Ankle foot orthosis, AFO

Children, youth, adults and seniors

Mobility – the goal of orthotic treatment.

Successful orthotics treatment help children establish normal patterns of joint and muscle motion.

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AFOs, and lower limb orthoses are generally prescribed to correct neuromotor conditions.

Kenneth A. Stern, CerebralPalsy.org

According to estimates, about two-thirds of children with cerebral palsy have the ability to walk and ambulate. But because of the nature of cerebral palsy – and its effect on the muscles, joints, and patterns of motion – establishing a gait that is meaningful can be a challenge.

Orthotics help by
  • Providing a stable base for movement
  • Establishing an efficient gait
  • Minimizing the effects of spasticity in limbs
  • Creating an environment in which a child can take repeatable steps
  • Reducing excessive energy used to move
  • Aiding the transition between sitting and standing
  • Reducing, or eliminating, hip and knee hyperextension, missteps
  • Reducing the potential for accidents
  • Increasing a child’s ability to function physically, and mentally
  • Weak muscles
  • Control muscular imbalances
  • Correct poor skeletal alignment
  • Prevent deformity
  • Provide stable base of support

In terms of mobility, lower limb orthotic devices can be used separately, or together, to help a child maintain the stability. This is achieved by limiting certain movements that are irregular so that a child can develop and re-learn how to stand, and take steps.

Additionally, bringing affected limbs into proper alignment helps correct flexible deformities, stop the progression of fixed deformities, and helps transfer a person’s body weight to prevent unwanted load on affected joints and muscles.

For children with cerebral palsy, mobile joint deformities caused by unbalanced muscle tone is a vexing problem that can be treated using orthotics. One common condition is the tendency for children with cerebral palsy to walk on the tips of their toes, as opposed to their feet – this can be treated over time by using foot-ankle devices that help stabilize, and strengthen, the muscles and joints of the foot and ankle.

Because 80% of children with cerebral palsy have spasticity, orthotic intervention can have a major effect on a child’s body mechanics. Once the child has a stable basis for movement, he or she can develop higher levels of functioning, including:

  • Increased range of motion
  • Strengthened muscles
  • Improved endurance
  • Increased coordination, cadence
  • Increased step length
  • More control over spastic movements
From a practical standpoint, the goal of orthotics is to enhance the quality of life to children with cerebral palsy. Some ways orthotics can help children with disabilities include:

  • Improve independence by enhancing mobility
  • Reduce stress and fatigue
  • Reduce the likelihood of a fall, or an injury
  • Take the focus off mobility and onto family time, play time, building relationships and pursuing interests

There are several types of orthotics, including:

Foot orthotics
These are more commonly referred to as inserts that are placed in shoes to shift the weight of the feet and legs and bring balance, relieve shock, and minimize stress. They are can be rigid or soft, and they can be custom-made or fitted. Also, the orthotic device can come in the form of an actual shoe.
Ankle-Foot Orthotics
Sometimes referred to as AFOs or foot drop braces, these semi-rigid L-shaped braces stabilize both the foot and ankle to bring muscles and joints into alignment. The braces extend up the calf, and are typically made of metal or hard plastic; they have straps that can connect together to hold the device in place, and bring stability to foot, ankle and lower leg by immobilizing it. These are also used to correct foot drop. AFOs account for 26 percent of all orthotics used in the United States. AFOs include anti-Talus AFOs, Rigid AFOs, Tamarack Flexure Joint AFOs, Solid AFOs, Spiral AFOs, Hemispiral AFOs, Hinged AFOs, Tone-Reducing AFOs, and Posterior Leaf Spring AFOs.
Hip-Knee-Ankle-Foot Orthotics
Called HKAFOs use bands, belts, pelvic girdles and knee-ankle orthotics to help position a person upright while centering the knee joint.
Knee-Ankle-Foot Orthotics
Called KAFOs, these devices stabilize the knee, ankle and foot, allowing for proper function and movement. KAFOs are equipped with mechanically or electronically controlled hinges. They are useful when a child has limited movement in his or her legs so they can help when learning to walk.
Knee Orthotics
A brace that is worn to support and align the knee; it extends from above the knee to below it.
Spinal Orthotics
If a child needs additional support or alignment in his or her upper torso, a spinal orthotic device can help a child sit up or stand; it is particularly useful if a child has limited trunk control.
Trunk-Hip-Knee-Ankle-Foot Orthotics
Sometimes called THKAFOs, are HKAFOs with spinal orthosis for control over trunk motion and spine alignment, most often used by individuals with paraplegia.
Prophylactic Braces
This brace is rigid and has knee hinges. It is used mostly for people who have knee injuries.

Read more about orthotic brace therapy at CerebralPalsy.org

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