{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T10:55:57Z","timestamp":1769511357882,"version":"3.49.0"},"reference-count":25,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>The recommended treatment for idiopathic congenital clubfoot deformity involves a series of weekly castings, surgery, and a period of bracing using a foot abduction brace (FAB). Depending on the age of the child, the orthotic should be worn for periods that reduce in duration as the child develops. Compliance is vital to achieve optimal functional outcomes and reduce the likelihood of reoccurrence, deformity, or the need for future surgery. However, compliance is typically monitored by self-reporting, which is time-consuming to implement and lacks accuracy. This study presents a novel method for objectively monitoring FAB wear using a single 3-axis accelerometer. Eleven families mounted an accelerometer on their infant\u2019s FAB for up to seven days. Parents were also given a physical diary that was used to record the daily application and removal of the orthotic in line with their treatment. Both methods produced very similar measurements of wear that visually aligned with the movement measured by the accelerometer. Bland Altman plots showed a \u22120.55-h bias in the diary measurements and the limits of agreement ranging from \u22122.96 h to 1.96 h. Furthermore, the Cohens Kappa coefficient for the entire dataset was 0.88, showing a very high level of agreement. The method provides an advantage over existing objective monitoring solutions as it can be easily applied to existing FABs, preventing the need for bespoke monitoring devices. The novel method can facilitate increased research into FAB compliance and help enable FAB monitoring in clinical practice.<\/jats:p>","DOI":"10.3390\/s22072433","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T23:30:23Z","timestamp":1647991823000},"page":"2433","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Measuring Foot Abduction Brace Wear Time Using a Single 3-Axis Accelerometer"],"prefix":"10.3390","volume":"22","author":[{"given":"Benjamin","family":"Griffiths","sequence":"first","affiliation":[{"name":"School of Health and Society, University of Salford, Salford M5 4WT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natan","family":"Silver","sequence":"additional","affiliation":[{"name":"Shaare Zedek Medical Center, Jerusalem 9103102, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0722-2760","authenticated-orcid":false,"given":"Malcolm H.","family":"Granat","sequence":"additional","affiliation":[{"name":"School of Health and Society, University of Salford, Salford M5 4WT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9134-1721","authenticated-orcid":false,"given":"Ehud","family":"Lebel","sequence":"additional","affiliation":[{"name":"Shaare Zedek Medical Center, Jerusalem 9103102, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1007\/s00264-013-2031-1","article-title":"The Ponseti method for the treatment of congenital club foot: Review of the current literature and treatment recommendations","volume":"37","author":"Radler","year":"2013","journal-title":"Int. Orthop."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.2106\/JBJS.ST.14.00112","article-title":"Treatment of clubfoot using the ponseti method","volume":"6","author":"Dietz","year":"2016","journal-title":"JBJS Essent. Surg. Tech."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"486","DOI":"10.5435\/00124635-201008000-00005","article-title":"Bracing following correction of idiopathic clubfoot using the ponseti method","volume":"18","author":"Zionts","year":"2010","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1302\/1863-2548.12.180117","article-title":"Relapse following use of Ponseti method in idiopathic clubfoot","volume":"12","author":"Chand","year":"2018","journal-title":"J. Child. Orthop."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"382","DOI":"10.12680\/balneo.2018.216","article-title":"The importance of foot abduction brace after the Ponseti treatment of clubfoot","volume":"9","author":"Cosma","year":"2018","journal-title":"Balneo Res. J."},{"key":"ref_6","first-page":"161","article-title":"The Ponseti method of treatment for clubfoot in Brazil: Barriers to bracing compliance","volume":"33","author":"Nogueira","year":"2013","journal-title":"Iowa Orthop. J."},{"key":"ref_7","first-page":"620","article-title":"Factors affecting adherence with foot abduction orthosis following Ponseti method","volume":"49","author":"Goksan","year":"2015","journal-title":"Acta Orthop. Traumatol. Turc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/j.jsams.2014.08.004","article-title":"(Geeske) Validity of self-report methods for measuring sedentary behaviour in older adults","volume":"18","author":"Brown","year":"2015","journal-title":"J. Sci. Med. Sport"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Barone Gibbs, B., Paley, J.L., Jones, M.A., Whitaker, K.M., Connolly, C.P., and Catov, J.M. (2020). Validity of self-reported and objectively measured sedentary behavior in pregnancy. BMC Pregnancy Childbirth, 20.","DOI":"10.1186\/s12884-020-2771-z"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Fiedler, J., Eckert, T., Burchartz, A., Woll, A., and Wunsch, K. (2021). Comparison of self-reported and device-based measured physical activity using measures of stability, reliability, and validity in adults and children. Sensors, 21.","DOI":"10.20944\/preprints202102.0574.v1"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1097\/BPO.0000000000000205","article-title":"A Randomized clinical trial comparing reported and measured wear rates in clubfoot bracing using a novel pressure sensor","volume":"35","author":"Morgenstein","year":"2015","journal-title":"J. Pediatr. Orthop."},{"key":"ref_12","first-page":"411","article-title":"Clubfoot therapy in accordance with ponseti-current standard","volume":"157","author":"Funk","year":"2019","journal-title":"Z. Orthop. Unf."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"383","DOI":"10.5435\/JAAOS-D-19-00163","article-title":"Objective measurement of brace wear in successfully ponseti-treated clubfeet: Pattern of decreasing use in the first 2 years","volume":"28","author":"Richards","year":"2020","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.2106\/JBJS.16.00170","article-title":"The objective measurement of brace-use adherence in the treatment of idiopathic clubfoot","volume":"98","author":"Sangiorgio","year":"2016","journal-title":"J. Bone Jt. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2401","DOI":"10.1007\/s00264-021-05042-0","article-title":"Development of a functional prototype of a SMART (Sensor-integrated for Monitoring and Remote Tracking) foot abduction brace for clubfoot treatment: A pre-clinical evaluation","volume":"45","author":"Aroojis","year":"2021","journal-title":"Int. Orthop."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Aadland, E., Andersen, L.B., Anderssen, S.A., and Resaland, G.K. (2018). A comparison of 10 accelerometer non-wear time criteria and logbooks in children. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5212-4"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"11084","DOI":"10.1038\/s41598-018-29503-6","article-title":"Upper limb activity in myoelectric prosthesis users is biased towards the intact limb and appears unrelated to goal-directed task performance","volume":"8","author":"Chadwell","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Vanhelst, J., Vidal, F., Drumez, E., B\u00e9ghin, L., Baudelet, J.-B., Coopman, S., and Gottrand, F. (2019). Comparison and validation of accelerometer wear time and non-wear time algorithms for assessing physical activity levels in children and adolescents. BMC Med. Res. Methodol., 19.","DOI":"10.1186\/s12874-019-0712-1"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1123\/jmpb.2021-0036","article-title":"Comparing an objective measure of foot abduction brace non-wear time with self-reported measures-the 8th international conference on ambulatory monitoring of physical activity and movement","volume":"4","author":"Silver","year":"2021","journal-title":"J. Meas. Phys. Behav."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2351","DOI":"10.1249\/MSS.0000000000001344","article-title":"Generating ActiGraph Counts from Raw Acceleration Recorded by an Alternative Monitor","volume":"49","author":"Andersen","year":"2017","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"276","DOI":"10.11613\/BM.2012.031","article-title":"Interrater reliability: The kappa statistic","volume":"22","author":"McHugh","year":"2012","journal-title":"Biochem. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1302\/1863-2548.13.190069","article-title":"Bracing in clubfoot: Do we know enough?","volume":"13","author":"Alves","year":"2019","journal-title":"J. Child. Orthop."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1097\/BPO.0b013e318221eaa1","article-title":"Orthosis noncompliance after the ponseti method for the treatment of idiopathic clubfeet: A relevant problem that needs reevaluation","volume":"31","author":"Ramirez","year":"2011","journal-title":"J. Pediatr. Orthop."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1001\/archinte.1990.00390190043003","article-title":"On white-coat effects and the electronic monitoring of compliance","volume":"150","author":"Feinstein","year":"1990","journal-title":"Arch. Int. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1093\/ajh\/hpv008","article-title":"The Effect of self-monitoring of blood pressure on medication adherence and lifestyle factors: A systematic review and meta-analysis","volume":"28","author":"Fletcher","year":"2015","journal-title":"Am. J. Hypertens."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/7\/2433\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:40:45Z","timestamp":1760136045000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/7\/2433"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,22]]},"references-count":25,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["s22072433"],"URL":"https:\/\/doi.org\/10.3390\/s22072433","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,22]]}}}