Utilizing Mobile Health Technology to Enhance Brace Compliance: Feasibility and Effectiveness of an App-Based Monitoring System for Adolescents with Idiopathic Scoliosis.

Abstract

Background/Objectives: Adolescent idiopathic scoliosis (AIS) often requires prolonged brace use to prevent curve progression. However, adherence is challenging due to discomfort, mobility restrictions, and psychosocial stressors. This study evaluated the feasibility and clinical utility of a mobile health (mHealth) system for real-time tracking of brace adherence and treatment-related experiences in adolescents with AIS. Methods: Thirty adolescents with AIS (mean age = 12.9, SD = 1.8) undergoing brace treatment at a tertiary care center used a custom app for 90 days. The app collected daily self-reports on brace wear duration, discomfort, movement limitations, emotional distress, and social challenges. A clinical alarm system alerted providers when patient input indicated potential concerns. Primary outcomes were feasibility (adherence to daily use and usability ratings) and brace adherence. Secondary outcomes included the app's capacity to identify treatment-related challenges and its association with changes in stress, quality of life, anxiety, and depression. Results: Participants reported meeting recommended brace wear time (≥16 h/day) on 84.8% of days. The app triggered 186 clinical alarms, with the most frequent related to emotional distress (23.1%) and pain (15.6%). Alarm frequency declined over time. Improvements of ≥20% in psychological outcomes were observed in 20-26.7% of participants, while group-level changes were nonsignificant. Conclusions: mHealth-based monitoring appears feasible and acceptable for digitally engaged adolescents with AIS. The app supported early detection of treatment barriers and prompted timely clinical responses. Despite limitations, it shows promise as a tool to improve treatment engagement and address psychosocial challenges in scoliosis care.