AFO Orthotic Services
AFO stands for Ankle-Foot Orthosis.
An AFO is used to address instability and weakness in the lower limb and promote a safer and more natural walking motion. It is important to know there are different types of AFOs (described lower on this page).
Orthotics Plus is experienced in providing both pre-made and custom-made AFOs to the Melbourne community, with hundreds of successful fittings.
We see all patients, from complex to simple.
Our patients include adults, paediatrics, WorkCover/TAC patients, NDIS participants and private clients.
Types of AFOs
There is an array of AFOs that control the ankle and foot in different ways.
AFOs can be pre-made or custom-made. They are typically made out of plastic or carbon fibre. Your Orthotist will guide you on the correct type for your needs.
Ground Reaction Ankle-Foot Orthoses
Typically used for people exhibiting quadricep weakness by applying an anterior force at the knee.
These are often a good solution to enable a patient to stand and walk with more stability and safety.
Leafspring Ankle Foot Orthoses
Leafspring AFO’s focus on lifting the foot during gait.
These designs are very thin and most commonly used for dorsiflexion weakness (foot drop).
Being light, they aren’t suitable for patients requiring higher levels of stability or those with medial/lateral ankle instability
Solid Ankle Foot Orthoses
These are designed to control the foot and ankle at an appropriate angle and provide support in multiple different planes.
We can also gain control at the knee by influencing the ankle and a solid AFO is sometimes suitable for this.
Jointed Ankle Foot Orthoses
These are characterised by a joint mechanism allowing movement in the ankle.
A common design is a joint which allows the ankle to move up (dorsiflexion) but not move down (plantarflexion), if the patient is expereince foot drop.
They can also be made with joints assisting movement in a particular direction or allowing partial movements.
The type of joint and design of the AFO will depending on how much movement the Orthotist wants to allow and your presentation. The goal is safer, pain free, more efficient gait which is sustainable long-term.
Posterior Dynamic Element
Posterior Dynamic Element Ankle Foot Orthoses
They use a carbon fibre strut to connect the calf section to the foot section. The strut can be of varying stiffness depending on the needs of the patient and can be interchanged.
An AFO incorporating a PDE can provide some energy return during walking as well as accommodate postural shifts during stance for better balance and more natural gait.
The PDE can be an effective solution for younger patients, complex patients and those who need a robust orthotic device.
Propulsion Ankle Foot Orthoses
The main difference between a propulsion AFO and any other AFO is the material, weight, and minimalist design.
Propulsion AFOs allow for more energy storage compared to plastic AFOs while still providing good control through the forefoot and stability at the ankle.
The overarching purpose of an AFO fitting is to provide control at the lower limb to help the patient develop a more natural walking pattern.
Which Conditions Require an AFO?
They may be used to support people living with a wide range of physical and neurological conditions. Some of these include:
- Cerebral palsy
- Acquired brain injury
- Muscular dystrophy
- Spinal cord injury
- Peripheral nerve damage
- Charcot Marie Tooth
- Spina Bifida
Some examples of presentations requiring an AFO include:
- Lower limb weakness
- Lack of control of the foot and ankle
- Dorsiflexion weakness causing foot drop
- Severe tibialis posterior dysfunction
- Plantarflexion weakness
- Ankle osteoarthritis (requires total immobilisation)
- Plantar flexion contractures (inverse to a dorsiflexion weakness) to help keep the ankle in a neutral position
- Muscle spasticity of the lower limbs
How Long Does a Patient Wear an AFO For?
In most cases, the use of an AFO is ongoing.
There are cases (such as trauma patients) where an AFO is used short-term.
The type of AFO a patient requires can change as their situation changes, for example, if muscle strength and coordination improve post-stroke or partial spinal cord injury, the AFO design may change or usage may be ceased altogether.
Our approach is to provide enough support for the patient, but not to overprescribe. This allows patients to improve upon their current function and facilitates better rehabilitation.
Ready to Work with Orthotics Plus?
Our senior orthotists each have a minimum of 10 years of active clinical experience and we have hundreds of successful patient outcomes.
We are the experts in the Orthotic management of complex conditions and injuries.
Please note that all our AFO products are warrantied appropriately and we will provide you with ongoing support.
If you are unsure if an AFO would benefit you, a client or a loved one, please reach out and we can assist.
The AFO is only as good as the shoe it’s in!
Generally speaking, the person would be required to wear practical shoes, such as runners, light boots, lace up shoes or office shoes to synchronise an AFO.
Footwear such as sandals, ballet shoes or thin flat shoes are not appropriate, but there are a few exceptions which we can discuss with you.
We understand that people may have a preference for more fashionable shoes, in this case, our Orthotist will help you choose new shoes as many options now exist.
Yes, we stock a small range of shoes.
We also have the ability to order shoes from a supplier, and if they’re not the right fit, we have the option of returning them.
We can arrange custom made shoes if needed.
The usage of either of these largely depends on the patient and what we are aiming to achieve.
For example, for a 150kg patient requiring a rigid device, plastic would flex, so we would use carbon fibre laminate, which is stronger.
While carbon fibre laminates are generally stronger, thinner and lighter, they’re more difficult to modify and less flexible after fabrication, so it’s situational.
If a patient has a strong preference for either we will factor this into our prescription.
At Orthotics Plus we prefer the ‘just enough’ approach to management.
The style of device selected will match your stage of recovery and allow you to function as effectively as possible, while still allowing you to gain or maintain your body’s own abilities.
For patients in the very early stages of recovery, we may encourage an AFO which maximises rehabilitation and neuroplasticity. During this time we must consider safety and other factors too.
We recommend long socks that will create a barrier between the skin and the AFO.
The material of the sock is the preference of the client.
Pre-made AFOs are often suitable for people with a simpler presentation and a typical anatomy.
Custom made AFOs are used for patients with a complex clinical presentation or unusual anatomy or if the Orthotist determines this will result in a better outcome.
Most growing children will require a re-assessment approximately every 12 months.
We suggest making an appointment with us ASAP if your child complains of an AFO feeling too tight or you notice rubbing.
We ensure our clinics are sufficiently staffed so you should be able to see your Orthotist within a day or two