Lesson 1Materials and measurement: sizing TLSO, pads, straps, donning aids, clothing considerationsThis lesson covers measuring for brace fit, including body length and width, pad and strap choices, putting-on aids, and clothing to protect sensitive skin in older folks.
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 follow-up after bracing, including pain and function checks, x-ray review, bone health assessment, slow brace reduction, and referrals for bone treatment 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 teaching for brace use, covering putting on and off, wearing times, avoided activities, safe moves, bending warnings, and fitting into daily routines for patients and helpers.
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 L2 compression fractures happen, effects of weak bones like osteopenia and osteoporosis, and daily function impacts for elderly, guiding bracing and rehab.
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 signs in braced patients, like growing weakness, bowel or bladder issues, new numbness, or worse pain, with triage and quick reporting methods.
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-bracing checks for safety, including skin, breathing, movement baseline, thinking ability, and warnings, ensuring the brace suits the elderly patient well.
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 semi-rigid TLSO or Jewett for stable L2 fractures, factoring fracture type, bone weakness, posture, balance, and daily needs for safety and comfort.
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 spinal support for stable L2 fractures, like pain relief, bending control, protection in daily tasks, while keeping safe movement and avoiding weakness in seniors.
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 back supports for stable L2 fractures, comparing TLSO types, Jewett braces, and soft corsets, with uses, warnings, and mechanics for older patients.
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 after fitting to ensure safety, covering comfort, breathing, sit-to-stand ability, and pressure spots, allowing quick fixes to avoid issues and improve 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 steps for fitting TLSO or Jewett braces, stressing spine alignment, pad spots, strap tightness, bending relief, and checks for comfort across users.
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
