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Measuring Foot Abduction Brace Wear Time Using a Single 3-Axis Accelerometer.

Benjamin Griffiths1, Natan Silver2, Malcolm H Granat1

  • 1School of Health and Society, University of Salford, Salford M5 4WT, UK.

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This study introduces an objective method using a 3-axis accelerometer to monitor foot abduction brace (FAB) wear in clubfoot treatment. The novel approach offers accurate, reliable compliance data, improving upon traditional self-reporting methods.

Keywords:
clubfootcompliancefoot abduction braceinfantsnon-wearopen accesswear

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Area of Science:

  • Orthopedics
  • Biomedical Engineering
  • Pediatric Care

Background:

  • Idiopathic congenital clubfoot requires treatment with serial casting, surgery, and foot abduction brace (FAB) wear.
  • Optimal functional outcomes and reduced reoccurrence depend on patient compliance with FAB wear.
  • Current compliance monitoring relies on self-reporting, which is inaccurate and time-consuming.

Purpose of the Study:

  • To present and validate a novel, objective method for monitoring FAB wear using a 3-axis accelerometer.
  • To compare the accuracy of accelerometer-based monitoring with traditional parent-reported diary logs.

Main Methods:

  • Eleven families used a 3-axis accelerometer attached to their infant's FAB for up to seven days.
  • Parents concurrently maintained a physical diary to record FAB application and removal times.
  • Data from accelerometers and diaries were analyzed for wear time agreement.

Main Results:

  • Accelerometer and diary measurements of FAB wear showed high correlation and visual alignment.
  • Bland Altman analysis revealed a -0.55-hour bias for diary measurements with limits of agreement from -2.96 to 1.96 hours.
  • A Cohen's Kappa coefficient of 0.88 indicated a very high level of agreement between the two monitoring methods.

Conclusions:

  • A 3-axis accelerometer provides an accurate and objective method for monitoring FAB compliance in clubfoot treatment.
  • This novel method is easily integrated with existing FABs, avoiding the need for specialized devices.
  • Objective monitoring can enhance research into FAB compliance and support clinical practice.