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Jewett and Cash Brace

The Jewett brace and CASH brace are designs for an anterior hyperextension brace. The Jewett brace consists of an anterior and lateral torso frame connected to lateral pads, a sternal pad, suprapubic pad, and thoracolumbar pad. It provides a three-point force system through posterior forces from the sternal and suprapubic pads and anterior forces from the thoracolumbar pad. This restricts forward flexion and encourages hyperextension of the spine to increase lumbar lordosis and stabilize the spine. The CASH brace is a cruciform design that functions similarly by connecting a sternal pad, suprapubic pad, and lateral pads.

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869 views19 pages

Jewett and Cash Brace

The Jewett brace and CASH brace are designs for an anterior hyperextension brace. The Jewett brace consists of an anterior and lateral torso frame connected to lateral pads, a sternal pad, suprapubic pad, and thoracolumbar pad. It provides a three-point force system through posterior forces from the sternal and suprapubic pads and anterior forces from the thoracolumbar pad. This restricts forward flexion and encourages hyperextension of the spine to increase lumbar lordosis and stabilize the spine. The CASH brace is a cruciform design that functions similarly by connecting a sternal pad, suprapubic pad, and lateral pads.

Uploaded by

ucss
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Jewett & CASH brace

IIPO
Objectives
• What is jewett and CASH brace?
• Components
• Functions
• Motion Control
Thoracolumbosacral (F) Control Orthosis (Anterior Hyperextension)

• There are 2 designs of anterior hyperextension brace.


a) Jewett style
b) CASH style

Jewett style

• Consists of an anterior and lateral torso frame to which are


attached two Lateral pad, a sternal pad, suprapubic pad, and
a thoracolumbar pad.
• With the patient seated in prescribed posture and the
orthosis properly adjusted, the sternal pad will have
its superior border 1.3 cm (1/2 in.) inferior to the
sternal notch, and the suprapubic pad will have its
inferior border 1.3 cm (1/2 in.) superior to the pubic
symphysis.
Functions
Provides a three-point force system consisting of
• a. Posteriorly directed forces from the sternal and
suprapubic pads
• b. Anteriorly directed forces from the thoracolumbar pad.

This pressure system tends to restrict forward flexion


occurring in the thoracolumbar area and encourages a
hyperextension posture. The posture increases lumbar
lordosis and thereby tends to stabilize ("lock") the spine
to resist lateral and rotary movements.
F - No restriction of motion as a function of the
orthosis, or minor enough to be ignored
S - Restricted motion to a clinically significant extent
S- - Intermediate degree of motion restriction
CI - Compensatory increase in motion
Special Considerations
1. This orthosis is prefabricated and is ordered by
measurements and adjusted on the patient.
2. Control of flexion and encouragement of a
hyperextension posture are achieved by the pads
only; the frame should not contact the patient.
CASH Style
• Full form is cruciform anterior spinal hyperextension
(CASH) orthosis
• A variation in design of the Thoracolumbosacral F
Control Orthosis is the configuration in Figure 8.
• Its function is essentially the same as for the basic
TLS Flexion Control Orthosis.
• Sternal and suprapubic pads are connected by an
upright that lies over the anterior midline of the trunk.
• A horizontal bar is attached at its midpoint to the
upright, and its ends are connected to lateral pads.
Slots in the upright and bar permit sliding
adjustments. The orthosis is lighter and easier to don
and doff than the device.
Review Questions
• Jewett brace is a anterior hyperextension brace.(T/F)
• The inferior border of suprapubic pad should be 1/2
in. inferior to the pubic symphysis.(T/F)
• Jewett brace will increase lumbar lordosis.(T/F)
• Full form of (CASH) orthosis is cervical anterior
spinal hyperextension orthosis.(T/F)
• Ventral bar and thoracic bar in CASH brace are
adjustable .(T/F)
Reference
• NYU spinal orthotics manual. Chapter 1, flexible spinal
orthoses; p. 25-26.

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