Hypermobility is the term used to describe the ability to move joints beyond the normal range of motion, more commonly known or referred to as double-jointed. It can be a symptom of a variety of conditions such as Ehlers-Danlos syndrome or Marfan syndrome. It is very common in children and adolescents and may have no medical consequences whatsoever.
However, some hypermobility can affect the structure of joints, particularly ligaments and other ‘soft’ tissues around their joints. These injuries may cause immediate acute pain and sometimes lead to a chronic longer-term issue.
Typically, the feet are the most commonly affected area, due to their complex mixture of bones and soft tissue structures. Postural alignment issues can have a knock-on effect, causing postural issues throughout the body.
Bespoke foot orthotics are the recommended treatment option for the majority of patients with hypermobility. Often patients present with pain issues or have altered their posture to try and offset the pain; proprioceptive insoles may be the preferred prescription for these patients.
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.
Sofia’s AFOs Help Her to Stand and Walk During Lockdown
LOC’s gait lab has helped Lilac to move independently
Sam Walmsley to explain OSKAR Framework to Neuro Conference 2021 Delegates
Meet John Turner – our Manchester Orthotics Lead
LOC to launch OSKAR Framework to CMSUK 2020 Delegates
OSKAR Clinic AFOs and gait laboratory are game-changers for cerebral palsy patient Austin
Cerebral palsy patient, Sophie, maintains independence during lockdown with LOC’s help