Lesson 1Materials and measurement: sizing TLSO, pads, straps, donning aids, clothing considerationsThis lesson covers measures and items for right brace size, like body length and width, pad and strap choice, putting-on helps, 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 physiotherapyThis lesson describes planned follow-up after bracing, covering pain and function recheck, x-ray review, bone health look, slow brace drop, and timely send for bone weakness care and 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, like putting on and off, wear times, no-go activities, safe moves, bend warnings, and ways to fit 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 adultsThis lesson explores how spine compression breaks happen, how bone thinning and weakness play in, and exact function effects for elders, guiding right holding 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 danger signs needing quick clinic look in braced folks, like new weakness, gut or bladder shifts, feeling loss, or rising pain, and how to sort and tell fast.
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 pre-brace checks for safe holding, covering skin health, breathing state, start mobility, mind to follow orders, and danger signs, ensuring brace is okay and used right by 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 needsThis lesson explains picking between semi-stiff TLSO and Jewett for steady L2 breaks, thinking break shape, bone thin level, posture, balance, and daily doings to best safety, comfort, and stick-to-it.
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 clears aims of outside spine support for steady L2 breaks, focusing pain ease, bend control, and guard in daily tasks while keeping safe move 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 spine-back supports for steady L2 breaks, comparing TLSO types, Jewett stretch braces, and soft waist belts, stressing when to use, no-gos, and body mechanics 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 right-after-fit checks for safety and okay, covering comfort, breathing issues, sit-to-stand skill, and pressure spot look, for quick fix to stop problems and no-stick.
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 step guide to fit TLSO or Jewett braces, stressing spine line, pad spot, strap pull, and bend ease, 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
