As the name would suggest, an Ankle Foot Orthosis is an orthotic or brace that encompasses the ankle and foot. The objective is to control the position and movement of the ankle. AFOs are used to support weak limbs; they can also be used to immobilise the ankle and lower leg to correct foot drop. They are the most commonly used Orthoses.
Depending on the condition the London Orthotic Consultancy is treating, we can design them to be fixed at the ankle; this allows us to fine-tune a patient’s gait more effectively. Or they can hinge at the ankle to allow a limited range of movement in one plane.
Whatever kind of AFO is prescribed we fine-tune our bespoke orthotics; this is fundamental to ensuring optimum alignment and comfort. In 2015 a study of UK orthotists found that only 46% reported that tuning of AFOs was standard practice.
In a recent article in the Journal of Prosthetics and Orthotics - Elaine Owen argues that it is not a question of whether to tune or not as it should be standard practice and time should be allocated to the task by the orthotist.
Our clients want to be able to live an active lifestyle and exercise plays its part. Several patients approached us requesting we design them an AFO that could be worn in the shower, for swimming, for holiday. So we designed an AFO specifically for use in water.
Our waterproof AFOs have a removable liner and plastic components are used instead of metal to avoid rusting. Importantly they have a rubberised sole plate to allow safe weight-bearing without footwear. They allow for complete submersion in water and can be used to help transfer in and out of water for swimming and other water-based activities.
If you have any other specific requirements for your orthotic devices please speak with one of our orthotists to see if we can help. We are keen to be at the forefront of modern bespoke orthotic design and manufacture.
Our nighttime versions of our bespoke AFOs are very well padded as they are often worn without socks. They can be produced with adjustable ankle joints to encourage a greater range of movement as treatment progresses.
Plantar Fasciitis is one of the common conditions that can benefit from treatment with night splints; the fascia ligament is kept stretched while the patient sleeps. There are two main types of splint: the Dorsal and the Boot. The Dorsal has a hard plastic support that rides along the shin and top of the foot while the spine for the Boot’s brace is on the back of the leg and calf and runs under the foot.
There are advantages and disadvantages of both treatments; LOC’s specialist clinician will explain the pros and cons before prescribing treatment.
Sometimes called a Floor Reaction AFO, the GRAFO is used to control instabilities in the lower limb by maintaining proper alignment of limbs and controlling their motion. It is often used to try and maintain the length of the hamstring and prevent crouch gait which is one of the most prevalent movement disorders among children with cerebral palsy.
Crouch gait is characterised by excessive knee flexion during stance, this substantially increases the energy requirements of walking and, if not corrected, can lead to chronic knee pain and joint degeneration.
The GRAFO is complex to manufacture and in larger patients will require carbon fibre reinforcement.
An insole is a contoured orthotic device which alters the characteristics and biomechanics of the foot and ankle area. Biomechanics are concerned with mechanical laws and how they affect the living body, especially the musculoskeletal system.
They are removable devices, often made from plastic, that are designed to fit inside a shoe to provide additional support for your feet. As well as offering shock absorption, an insole can help distribute the weight of your body more effectively across the foot and can be made bespoke to cover a range of biomechanical conditions.
If you have symptoms in your feet, ankles, hips or your lower back that are intermittent or were not there to start with in early life, and have started to cause you pain over a period of time, bespoke orthotic insoles could be an excellent option.
If you have already tried rest, icing, compression and elevation and your feet have not recovered, we recommend a biomechanical assessment to consider the possibility of insoles. They are a non-invasive approach to treatment and in many cases, are a great option for symptoms that are not severe enough to warrant surgical intervention. Alternatively, they can be considered as an option prior to surgery.
We will send patients away when an insole is not appropriate, if a patient is suffering with iliotibial band syndrome for example, the problem can be helped with physiotherapy and a stretching programme. That’s what our biomechanical assessment is all about; determining whether there would be any benefit from altering the alignment of your feet.
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