This AFO provides maximal stability & control by preventing motion at the foot-ankle complex. It can influence the position of the knee when moderate knee instability is of concern and position the foot-ankle complex into proper alignment.
- Absent active Range of Motion
- Ligament injury around the ankle
- Lack of Medial/Lateral control or ankle instability
- Prevent foot drop by blocking plantar flexion
- Assist push off by not collapsing into dorsiflexion
This type of design has hinges at the ankle to provide controlled movement around the ankle joint to support a desired range of motion and preventing unwanted motion. This device may allow for full range of plantarflexion/dorsiflexion or may block plantar flexion. This dynamic design offers added stability, limits values and various motion and can be modified to correct adduction/abduction issues of the forefoot. Any specific kind of hinged AFO may be prescribed to a patient depending on that patient’s capabilities, disabilities, deficits, daily activities and prognosis.
The provided photos show straight tamarack joints that allow free dorsiflexion motion with posterior plantar flexion stops. This is a typical AFO for a patient experiencing drop foot secondary to a stroke.
Free Motion AFO
This style of AFO is commonly prescribed for posterior tibial tendon dysfunction and frontal plane instabilities of the ankle and subtalar joint. It allows for full ankle plantar flexion and dorsiflexion range of motion but maintains medial/lateral stability.
Limited Motion AFO
A limited motion AFO is an AFO that does exactly how it sounds, it allows the orthotist to customize the allowed ankle range of motion. This joint is called a Camber Axis Joint and can be set to any desired ankle angle. It allows for solid ankle configuration or variable anterior/posterior stop settings.
DorsiFlexion Assist (DFA) AFO
This is a style of articulated AFO. The DFA AFOs aid in dorsiflexion during swing phase gait for increased foot clearance and safety. These AFOs can be fabricated with out with out a plantar flexion stop, depending on the patients clinical presentation.
- Cerebral Palsy & Stroke presenting with weak dorsiflexors
- Frontal plane instabilities of the subtalar joint
- Personal Nerve Palsy
Nighttime Stretching AFO
This type of AFO has free motion hinges at the ankle, similar to the straight tamarack articulated AFO. However this style has the added medial and lateral straps attached to the sides of the calf that hold the foot in dorsiflexion. When worn throughout the night, this low-grade prolonged stretch works to increase the plantar flexion range of motion (the muscles in the back of the calf). The straps are fabricated such that the applied stretch can be adjusted and modified.
- Patients with a lack of range of motion at the ankle due to tight calf muscles and achilles tendon
- Toe walking, Cerebral Palsy
In a conventional AFO, the structure is made with either aluminum or stainless steel and is not total contact like a thermoplastic AFO. This brace is common in individuals with fluctuating edema, diabetic ulcers, skin conditions and sustained clonus. With this design, the uprights are either directly attached to the shoe or to a split stirrup, making the shoe interchangeability difficult. A conventional AFO is typically fabricated with two (2) metal upright bars and a leather covered calf band. The ankle joints are adjustable to control the amount of motion allowed in the ankle; dorsiflexion assist, free motion or limited motion.
(Charcot Restraint Orthotic Walker)
This type of AFO is total contact and bivalved in design. It allows for maximal protection of the foot and ankle, while immobilizes the entire joint to promote healing. A rocker sole is incorporated to allow for easier roll over and ambulation.
- Charcot Foot Deformity
- Ulcer management
- Unstable neuropathic foot.
Posterior Leaf Spring (PLS) AFO
Other Names: Dynamic, flexible
These devices help facilitate a natural gait; assisting toe clearance in swing phase and preventing foot slap at heel strike. The AFO holds the ankle & foot in a desired position, supporting weak muscles around the ankle but allowing some flexibility of the ankle. Individuals are able to use their (limited) muscular strength during push off while having extra support lifting their toes during swing through gait.
- Individual with isolated dorsiflexion weakness OR mild knee hyperextension secondary to:
- Charcot Marie Tooth
- Multiple Sclerosis
- Peroneal Palsy
- Lower extremity weakness.
Ground Reaction AFO
This type of device indirectly controls knee function by affecting the range of motion of the ankle joint. It utilizes the floor reaction forces through the distal toe aspect of the foot plate to reduce tibial progression (ankle dorsiflexion) and subsequent knee collapse (inducing knee hyperextension).
- Excessive ankle dorsiflexion
- Patients presenting with a “crouched” gait due to weakness & lack of voluntary plantar flexion.
Patellar Tendon Bearing AFO
These two-piece AFOs incorporate a smaller and flexible supramalleolar orthosis (SMO) inside a rigid AFO to provide greater hindfoot and midfoot control and support over the foot. We have created hybrid AFOs using both a solid AFO and an articulated AFO design.
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