DonJoy Exos FORM II 621 Sacroiliac (SI) Belt

The Exos FORM II 621 Sacroiliac belt is a high-quality brace designed to provide effective stabilization for the sacroiliac (SI) joint. This product features a unique design that delivers direct compression to the SI joint, providing superior support and reducing pain. The brace incorporates high-quality materials that provide both durability and comfort, making it an ideal choice for extended use.

Exos Form II 621, is designed with Diamond2 Grid construct for a more durable and longer-wearing brace, trimmable belts allowing for accurate patient sizing, and silicone grip strips that prevent the brace from migrating.  The end result is a sacroiliac (SI) brace that provides superior stabilization through direct compression.  

Features and Benefits

• ComfortCORE™ Foam:  Conforms to the unique contours of a patient’s body, and adjusts instantly to individual movements.
• Diamond2 Grid™:  Uniquely designed construct, delivers patients a more durable, longer-wearing brace.
• Adjustable Belt Wings:  Modifiable belt accommodates varying patient body structures for optimal fit.
• Modular Design:  Step-up / Step-down design allows for single brace use through rehabilitation and recovery.
• Semi-Universal Sizing:  Removable circumference tape allows for accurate patient sizing.

Indication For Use – Sacroiliac Pain

• Sacroiliac Pain
• Pubic symphysis separation
• Pubic symphysis rupture

Sacroiliac (SI) pain is a type of lower back pain that occurs in the area where the sacrum (the triangular bone at the base of the spine) meets the ilium (the upper portion of the hip bone).

This joint is responsible for transmitting forces between the upper body and the legs, making it an important part of the body’s support structure.  When the sacroiliac joint becomes damaged or irritated, it can cause significant pain and discomfort in the lower back and hips.

Factors such as injury, arthritis, pregnancy, or changes in posture often cause SI pain. It can also be the result of overuse or repeated strain on the joint, such as from repetitive motions or heavy lifting.

The symptoms of SI pain may include a dull ache in the lower back, hip pain, and stiffness. In some cases, patients may also experience pain radiating down the leg or difficulty standing or walking. The DonJoy Exos FORM II 621 SI brace is a specific design that addresses these issues by applying direct compression to the SI joint.  This compression stabilizes the joint, reducing pain and discomfort.

Materials

Nylon, Polyethylene, Polyester, Silicone, Elastic

Instructions for Use – Exos Form II 621 Sacroiliac Belt

1. Apply the brace by centering the Rear Panel Section at the midline so that the belt is just above the tailbone.
2. Wrap the belt wings in front, approximately 1” (2.5cm) above the widest part of the hips and secure the hook on the front side of you.
3. Before tightening the brace, make sure the Rear Panel Section is positioned evenly on both sides of you. In order to achieve optimal comfort and fit, it may be necessary to readjust and reposition the two Belt Wings
   to the Rear Panel Section.
4. To apply compression, grasp the Pull Tab with the thumb and pull away from the body until reaching the desired compression, then secure the Pull Tab to the Belt Wing.

Sizing Guide

Size	Waist Circumference (Inches / cm)
Small/Medium	Less than 35” (89 cm)
Large/XLarge	36”– 55” (91–140 cm)

Measurement:  Measure the circumference 1″ (2.5 cm) above the widest part of your hips.

Videos for the Exos Form II 621 Sacroiliac Belt

Documents

Exos Form II 621 Sacroiliac Belt Sell Sheet

Exos Form II Brochure

Instructions for Use – Clinician

Exos Form II Family Brochure – Recovery Sciences

Exos Form II Indications Poster