Objective Monitoring of Jewett Brace Compliance in Osteoporotic Vertebral Fractures: A Prospective Sensor-Based Study

Abstract

Introduction: Osteoporotic vertebral fractures (OVFs) are the most common type of fragility fracture in elderly patients with osteoporosis. Bracing is widely used for conservative treatment; however, few studies have objectively assessed patient adherence to prescribed brace usage. This prospective study aimed to evaluate true patient compliance with the Jewett brace for acute OVFs using a temperature logger embedded in the brace.

Methods: Patients aged ≥65 years with an acute OVF diagnosed within two weeks of injury were enrolled between February 2024 and January 2025. After two weeks of bed rest, patients began ambulation while wearing a Jewett brace. A button-type temperature logger was installed on the sternal pad of the brace to record the temperature every 30 minutes for 42 consecutive days. Wearing was defined as temperatures ≥30°C. Based on previous reports, wearing the brace for 15 hours daily was defined as 100% compliance. Compliance was calculated for the entire period, for hospitalization versus post-discharge, and at three 14-day intervals. Correlations between vertebral instability and compliance were also analyzed.

Results: A total of 17 patients were included in the final analysis. The mean overall compliance rate was 85.8%, corresponding to an average wearing time of 12.9 hours per day. Brace compliance was consistently maintained at a high level during hospitalization and after discharge, as well as across the first, second, and last 14-day intervals. The daily wearing rate peaked at approximately 80% around mealtimes and remained above 70% during daytime hours. A significant, moderately positive correlation was observed between vertebral instability and compliance in the last 14 days.

Conclusions: This study objectively demonstrated a remarkably high patient compliance rate of 85.8% (12.9 hours per day) with Jewett braces for OVFs during the 42-day period following the initial two-week hospitalized bed rest.