AFOs – When Splints Aren’t Just Splints

 AFO = Ankle Foot Orthosis

Hearing the word ‘splint’ people often picture a rigid, single, simple brace. But rather, Ankle Foot Orthoses (AFOs) come in multiple shapes and forms – each with their own characteristics created to support specific clinical needs.

The correct AFO can significantly improve walking efficacy, comfort, stability and long-term joint health.

What is an AFO?

An AFO is a form of brace worn on the lower limb/s. When scripted properly an AFO can:

• Improve gait pattern and quality

• Support weak muscles

• Control joint positioning

• Prevent contractures

• Reduce falls risk

• Improve energy whilst mobilising

AFOs are commonly seen in multiple conditions across the lifespan. Some examples include stroke, multiple sclerosis (MS), cerebral palsy (CP) and foot drop.

Common AFOs:

1.      Flexible AFO

• Designed to allow more natural movement

• Providing mild support

• Often used for mild foot drops, minor instability and clients who still have some active mediolateral muscular control preserved.

• Some examples include; a posterior leaf spring (PLS) AFO, foot up splint and dictus band

• These AFOs are often off the shelf and can be used as interim support whilst a customised splint is being created.             

2.      Rigid AFO

• This type of AFO is custom made and allows no movement at the ankle

• Rigid AFOs provide maximum control and stability but can feel restrictive. These are often prescribed and used when joint integrity and safety are the priority.

• Common conditions include cerebral palsy, stroke, traumatic brain injury

• GRAFO (ground reaction ankle foot orthosis) is a type of rigid AFO that has an anterior shell (part of the brace on the shin, rather than calf area) which spreads the load differently to a regular rigid AFO. The force is instead distributed to the front of the shin, which assists in extending the knee and maintaining ankle in a plantar grade position.

  3.      Hinged / Jointed AFO

• This type of AFO includes an ankle joint hinge allowing some movement at the ankle (plantarflexion/dorsiflexion).

• Best used for client who need support but will still benefit from ankle motion. It can improve gait mechanics and reduce knee hyperextension.

• Commonly seen in conditions such as stroke, cerebral palsy, multiple sclerosis, traumatic brain injury, foot drop