The advent of carbon fibre technology has allowed the creation of a new range of orthoses that are not only lighter and less bulky, but also stronger than traditional makes.
Bespoke carbon fibre orthoses can benefit patients in numerous ways.
At LOC, we can create any type of orthotic device you require. From Ankle-Foot-Orthoses through to complex, stance phase control Neuroswing Knee Ankle Foot Orthoses (KAFOs).
In KAFOs weight reductions of up to 30% are normal. This kind of weight reduction has an immediate positive clinical impact, particularly for patients with polio or post-polio syndrome.
There are many types of carbon fibre manufacturing processes. The London Orthotic Consultancy (LOC) uses a process that borrows from Formula One racing. As a result, the end product is an incredibly strong, yet lightweight, product. This has huge advantages in orthotics, as it can reduce the weight and bulk of an orthosis. Due to this reduction in weight, our clients can reduce their energy expenditure, allowing them to walk faster or for longer distances.
The inherent increased strength of the material allows us to manufacture orthoses that were not previously possible. We can use them to completely offload an ankle joint by taking weight through the knee.
Carbon fibre also has excellent storage and return properties. While walking, the force created by an individual's momentum is stored and, as one moves forward, this energy is released, giving the user a 'push' start.
As one of our clients put it: "You have put the spring back into my step."
The reduced bulk of carbon fibre orthoses has another advantage - it means they fit a wider selection of footwear and for some of our clients that is the most important factor when choosing a new orthosis.
An AFO is an Ankle Foot Orthosis which as the name would suggest 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. When set up correctly they can also have a great influence on the knee and hip joints. They are the most commonly used Orthoses.
A patient’s comfort in their AFO is vital for compliance with the prescribed wearing regime.
So there are a number of steps the orthotist should take to ensure a comfortable fit: the patient’s heel should fit fully into the heel cup without excess space, the contours of the plantar surface of the AFO should match the patient’s foot, for children there needs to be up to half an inch growth room in the toe shelf length. At LOC we use our Gait Laboratories at our Kingston and Manchester clinics to fine-tune our bespoke orthotics.
A GRAFO is used to control instabilities in the lower limb by maintaining proper alignment of limbs and controlling their motion. It reaches around to the front of the knee extending down to the ankle. It works by altering a patient’s limb presentation to displace load and impact as well as offering further control to the knee.
The ability to drive while wearing an AFO is dependent on the condition being treated and the orthosis that has been prescribed. If wearing a hinged AFO, for example, you will be able to drive, but if wearing a knee brace, you won’t. Your orthotist will advise you.
The most flexible type of AFO is a Dynamic Ankle Foot Orthosis (DAFO). It is thin and provides flexible support to the foot and ankle.
Both normal AFOs and DAFOs improve static balance (eg: while standing). Research among MS sufferers suggests that DAFOs aided balance while walking more than AFOs.
The simple answer is: yes they can. However one has to be sensible and look for wide-fitting trousers/jeans preferably of light and thin material.
Typically an AFO is stiff and rigid whereas a DAFO is thin, flexible and wraps around the patient’s entire foot. A DAFO provides support but also allows some range of normal movement.
A Supra Malleolar Orthosis SMO gets its name from the part of the body it encompasses. Thus an SMO supports the leg just above the ankle bone or malleoli. It allows dorsiflexion and plantar flexion(toes up and toes down) but eliminates mediolateral movement.
It typically takes a few weeks but is slightly dependent on the chosen materials and current availability.
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