Ankle Foot Orthosis (AFO)

Answer yes or no to the following statements about the Ankle Foot Orthosis (AFO).

1. AFOs can be prefabricated or custom made – Yes – Prefabricated or custom made AFOs are available. It is vital that the device provided meets the biomechanical and functional needs of the patient. Whilst prefabricated splints are available in a variety of sizes for some patients they may not provide an intimate enough fit or be firm enough to inhibit unwanted movement in these patients a custom made splint is indicated.

2. AFOs are provided to stop the foot catching when walking – Yes – AFOs are provided to assist with the swing through of the affected leg when walking but they can also have a significant impact on the stability of the lower limb when standing on the leg during walking.

3. AFOs provide direct control of the ankle and foot – Yes – An AFO is designed to have direct control on the ankle and foot.

4. AFOs do not have any impact on the control of the knee and hip – No – When standing on the leg during walking a custom made AFO can improve the alignment and motion of the foot and ankle and therefore have indirect impact on the control of the hip and knee alignment which may in turn improve patients motor recovery and overall mobility.

5. AFOs should only be provided when the patient is nearing the end of their rehabilitation – No – AFOs should be considered early on in rehabilitation to prevent contracture and deformity, assist in early mobilisation and optimise gait rehabilitation.

6. If the custom made AFO provided by the orthotist isn’t fitting well I can get my heat gun out and modify it – No – A custom made AFO is usually provided by a trained orthotist. The provision and fit of the AFO is the responsibility of the orthotist. Modifications should not be undertaken by untrained staff. The patient should be referred back for an orthotic review.

7. The person that provided the AFO is responsible for the ongoing monitoring of the fit and suitability of the AFO – No – The monitoring of an AFO is the shared responsibility of all members of the multidisciplinary team.