton A, Riddle R, Buchanan R, et al. Accuracy in the prediction and estimation of adherence to bracewear before and during treatment of adolescent idiopathic scoliosis. J Pediatr Orthop, 2008, 28(3): 336-341.
18.	Rahman T, Sample W, Yorgova P, et al. Electronic monitoring of orthopedic brace compliance. J Child Orthop, 2015, 9(5): 365-369.
19.	Aulisa AG, Giordano M, Falciglia F, et al. Correlation between compliance and brace treatment in juvenile and adolescent idiopathic scoliosis: SOSORT 2014 award winner. Scoliosis, 2014, 9: 6. doi: 10.1186/1748-7161-9-6.
20.	Brigham EM, Armstrong DG. Motivations for Compliance With Bracing in Adolescent Idiopathic Scoliosis. Spine Deform, 2017, 5(1): 46-51.
21.	Mak I, Lou E, Raso JV, et al. The effect of time on qualitative compliance in brace treatment for AIS. Prosthet Orthot Int, 2008, 32(2): 136-144.

1. 邱勇, 朱丽华, 宋知非. 脊柱侧凸的临床病因学分类研究. 中华骨科杂志, 2000, 20(5): 265.
2. 孙超, 邱勇. 青少年特发性脊柱侧凸支具治疗的研究进展. 中国脊柱脊髓杂志, 2010, 20(5): 421-424.
3. Rahimi S, Kiaghadi A, Fallahian N. Effective factors on brace compliance in idiopathic scoliosis: a literature review. Disabil Rehabil Assist Technol, 2020, 15(8): 917-923.
4. Wiley JW, Thomson JD, Mitchell TM, et al. Effectiveness of the boston brace in treatment of large curves in adolescent idiopathic scoliosis. Spine (Phila Pa 1976), 2000, 25(18): 2326-2332.
5. Karol LA. Effectiveness of bracing in male patients with idiopathic scoliosis. Spine (Phila Pa 1976), 2001, 26(18): 2001-2005.
6. Nicholson GP, Ferguson-Pell MW, Smith K, et al. The objective measurement of spinal orthosis use for the treatment of adolescent idiopathic scoliosis. Spine (Phila Pa 1976), 2003, 28(19): 2243-2250.
7. Donzelli S, Zaina F, Minnella S, et al. Consistent and regular daily wearing improve bracing results: a case-control study. Scoliosis Spinal Disord, 2018, 13: 16. doi: 10.1186/s13013-018-0164-0.
8. Karol LA, Virostek D, Felton K, et al. Effect of compliance counseling on brace use and success in patients with adolescent idiopathic scoliosis. J Bone Joint Surg (Am), 2016, 98(1): 9-14.
9. Miller DJ, Franzone JM, Matsumoto H, et al. Electronic monitoring improves brace-wearing compliance in patients with adolescent idiopathic scoliosis: a randomized clinical trial. Spine (Phila Pa 1976), 2012, 37(9): 717-721.
10. Lou E, Hill DL, Raso JV. A wireless sensor network system to determine biomechanics of spinal braces during daily living. Med Biol Eng Comput, 2010, 48(3): 235-243.
11. Lou E, Hill D, Hedden D, et al. An objective measurement of brace usage for the treatment of adolescent idiopathic scoliosis. Med Eng Phys, 2011, 33(3): 290-294.
12. Lou E, Raso JV, Hill DL, et al. The daily force pattern of spinal orthoses in subjects with adolescent idiopathic scoliosis. Prosthet Orthot Int, 2002, 26(1): 58-63.
13. 王凯, 王胜利, 吴志宏, 等. 用于测量Boston支具表面压力的无线压力传感器研制. 中国骨与关节外科, 2014, (2): 142-145.
14. 易红蕾, 李明, 朱晓东, 等. 新型脊柱侧凸三维矩形支具的有限元分析、顺应性监测及临床应用初探. 上海: 第二军医大学, 2014.
15. Chhabra HS, Sharma S, Verma S. Smartphone app in self-management of chronic low back pain: a randomized controlled trial. Eur Spine J, 2018, 27(11): 2862-2874.
16. Debono B, Bousquet P, Sabatier P, et al. Postoperative monitoring with a mobile application after ambulatory lumbar discectomy: an effective tool for spine surgeons. Eur Spine J, 2016, 25(11): 3536-3542.
17. Morton A, Riddle R, Buchanan R, et al. Accuracy in the prediction and estimation of adherence to bracewear before and during treatment of adolescent idiopathic scoliosis. J Pediatr Orthop, 2008, 28(3): 336-341.
18. Rahman T, Sample W, Yorgova P, et al. Electronic monitoring of orthopedic brace compliance. J Child Orthop, 2015, 9(5): 365-369.
19. Aulisa AG, Giordano M, Falciglia F, et al. Correlation between compliance and brace treatment in juvenile and adolescent idiopathic scoliosis: SOSORT 2014 award winner. Scoliosis, 2014, 9: 6. doi: 10.1186/1748-7161-9-6.
20. Brigham EM, Armstrong DG. Motivations for Compliance With Bracing in Adolescent Idiopathic Scoliosis. Spine Deform, 2017, 5(1): 46-51.
21. Mak I, Lou E, Raso JV, et al. The effect of time on qualitative compliance in brace treatment for AIS. Prosthet Orthot Int, 2008, 32(2): 136-144.

Chinese Journal of Reparative and Reconstructive Surgery

The preliminary clinical application of a smart orthosis personalized management system for the treatment of patients with adolescent idiopathic scoliosis

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