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

Abstract

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. 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. 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). The smart orthosis personalized management system has high feasibility to treat AIS, and can improve the compliance of such patients with orthosis wearing.