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In defense of adolescents: They really do use braces for the hours prescribed, if good help is provided. Results from a prospective everyday clinic cohort using thermobrace.

Donzelli S, Zaina F, Negrini S - Scoliosis (2012)

Bottom Line: We hypothesize that the treating team (SOSORT criteria) plays a major role in our results.This study suggests that compliance is neither due to the type of treatment only nor to the patient alone.According to our experience, TB offers valuable insights and do not undermine the relationship with the patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Physical and Rehabilitation Medicine, University of Brescia, Brescia, Italy. stefano.negrini@isico.it.

ABSTRACT

Background: The effectiveness of bracing relies on the quality of the brace, compliance of the patient, and some disease factors. Patients and parents tend to overestimate adherence, so an objective assessment of compliance has been developed through the use of heat sensors. In 2010 we started the everyday clinical use of a temperature sensor, and the aim of this study is to present our initial results.

Population: A prospective cohort of 68 scoliosis patients that finished at least 4 months of brace treatment on March 31, 2011: 48 at their first evaluation (79% females, age 14.2±2.4) and 20 already in treatment.

Treatment: Bracing (SPoRT concept); physiotherapic specific exercises (SEAS School); team approach according to the SOSORT Bracing Management Guidelines.Methods. A heat sensor, "Thermobrace" (TB), has been validated and applied to the brace. The real (measured by TB) and referred (reported by the patient) compliances were calculated.Statistics. The distribution was not normal, hence median and 95% interval confidence (IC95) and non-parametric tests had to be used.

Results: Average TB use: 5.5±1.5 months. Brace prescription was 23 hours/day (h/d) (IC95 18-23), with a referred compliance of 100% (IC95 70.7-100%) and a real one of 91.7% (IC95 56.6-101.7%), corresponding to 20 h/d (IC95 11-23). The more the brace was prescribed, the more compliant the patient was (94.8% in 23 h/d vs. 73.2% in 18 h/d, P < 0.05). Sixty percent of the patients had at least 90% compliance, and 45% remained within 1 hour of what had been prescribed. Non-wearing days were 0 (IC95 0-12.95), and involved 29% of patients.

Conclusion: This is the first study using a TB in a setting of respect for the SOSORT criteria for bracing, and it states that it is possible to achieve a very good compliance, even with a full time prescription, and better than what was previously reported (80% maximum). We hypothesize that the treating team (SOSORT criteria) plays a major role in our results. This study suggests that compliance is neither due to the type of treatment only nor to the patient alone. According to our experience, TB offers valuable insights and do not undermine the relationship with the patients.

No MeSH data available.


Related in: MedlinePlus

Clime temperature and comparison among environmental temperature in the north and in the south of Italy. The upper graph shows that the hottest period of the year was during the month of August, in the lower part the graph shows that the trendo of temeprature in Milan and in Messina were very similar.
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Figure 4: Clime temperature and comparison among environmental temperature in the north and in the south of Italy. The upper graph shows that the hottest period of the year was during the month of August, in the lower part the graph shows that the trendo of temeprature in Milan and in Messina were very similar.

Mentions: Environmental clime and temperature didn’t seem to affect data recorded by the heat sensor. This is a very challenging question and, due to reviewers suggestions, we analyzed our data in the attempt to investigate this possibility. So in a wider group of 312 patients (obtained in February 2012, after the original study was performed) we collected the moving mean obtained by the TB, for the high and low threshold in each months of the year. We looked for the hottest period of the year and we compared the average temperature per hour of the day with the mean brace wearing time per hour of the day in the same month. Moreover, we compared the mean moving average obtained from the TB in a city of the North of Italy with one in the South, as well as the hottest temperatures in the same period in these two towns: the trend was similar. The Figure 4 A and B shows the mean temperature per months of the year and the comparison of temperatures in Milan (North) and in Messina (South).


In defense of adolescents: They really do use braces for the hours prescribed, if good help is provided. Results from a prospective everyday clinic cohort using thermobrace.

Donzelli S, Zaina F, Negrini S - Scoliosis (2012)

Clime temperature and comparison among environmental temperature in the north and in the south of Italy. The upper graph shows that the hottest period of the year was during the month of August, in the lower part the graph shows that the trendo of temeprature in Milan and in Messina were very similar.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475113&req=5

Figure 4: Clime temperature and comparison among environmental temperature in the north and in the south of Italy. The upper graph shows that the hottest period of the year was during the month of August, in the lower part the graph shows that the trendo of temeprature in Milan and in Messina were very similar.
Mentions: Environmental clime and temperature didn’t seem to affect data recorded by the heat sensor. This is a very challenging question and, due to reviewers suggestions, we analyzed our data in the attempt to investigate this possibility. So in a wider group of 312 patients (obtained in February 2012, after the original study was performed) we collected the moving mean obtained by the TB, for the high and low threshold in each months of the year. We looked for the hottest period of the year and we compared the average temperature per hour of the day with the mean brace wearing time per hour of the day in the same month. Moreover, we compared the mean moving average obtained from the TB in a city of the North of Italy with one in the South, as well as the hottest temperatures in the same period in these two towns: the trend was similar. The Figure 4 A and B shows the mean temperature per months of the year and the comparison of temperatures in Milan (North) and in Messina (South).

Bottom Line: We hypothesize that the treating team (SOSORT criteria) plays a major role in our results.This study suggests that compliance is neither due to the type of treatment only nor to the patient alone.According to our experience, TB offers valuable insights and do not undermine the relationship with the patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Physical and Rehabilitation Medicine, University of Brescia, Brescia, Italy. stefano.negrini@isico.it.

ABSTRACT

Background: The effectiveness of bracing relies on the quality of the brace, compliance of the patient, and some disease factors. Patients and parents tend to overestimate adherence, so an objective assessment of compliance has been developed through the use of heat sensors. In 2010 we started the everyday clinical use of a temperature sensor, and the aim of this study is to present our initial results.

Population: A prospective cohort of 68 scoliosis patients that finished at least 4 months of brace treatment on March 31, 2011: 48 at their first evaluation (79% females, age 14.2±2.4) and 20 already in treatment.

Treatment: Bracing (SPoRT concept); physiotherapic specific exercises (SEAS School); team approach according to the SOSORT Bracing Management Guidelines.Methods. A heat sensor, "Thermobrace" (TB), has been validated and applied to the brace. The real (measured by TB) and referred (reported by the patient) compliances were calculated.Statistics. The distribution was not normal, hence median and 95% interval confidence (IC95) and non-parametric tests had to be used.

Results: Average TB use: 5.5±1.5 months. Brace prescription was 23 hours/day (h/d) (IC95 18-23), with a referred compliance of 100% (IC95 70.7-100%) and a real one of 91.7% (IC95 56.6-101.7%), corresponding to 20 h/d (IC95 11-23). The more the brace was prescribed, the more compliant the patient was (94.8% in 23 h/d vs. 73.2% in 18 h/d, P < 0.05). Sixty percent of the patients had at least 90% compliance, and 45% remained within 1 hour of what had been prescribed. Non-wearing days were 0 (IC95 0-12.95), and involved 29% of patients.

Conclusion: This is the first study using a TB in a setting of respect for the SOSORT criteria for bracing, and it states that it is possible to achieve a very good compliance, even with a full time prescription, and better than what was previously reported (80% maximum). We hypothesize that the treating team (SOSORT criteria) plays a major role in our results. This study suggests that compliance is neither due to the type of treatment only nor to the patient alone. According to our experience, TB offers valuable insights and do not undermine the relationship with the patients.

No MeSH data available.


Related in: MedlinePlus