 The full-back orthosis or the TLSO brace is an orthotic treatment for a variety of spinal issues.
Although these days the brace is rather common and you’ll see people of all ages wearing it, it’s still a bit daunting for first-time users who have several questions about it. If you’re new to TLSO then keep reading as we explore its types, indications, and other FAQs. By the end of this post, I trust that you’ll know all the basic information about this orthosis and that’ll make wearing the brace much easier for you. What is The TLSO Brace? The Thoracic Lumbar Sacral Orthosis [TLSO] is a corrective brace that covers the entire back, from below the chin or the collar bone down to your pelvis. It’s made of a plastic material with foam and padding inside so that it’s comfortable to wear. The TLSO brace is fitted for your body and it applies pressure and provides stabilization to the back. This brace is for the entire back but your Orthotist can prescribe the brace for specific segments of your spine as well. Such braces are named according to the regions they support. So the brace that only covers the thoracic spine [mid back] and the lumbar spine [low back] is called a Thoracic- Lumbar Brace [TLO]. There are several brace designs; some are one-piece with an opening on the front or the back while others are two-piece braces called clamp-shell style that come together by straps on the sides. TLSO Brace Types The two main categories of this brace are off-the-shelf or prefabricated brace and custom TLSO brace. Your waist measurements are used to determine the size for the premade ones. And your Orthotist makes the custom brace based on a mold or exact measurements of your body. Here are some types of the spinal brace: 1. Boston Brace The Boston brace is the most widely used TLSO brace for scoliosis patients today. It’s prefabricated and comes in many different sizes. The Orthotist matches the brace according to each patient's abnormal curvatures. 2. Wilmington Brace The Wilmington brace is a customized scoliosis brace. Its pressure points are designed according to the specific patient and it doesn’t have open slots or relief areas as seen in the Boston brace. 3. Knight Taylor TLSO This brace is different from the other TLSO braces because it usually only has rigid support on the back while the front is a cloth-like material to hold the back frame tight. However, some variations of the Knight Taylor brace do come with chest support/pad. It’s used to stabilize fractures or injuries. Indications for Prescribing the TLSO Brace The TLSO is mostly prescribed to fix lateral curvatures of the spine in Scoliosis. But it’s also used to correct postural issues, stabilize your back after an injury, surgery, or a degenerative condition. Some of the TLSO brace indications include:
Patients just beginning to use the TLSO have several questions about what they can expect down the line. Based on our experience with back brace clients, here’re some of the FAQs: 1. How Long Should I Wear the TLSO Brace? The brace is worn for 18-23 hours a day. You have to keep it on while sitting, standing, and doing your daily activities. Some of the braces are required to be worn while laying in bed as well. Your Orthotist is the best person who can tell you the exact duration you have to wear it based on your condition. Most scoliotic patients wear it for several months to a year and a half. 2. How Can I Clean the TLSO Brace? The different parts of the brace are cleaned separately. You can wash the cloth straps with mild detergent and water, the plastic with mild soap and water, and clean the leather portion with a damp cloth. Don’t use strong cleaners or detergents on the brace. And always ensure it’s completely dry before putting it back on. 3. Can I Wear the TLSO Brace While Exercising or Being Otherwise Physically Active? Yes, since you’ve got to wear the brace all day you can exercise with it as well. Each brace has some limitations that your doctor can tell you about. Generally, it’s recommended not to lift heavy weights more than five pounds or perform exercises that’ll make you excessively sweaty. 4. How Much Does TLSO Cost? The TLSO brace cost is dependent on various factors such as materials used, customizations, and production company. An off-the-shelf brace can cost an average of $1000-2000 while a custom TLSO brace can be over $5,000. There are other costs involved in TLSO care such as screenings, lab tests, scans, and doctor’s office visits. Insurance plans do cover most of the cost. You should check with your insurance provider to get an estimate of how much will be covered in your case. 5. How Will the TLSO Brace Affect My Skin? Some redness on the pressure areas is normal and it’s nothing to worry about as long as it’s resolved once you take the brace off and the region isn’t painful or tender. Wearing a T-shirt helps avoid friction between the brace and skin and it keeps the skin healthy by absorbing perspiration as well. You should contact your Orthotist in case of skin breakdown or if you develop a bruise because that’s an indication that your orthosis needs to be refitted. Find a TLSO Expert Near You You’ve got to remember several details and tips about cleaning, maintenance, donning, and doffing when using the TLSO brace so that you can fully benefit from it. For that, you need qualified Orthotists who can guide you through this challenging process. Book an appointment with our Orthotist or visit our clinic near you to get a brace fitted for your back. Our multidisciplinary teams can answer all your questions and help you get started with the best TLSO for your needs!
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 It provides external support to the foot and helps resolve numerous deformities in pediatrics.
This article is for anyone who’s new to the world of foot orthoses. We’ve been making orthoses and training patients in using them for many years now and here’s the information we share with patients and parents during our preliminary meetings. 1. What Is DAFO? The dynamic ankle-foot orthosis is a modification of the rigid AFO. Its working mechanism is different from the classic version in the sense that it gives you more freedom to move hence you have more active muscle training while staying in a safe range of ankle motion. The DAFO brace is made of a thin and flexible thermoplastic material that is strong enough to support the body weight and also to provide control to the foot to maintain neutral alignment. You can get a custom-fitted DAFO or one off-the-shelve. The cost of the two versions will vary and you won’t always get your preferred designs or graphics on the prefabricated one. 2. Who Is the DAFO Brace For? The DAFO is for people- adults and kids alike- who need extra support maintaining the correct posture of their feet and ankle. Although the AFO does the same thing, the dynamic brace is for such candidates who need minimal support. Some more indications for prescribing a DAFO include:
However, that doesn’t mean adults can’t benefit from these at all. DAFOs for adults are mostly prescribed to provide additional external support during walking after injury or surgery. It’s used by the elderly suffering from degenerative joint conditions, drop foot and ankle instability. The muscle weakness in old age makes the ankle vulnerable to twisting injuries, especially while walking on uneven surfaces. The orthosis provides ease of mind to the elderly and improves their confidence in walking independently. 3. Benefits of DAFO The DAFO brace is helpful not only in walking but also in preventing contractures and supporting the ankle and surrounding structures during rest. Here’re some benefits of dynamic ankle orthosis:
That facilitates skill training sessions with the physical therapists because it increases active patient participation. 4. Complications of DAFO The dynamic AFO comes with some avoidable complications and side effects along with the many benefits. Faulty and ill-fitting orthosis are the primary culprits of causing complications. That’s why you should never use lower quality orthosis. Some common complications include:
You should contact your Orthotist’s clinic at once if you face any complications and they’ll help you sort out the issues. 5. How’s the DAFO Brace Different From a Rigid AFO? Since the dynamic AFO and the rigid AFO [R-AFO] cover the same regions of the leg, it’s good to know how the two are different. The R-AFO improves balance and provides excellent support by holding the ankle in one position and not giving room for any motion. But not all patients need the same level of stability and so a DAFO fixes this issue with its flexible nature by allowing sufficient movements while also providing necessary support. The various types of AFO are prescribed for different conditions and the expected outcomes also vary. Duration for adjustment to the orthosis, training styles and the effects on your body are also different for the DAFO brace and the R-AFO. Reach Out to Our DAFO Experts Getting a well-fitted DAFO brace for yourself or your kid doesn’t have to be a difficult process. You just need to find the right team that’ll take care of all the technical aspects of it and train you to properly use the orthosis. We’ve got several clinics all over the USA with certified Orthotists in each one. You can book an appointment or walk into our office near you to get a consultation for your dynamic orthosis. With years of experience in dealing with patients of all ages and conditions, we’re sure that we can help you with whatever you need related to orthosis and prosthetics.  Rehabilitation after amputation is a long and laborious process. Generally speaking, the fewer joints that are lost in the amputation, the easier the rehab is.
A below-knee [BKA] prosthesis rehab is a difficult process. There are numerous items to check before prescribing the prosthesis such as the condition of soft tissues on the residual limb, range of motion, and mobility goals to name a few. It’s best to know what you’re getting into before you begin the rehab program. This article covers the top five things you should be prepared for during your prosthesis rehabilitation. What Is the BKA Prosthesis Rehab? The below-knee prosthesis rehab is a specialized program to get amputees back to regular functioning with their new prosthetic leg. It involves re-learning to walk, run, pick up objects from the floor and return to life as much as possible! There are distinctive protocols to follow for the various types of lower limb prostheses. Some of the commonly used prostheses types include the preparatory prosthesis, total surface or the patella tendon weight-bearing prosthesis, and sports prosthesis for athletes and runners. The rehab begins with counseling and physical assessment and ends with the patient being completely independent in performing his or her daily activities. In the beginning, the main portion of the rehab is conducted at the clinics under a professional Prosthetist’s supervision. As you progress and get better at balancing yourself and understanding the techniques, your appointments with the physical therapists [PTs] are spaced out and you’re given more tasks to do at home. Overview of BKA Prosthesis Rehab The rehab begins soon after the amputation surgery or after you get your first prosthesis fitted. The process looks different for each person but some general guidelines can help you prepare for what’s next. Here’re five things you should expect from a BKA prosthesis rehab: 1. A Multidisciplinary Rehab Team Your BKA prosthesis rehab team primarily has Prosthetists and physical therapists but physicians, nurses, and psychologists will also be a part of your multidisciplinary team. Your rehab doesn’t only mean training you to walk independently. Rather it also involves helping you emotionally cope with the change, getting your entire body adjusted to the prosthesis, and keeping an eye on the internal body systems. For that, an entire team of experts is required. Your physical therapist will also recommend support groups and community rehab sessions where you’ll interact with other patients going through a similar rehab program. 2. BKA Prosthesis Rehab Will be Ongoing The BKA prosthesis rehab process is a long one. Initially, you’ll need a cane or a walker to assist you in walking on your prosthesis. After sufficient rehab, you can reach a point where you no longer need assistive devices and you can easily walk on your legs but that’s not where the rehab journey ends. You should get comfortable with the fact that the below-knee prosthesis rehab will be ongoing for months. You won’t need aggressive pain management treatments or hour-long gait training once you’re past the initial phase, but you’ll need to come in for regular checkups for your stump and the prosthesis to make sure that your leg is in good operating condition. How long it’ll take varies from patient to patient; so you should ask your physical therapist for the estimated time. 3. The Rehab Depends on Your Level of Activity The BKA prosthesis rehab is highly customized to each patient and it depends on what your daily routine is like. So before beginning the rehab, your physical therapist will conduct a detailed assessment of your activities, functions, endurance levels and gait pattern then set up your goals and expected outcomes. The rehab is designed differently for different people. For example, there’ll be higher intensity and fast-tracked programs for the relatively young and active adults or veterans as compared to the elderly or chronically ill patients. So don’t be alarmed if your rehab program isn’t the same as someone else’s, even if the two cases look the same to you. PTs are experts in physical rehab and they’ll develop a program best suited to your needs. 4. It’s Going to Be Painful You should brace yourself for a physically, mentally, and emotionally draining journey. Re-learning to walk and to do all the things that you did before takes effort, time and a lot of strength. You’ll deal with issues related to your stump, sweating, prosthesis damage, and phantom limb pain. The good news is that it’ll get better with suitable pain management protocols. And with the right team of Prosthetists and PTs, you’ll be on the other side sooner than later. But the process will test your limits and unfortunately, there’s no avoiding that. 5. Rehab Continues Outside the Clinic as Well You’ll spend a few hours at most at the PT clinic. After that, the rest of the rehab is continued at home. Your doctors and PTs will give you a few tasks to do at home; such as home exercises for strength, stretching, weight shifting maneuvers, massaging the stump, and a pain management routine. There’ll be several precautions to follow as well and these’re just as critical as the active exercises. Your BKA prosthesis rehab will be a full-time job in the beginning, and then it’ll become a part of your routine as time goes on. We Offer Expert BKA Prosthesis Rehab These are some of the general things you can expect from a rehab program. But it’s good to remember that each person has a unique experience and you shouldn’t compare your progress or program with anyone else’s. We’ve got an experienced team for BKA prosthesis rehab. With us, you’ll have access to various experts under one roof because we’ve got Prosthetists, physical therapists, nurses and more all working in the same clinics. Reach out to us if you’ve got a new prosthesis fitted for your lower limb or if you want a customized rehab program to improve your activity level. |
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March 2023
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