Mhealth for the monitoring of brace compliance and wellbeing in adolescents with idiopathic scoliosis: Study protocol for a feasibility study

Attempts to optimize monitoring of brace adherence prescribed to adolescents withidiopathic scoliosis (IS) have generally relied on sensors. Sensors, however, are intrusive and do notallow the assessment of psychological and physical consequences of brace use that might underliepoor adherence. Mobile applications have emerged as alternatives to monitor brace compliance.However, the feasibility and utility of these app-based systems to assess key psychological andphysical domains associated with non-adherence remain unexplored. This feasibility study aims totest the usability, acceptability, and clinical utility of an app-based system that monitors brace useand related psychological and physical factors. Forty adolescents with IS daily respond to the app for90 days. The patient responses may generate clinical alarms (e.g., brace non-adherence, discomfort,or distress) that will be sent daily to the medical team. Primary outcomes will be app usability,acceptability, and response rates. Secondary outcomes will include brace adherence, the number ofside effects reported, number and type of clinical alarms, stress, quality of life, perceived health status,and mood. If accepted by patients and clinicians, apps may allow rapid detection and response toundesired events in adolescents undergoing brace treatment.