Lesson 1Materials and measurement: sizing TLSO, pads, straps, donning aids, clothing considerationsExplains measuring and materials for proper brace fit, including body length and width, pad and strap choices, putting-on helpers, and clothes that work well to support without skin harm in seniors.
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 physiotherapyOutlines planned check-ins after bracing, pain and ability reviews, x-ray looks, bone strength checks, slow brace reduction, and referrals for bone care and physio to aid long-term health.
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 precautionsProvides key teaching for patients and helpers on brace on/off, daily wear times, no-go actions, safe moves from sit to stand, bend warnings, and fitting into routine life easily.
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 spine compression breaks happen, effects of weak bones like osteopenia and osteoporosis, and daily life impacts on elders, to plan right supports and rehab paths.
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 braceLists urgent signs in braced patients needing fast review, such as growing weakness, toilet changes, feeling loss, or worse pain, with steps to sort and report 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 instructionsDetails checks before brace use for safe hold, covering skin health, breathing ease, starting movement level, thinking skills, and warnings to ensure brace suits the elder 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 needsGuides choosing semi-stiff TLSO or Jewett braces for stable L2 breaks, factoring break shape, bone weakness level, posture, balance, and daily tasks for best 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 mobilitySets out goals of outside spine support for stable L2 breaks, like pain cut, forward bend limits, daily task safety, while keeping safe movement and avoiding 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 back support types for stable L2 breaks, comparing TLSO kinds, Jewett stretch braces, soft waist belts, with uses, no-gos, and how they work mechanically for older folks.
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 assessmentGuides instant after-fit checks for safety and acceptance, like comfort feel, breathing issues, sit-stand ability, and pressure spots, to adjust fast and stop problems or 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 flexionStep-by-step for TLSO or Jewett brace fitting, stressing spine line-up, pad spots, strap tightness, bend relief, with ways to check comfort, safety, and steady use by carers.
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
