Propulsion AFOs
A propulsion AFO is a custom-fabricated, dynamic AFO that can be made in different designs. It provides ankle stability while still allowing some dorsiflexion and plantarflexion to occur (compared with other solid AFOs).
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.
How Propulsion AFOs Work
Propulsion AFOs are custom-made, which allows us to provide as much ankle stability as we require. In some situations, no ankle stability is needed. In other situations, a patient may have a severely pronated or supinated foot that needs to be controlled.
Propulsion AFOs work similarly to PDEs (Posterior Dynamic Element AFO). They include a solid calf strap that provides force distribution and a carbon fiber strut down the back that allows for a high amount of energy return- this gives a more natural and efficient ‘push off’ when walking.
The strut can be tuned according to the patient’s height, weight, and activity level.
The ankle section of the propulsion AFO is custom designed. It can be adjusted to be more flat and passive or made to mold around the foot in order to provide more stability at the subtalar joint and through the forefoot.
Individual Prescription of a Propulsion AFO
When a patient visits our office for an AFO, we always perform an assessment first and assess the patient anatomy, taking into account the patient height, weight and activity level to determine the strut stiffness.
Construction of the device will vary depending on the patient’s anatomy. For example, the length of the calf section will change depending on the length of the patient’s tibia. If the tibia is longer, we would customise a longer posterior section of the Propulsion AFO.
If indicated, we can trial various AFOs during the assessment and request the patient’s feedback in regards to comfort and function, as each can be further customised.
Their condition would also indicate the most appropriate type of device. We would consider statuses such as foot drop, plantarflexion weakness and joint range of motion, as these will alter the prescription/customisations of the AFO.
How a Propulsion AFO is Constructed
The AFO is made up almost entirely of pre-preg carbon fiber material.
Pre-preg carbon fiber has been impregnated with resin that sets once exposed to heat which acts as a catalyst. Pre-preg results in slimmer design than with standard carbon fiber laminate and resin, which is important for lifestyle/choice/fashion considerations.
Each propulsion AFO is completely custom made. We take a cast of the leg, and the AFO is then fabricated according to the metrics and information we collect during the initial assessment with the patient.
When making the device, the cast is first filled with plaster. This creates a plaster model of the patient’s foot, and then the carbon fiber is molded over the top.
After the pre-preg carbon fiber is laid over the plaster cast, it’s put in a type of oven to cure. Then, it is ready to be fitted to the patient.
Propulsion AFO Patient Success Story
We recently worked with a patient who has mild foot drop and ankle instability. She came to us complaining of ankle and subtalar joint pain, which we believed to be a result of her foot posture.
The goal was to correct her foot posture through the hindfoot and midfoot to keep her in a more neutral alignment, which ideally, would improve pain management.
The patient is quite slim and active, so we looked to prescribe her with something that’s lightweight and can fit into non-custom shoes.
For her, the propulsion AFO was both a sleek and practical solution. It helped with her foot drop and offered mediolateral stability to reduce ankle pain while also providing a minimalist design for everyday wear.
Book a Comprehensive Assessment at Orthotics Plus
If you or a loved one may benefit from an AFO, then we’d love to hear from you.
- We are NDIS registered
- We proudly work with paediatric and adult patients
- We offer home-visits nearby our clinics for NDIS participants
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FAQ
The propulsion AFO is similar in height and length to a standard plastic AFO.
When worn, it comes up just below the knee at the back of the calf with an anterior strap. The footplate will be a full-length footplate with some flexibility at the metatarsal head(above the toes) to provide a degree of energy when pushing off the ground.
Patients who have foot drop and possibly calf weakness are candidates for Propulsion AFOs.
Alternative devices are available as well to help treat these conditions, but the propulsion AFO can offer a great solution for patients who prioritise a sleek design.
A propulsion AFO would not be suitable for patients with moderate to severe calf weakness or those living with severe above-the-knee weakness, especially in the quadriceps.
For these patients, we would recommend a device with a more rigid design or anterior shell. A KAFO may also be a better solution.