Ankle-foot orthoses (AFOs) are medical devices designed to support, align, and control the motion of the ankle and foot. They are used to address a wide range of neuromuscular and musculoskeletal conditions affecting lower limb, such as foot drop, CVA, or ankle osteoarthritis. AFOs can be custom or off-the-shelf (prefabricated) depending on the patient’s needs, diagnosis, and anatomical considerations. AFOs are also used in conditions such as Charcot-Marie-Tooth, stroke, cerebral palsy, spinal cord injury, post-polio syndrome, and various congenital deformities.
Even though, Ankle-Foot Orthoses (AFOs) are primarily used to support and stabilize the ankle and foot, but in certain cases, they also play a significant role in controlling knee motion, particularly when there is quadriceps weakness or impaired ankle plantarflexion.
These are individually fabricated based on a mold or 3D scan of the patient’s limb. They offer precise fit, targeted support, and the ability to accommodate unique anatomical features or complex deformities like CVA or Ankle Osteo arthritis. Custom AFOs are ideal for progressive or severe conditions.
Prefabricated devices available in standard sizes and designs. They are typically used for less complex conditions, like flaccid foot drop. They are light weight, low profile and durable.
Solid AFOs are rigid braces that typically hold the ankle in a fixed position to provide maximum stability and control. They can allow controlled movement at the ankle joint based on trimlines. Solid AFOs are especially useful when motion needs to be restricted to ensure safety and effective gait mechanics. Their sturdy design makes them especially effective for patients with significant weakness, spasticity, or joint instability. Solid AFOs can also assist in controlling knee motion indirectly.
Articulated AFOs are orthotic devices designed with a mechanical hinge at the ankle joint, allowing controlled movement between the foot and lower leg. Unlike solid AFOs that restrict ankle motion, articulated AFOs permit varying degrees of dorsiflexion and plantarflexion, which can be adjusted based on the individual’s needs. This design offers a more natural gait pattern while still providing stability and support. These orthoses can be customized with dorsiflexion assists or plantarflexion stops to suit specific clinical needs, such as preventing foot drop or limiting painful ankle movements or control knee hyperextension. By allowing dynamic support, articulated AFOs improve walking efficiency, promote active muscle engagement, and enhance mobility, making them ideal for individuals who require ankle stabilization without full immobilization.
A Ground Reaction Ankle-Foot Orthosis (GRAFO) is a specialized type of orthotic device designed to provide control and support for individuals with lower limb weakness, particularly in the quadriceps and ankle plantarflexors. In addition to controlling foot and ankle motion, a GRAFO also helps influence knee stability and alignment during stance phase by using ground reaction forces. These braces promote a more upright posture and efficient gait, therefore reduce energy expenditure, enhance safety, and improve overall mobility in conditions such as cerebral palsy, spinal cord injury, and muscular dystrophy.
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