Sensor based braces: Challenges ahead.

Sensor based brace is a new technology driven initiative to address the adherence issues associated with clubfoot treatment. It encompasses various engineering fields (sensors, batteries, data transfer) to measure precise brace wear timings. Still in preliminary usage, yet they have lead to several significant findings; foremost being that caretakers tend to over report their brace usage. Enhanced surveillance and reinforcements is thus possible with sensor devices as defaulters can be picked up early. The introduction of these devices in common practice is postulated to lessen relapse rates by upto 40%. However, many challenges obscure the path of newer braces. Robust study designs and longer follow up is lacking in majority of studies detailing sensor based clubfoot braces. None of the currently available studies demonstrate effectiveness of patient interventions/changes based on the research data. Behavioral changes in caretakers may be difficult to achieve and could require repeated reinforcements. Since braces need to be worn for prolonged periods in clubfoot treatment, sensor data generated per patient would be colossal. It's processing and interpretation would be an uphill task. The cost of advanced inventory may burden ongoing clubfoot care programmes in low income countries. There is also a possibility that the newer technology may tone up the bracing protocol into a highly sophisticated and supervised medical intervention rather than a simplified maintenance phase. Till further development and evidence, sensor based clubfoot braces may find their initial application for high risk groups susceptible to relapse.