Lesson 1Materials and measurement: sizing TLSO, pads, straps, donning aids, clothing considerationsThis lesson covers measurements and materials for right brace sizing, including torso length and width, pad and strap picks, putting-on aids, and clothing layers to give good support while guarding delicate 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 physiotherapyThis lesson describes planned follow-up after bracing, including pain and function checks, x-ray reviews, bone health assessment, slow brace removal, and referrals for bone strength care and targeted 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 precautionsThis lesson details key teaching for patients and helpers on brace use, covering putting on and off, wearing times, no-go activities, safe moves, bending warnings, and ways to fit the brace into 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 adultsThis lesson explores how vertebral compression fractures happen, how weak bones from osteopenia or osteoporosis play a role, and specific daily function effects in elders, guiding immobilization and rehab plans.
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 braceThis lesson defines urgent warning signs in braced patients, like growing weakness, bowel or bladder shifts, new numbness, or rising pain, and how to sort and report these quickly.
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 instructionsThis lesson details checks before bracing for safe hold, including skin check, breathing status, starting mobility, thinking ability, and red flags, ensuring the brace is okay and used right by elders.
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 needsThis lesson explains choosing between semi-rigid TLSO and Jewett braces for stable L2 fractures, looking at fracture shape, bone weakness level, posture, balance, and daily needs for best safety, comfort, and use.
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 mobilityThis lesson clarifies goals of outside spinal support for stable L2 fractures, focusing on pain ease, bending control, and guarding during 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 mechanicsThis lesson reviews thoracolumbar supports for stable L2 fractures, comparing TLSO types, Jewett extension braces, and soft lumbar belts, stressing when to use, no-gos, and how they work 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 assessmentThis lesson outlines checks right after fitting to confirm safety and okayness, including comfort, breathing issues, sit-to-stand ability, and pressure spot checks, for quick fixes to stop problems and non-use.
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 flexionThis lesson gives a step-by-step guide to fitting TLSO or Jewett braces, stressing spine alignment, pad spots, strap tightness, and bending relief, with ways to check comfort, 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
