BRACE LOADS PATTERN DURING DAYTIME AND NIGHTTIME WEAR

Abstract

To determine the pattern of brace wear compliance over time in both day and night time wear by using objective force measurements within the brace.

Twenty subjects who were diagnosed of AIS, age between nine and fifteen years, and new to brace treatment were recruited in this study. To use the data for analysis, only subjects who used the brace for five hours continuously either in daytime or nighttime were considered. For daytime wear, the selected five hour intervals had to begin with an initial spike in force after a period of non-activity as recorded by the transducer, which would indicate that they had just put on the brace. At night, the measurements began at one am and ended at six am.

Among the twenty subjects, only nine subjects’ data were used for daytime and eleven subjects’ data were used in nighttime. The average wear period was 11.4 ± 4.3 days for the day group, 11.6 ± 3.9 days for the night group. There was a statistically significant decrease in force within the first five hours of consecutive brace wear during daytime hours. The decrease was from 1.4 ± 0.6 (140% of prescribed force) in the first hour to 1.0 ± 0.6 in the fifth hour, a difference of 0.4, which is a 29% drop from the initial force. Most of the drop in force happened between hour one and hour two, as the difference in those two hours is 0.2 ± 0.1 (p = 0.001); between hours two and five the difference did not reach statistical significance. The observed difference between hours one and five for the night group was 0.2 ± 0.2, p = 0.06, which did not reach significance as well. Daytime forces in a Boston Brace tend to decrease over a period of time, but the nighttime forces seem to be maintained at the same level. These results show that daily adjustment of the brace tightness may be required to maintain the tightness level and the efficiency of brace treatment.