Lesson 1Materials an measurement: sizin TLSO, pads, straps, donnin aids, clothin considerationsDis cover measurements an materials needed fi accurate brace sizin, includin torso length an girth, pad an strap selection, donnin aids, an clothin layers, fi ensure effective support while protectin fragile older 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 an function reassessment, bone health evaluation, gradual weanin from brace, referral fi bone density management an physiotherapyDis describe structured follow-up afta bracin, includin pain an function reassessment, radiographic review, bone health evaluation, gradual brace weanin, an timely referral fi osteoporosis management an targeted physiotherapy.
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: donnin/doffin, wearin schedule, activities fi avoid, safe transfers an bendin precautionsDis detail essential patient an caregiver education fi brace use, includin donnin an doffin, wearin schedule, restricted activities, safe transfers, bendin precautions, an strategies fi integrate di brace into daily routines.
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, an functional impact in older adultsDis explore how vertebral compression fractures develop, di role of osteopenia an osteoporosis in weakenin bone, an di specific functional consequences fi older adults, guidin appropriate immobilization an rehabilitation plannin.
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 fi urgent review: progressive weakness, bowel/bladder changes, new numbness, increased pain despite braceDis define warning signs weh require urgent clinical review in braced patients, such as new weakness, bowel or bladder changes, sensory loss, or escalatin pain, an explain how fi triage an communicate dese concerns promptly.
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 bracin: skin inspection, respiratory status, mobility baseline, cognitive ability fi follow instructionsDis detail di pre-bracin assessment required fi safe immobilization, includin skin integrity, respiratory status, baseline mobility, cognition, an red flags, ensurin di chosen orthosis tolerated an used correctly by di older adult.
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 fi L2 stable fractures: semi-rigid TLSO vs Jewett — selection criteria considerin osteopenia an activity needsDis explain how fi select between semi-rigid TLSO an Jewett braces fi stable L2 fractures, considerin fracture morphology, osteopenia severity, posture, balance, an daily activity needs fi optimize safety, comfort, an adherence.
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 durin ADLs while preservin mobilityDis clarify di therapeutic aims of external spinal support in stable L2 fractures, focusin pon pain relief, motion control, an protection durin daily activities while preservin safe mobility an minimizin deconditionin in older adults.
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 an comparative mechanicsDis review available thoracolumbar supports fi stable L2 fractures, comparin TLSO variants, Jewett hyperextension braces, an soft lumbar corsets, wid emphasis pon indications, contraindications, an biomechanical action in older adults.
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 fi perform sit-to-stan, pressure point assessmentDis outline immediate post-fittin checks fi confirm safety an tolerance, includin comfort, respiratory function, sit-to-stan ability, an pressure point inspection, allowin prompt adjustment fi prevent complications an nonadherence.
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 fittin an adjustment: proper alignment, pad placement, strap tensionin, unloadin flexionDis provide a stepwise guide fi fittin TLSO or Jewett braces, emphasizin spinal alignment, pad positionin, strap tension, an flexion unloadin, wid strategies fi verify comfort, safety, an consistent application across caregivers.
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
