Lesson 1Materials and measurement: sizing TLSO, pads, straps, donning aids, clothing considerationsCovers sizes and supplies for right brace fitting, including body length and width, pad and strap picks, putting-on aids, and clothes layers, to give good support while guarding weak elder skin.
Landmarks for torso length measurementChest, waist, and hip circumference sizingSelecting pads, liners, and strap typesUse of donning aids and reach toolsClothing layers to protect fragile skinDocumentation of brace size and componentsLesson 2Follow-up plan: pain and function reassessment, bone health evaluation, gradual weaning from brace, referral for bone density management and physiotherapyDescribes planned follow-up after bracing, including pain and use recheck, x-ray review, bone health check, slow brace lessening, and right send for bone weakness care and aimed physio.
Scheduled pain and function reassessmentsImaging to confirm fracture stabilityPlanning gradual reduction of brace timeScreening and labs for bone healthReferral for osteoporosis treatmentPhysiotherapy for posture and strengthLesson 3Patient education: donning/doffing, wearing schedule, activities to avoid, safe transfers and bending precautionsDetails key teaching for patients and helpers on brace use, including putting on and off, wear times, banned activities, safe moves, bend warnings, and ways to fit the brace in daily life.
Stepwise donning and doffing techniquesRecommended daily wearing scheduleActivities and postures to avoidSafe transfers, bed mobility, and gaitBending, lifting, and twisting precautionsWritten instructions and teach‑backLesson 4Vertebral compression fracture pathophysiology, osteopenia/osteoporosis influence, and functional impact in older adultsLooks at how vertebral compression fractures form, bone weakness from osteopenia and osteoporosis role, and exact use effects for elders, guiding right immobilization and rehab planning.
Mechanisms of vertebral body compression at L2Effects of flexion and axial load on weakened boneOsteopenia versus osteoporosis at the spinePain generators in compression fracturesFunctional limitations in older adultsRisk of progression and adjacent level fracturesLesson 5Warning signs for urgent review: progressive weakness, bowel/bladder changes, new numbness, increased pain despite braceSets warning signs needing quick clinical review in braced patients, like new weakness, gut or bladder shifts, feeling loss, or rising pain, and explains sorting and quick sharing of these worries.
New or progressive limb weaknessBowel or bladder dysfunction onsetNew numbness or saddle anesthesiaRapidly increasing or unrelenting painSkin breakdown or brace‑related woundsWhen and how to seek urgent careLesson 6Assessment before bracing: skin inspection, respiratory status, mobility baseline, cognitive ability to follow instructionsDetails before-bracing checks for safe immobilization, including skin wholeness, breathing state, base movement, mind skill, and warnings, ensuring the picked orthosis is handled and used right by the elder.
Skin inspection over bony prominencesRespiratory status and pulmonary reserveBaseline mobility and transfer abilityCognitive status and ability to learn tasksPain level and analgesia optimizationScreening for neurological red flagsLesson 7Brace selection for L2 stable fractures: semi-rigid TLSO vs Jewett — selection criteria considering osteopenia and activity needsExplains picking between semi-stiff TLSO and Jewett braces for steady L2 fractures, thinking fracture shape, bone weakness level, stance, balance, and daily activity needs to best safety, ease, and follow.
Radiographic features guiding brace choiceImpact of osteopenia and kyphosis on fitActivity level and balance considerationsAbdominal shape and respiratory factorsFall risk and need for donning assistanceShared decision‑making with patientLesson 8Objectives of external spinal support: pain reduction, motion limitation in flexion, protection during ADLs while preserving mobilityClears healing aims of outer spinal support in steady L2 fractures, focusing pain ease, movement control, and guard in daily tasks while keeping safe movement and cutting weakness in elders.
Pain reduction through controlled immobilizationLimiting flexion and micro‑motion at L2Protecting the fracture during ADLs and transfersMaintaining safe mobility and balancePreventing deconditioning and muscle wastingSetting realistic goals with patient and familyLesson 9Types of thoracolumbar supports: thoracolumbar sacral orthosis (TLSO) varieties, Jewett hyperextension brace, soft lumbar corset — indications and comparative mechanicsReviews open thoracolumbar supports for steady L2 fractures, comparing TLSO types, Jewett stretch-back braces, and soft low-back belts, stressing uses, bans, and movement action in elders.
Rigid and semi‑rigid TLSO designsJewett hyperextension brace mechanicsSoft lumbar corset roles and limitsIndications by fracture pattern and levelContraindications in frail older adultsComparing flexion control and comfortLesson 10Immediate checks: comfort, respiratory compromise, ability to perform sit-to-stand, pressure point assessmentLists right-after-fitting checks to confirm safety and handling, including ease, breathing issues, sit-to-stand skill, and pressure spot check, allowing quick changes to stop problems and non-follow.
Pain and overall comfort reassessmentRespiratory effort and chest expansionSit‑to‑stand and short walk testingInspection of high‑risk pressure areasAdjusting straps and pads after testingCriteria for safe discharge with braceLesson 11Step-by-step TLSO or Jewett fitting and adjustment: proper alignment, pad placement, strap tensioning, unloading flexionGives step-by-step guide to fitting TLSO or Jewett braces, stressing spine line, pad place, strap pull, and bend lessening, with ways to check ease, safety, and steady use by helpers.
Safe log‑roll and initial brace positioningAligning sternal, pelvic, and lateral padsProgressive strap tightening and rechecksEnsuring flexion unloading at L2Verifying fit in supine, sitting, standingCaregiver training for consistent fitting
