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View our privacy policyOrthotics are crucial in supporting mobility, stability, and posture for children with spina bifida. With customised orthotic solutions and ongoing reassessment, children can gain greater independence and improve their quality of life.
Spina bifida symptoms in patients can vary greatly, from mild to severe. Muscle strength, sensation and mobility can be affected in different ways.
In the case of lower limb paralysis, physiotherapy and custom orthotics can help maintain joint flexibility, provide stability, and enhance mobility.
Bespoke orthotics, combined with a detailed biomechanical assessment and gait lab analysis can help spina bifida patients in the following ways:
As children grow, their orthotic needs evolve.
In infancy and early childhood, ankle-foot orthoses (AFOs) may be used to:
When children begin to learn how to walk, fixed AFOs or ground reaction AFOs (GRAFOs) may be prescribed to:
Flora was initially prescribed AFOs by the NHS to help her walk with her spina bifida, but they provided inadequate support, causing her feet to slide. Seeking a better solution, her mother, Georgina, discovered LOC through a recommendation on Instagram. Senior orthotist Connor Mumford assessed Flora for the first time at our Cambridge clinic and advised that well-fitted AFOs, rather than KAFOs, would be more suitable. He also prescribed adapted footwear, ensuring the orthoses function effectively.
At the fitting appointment, Georgina immediately noticed the difference in the design of the AFOs
“There was an immediate improvement, She gained so much confidence in her ability to walk. Connor and the team have been outstanding and given Flora so much more independence. The service provided is excellent, with the critical differences being the gait analysis that leads to a very specific, bespoke AFO design and the frequent troubleshooting reviews provided.”
As children get older, their needs can change. Some may require additional knee and hip support, and a knee-ankle-foot orthosis (KAFO) may be introduced.
KAFOs with locked knee joints can help facilitate mobility for children who need additional support. These devices stabilise the knee, preventing it from collapsing during walking or standing.
Children with spina bifida require continuous reassessment to ensure their orthotic prescription meets their changing needs. As they grow taller and gain weight, gait patterns become more complex, requiring adjustments to orthotic design.
At LOC, we work closely with neuro teams, physiotherapists, occupational therapists, and parents to ensure each child’s orthotic treatment aligns with their therapy and development goals.
Every child with spina bifida has unique needs. The best way to determine the right orthotic solution is through a detailed assessment by our experienced clinicians.
Below, you’ll find more information about some of the more common orthoses we prescribe for spina bifida.
An Ankle Foot Orthosis (AFO) is a brace designed to support and control the position and movement of the ankle and foot. AFOs can also immobilise the ankle and lower leg to aid in rehabilitation and correct specific issues. They are the most well-known and frequently prescribed orthotic devices due to their versatility and effectiveness.
What sets our AFOs apart is the level of precision and customisation we bring to their design and tuning. Each orthosis we make is 100% bespoke. Depending on the patient’s needs, we can create AFOs with a fixed ankle for greater control of gait mechanics or incorporate a hinged design to allow controlled movement in a single plane.
A critical part of our process is the fine-tuning of each bespoke orthotic to ensure optimal alignment and comfort. We use state-of-the-art gait analysis technology as standard to help us assess, prescribe and fine-tune all our orthotics.
By prioritising this approach, we deliver AFOs that not only meet, but exceed, expectations for functionality and comfort.
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’s often used to try and maintain the length of the hamstring and prevent crouch gait, one of the most common movement disorders among children with cerebral palsy.
Crouch gait is characterised by excessive knee flexion during stance, which increases the energy needed to walk and, if not corrected, can lead to chronic knee pain and joint degeneration.
The GRAFO is complex to manufacture and in larger patients, often requires carbon fibre reinforcement.
A Dynamic Ankle Foot Orthosis (DAFO) is a custom-made brace that supports the ankle and foot. Unlike rigid orthotics, a DAFO is thin and flexible enough to help with balance and stability while allowing the foot to move more freely.
It wraps around the patient’s entire foot to improve stability and gives excellent proprioceptive feedback from the ground using its dynamic footplate, so the brain is more aware of the position and movement of the foot.
This can be particularly beneficial for those with neurological disorders like cerebral palsy and spina bifida.
A Knee Ankle Foot Orthosis (KAFO) is a custom-made brace that supports the entire leg, spanning the knee, ankle, and foot. KAFOs are primarily prescribed for individuals with muscle-weakening conditions or paralysis caused by conditions like post-polio syndrome, muscular dystrophy, multiple sclerosis, Acquired Brain Injury (ABI), stroke and spinal cord injury.
KAFOs help by:
Our bespoke KAFO service ensures every device is tailored to your specific needs and preferences, guided by our team’s expertise and the latest orthotic advancements.
We offer cutting-edge options that go beyond traditional fixed KAFOs with locking knee joints. While fixed systems provide stability, they can contribute to muscle atrophy, increased energy expenditure, and an unnatural gait.
To address these challenges, we provide modern, innovative solutions. For example, KAFOs that automatically lock and unlock at the appropriate points in the gait cycle, promoting a more natural and energy-efficient walk.
The Agilik™ smart orthosis from Bionic Power is a state-of-the-art lightweight device designed to enhance walking by working with the user’s natural movement. Unlike exoskeletons, which support a patient’s body and move for them, the Agilik™ provides dynamic assistance and resistance during walking. This helps users stand straighter, walk more easily, walk for longer and build strength.
The London Orthotic Consultancy has been appointed the paediatric specialist centre for the Agilik™ smart orthosis in the UK.
A Reciprocating Gait Orthosis (RGO) is designed to assist individuals in walking by supporting a natural, reciprocal gait pattern. This device typically features jointed metal frames, straps, and components that attach to the user’s legs and torso. Its main function is to mimic the natural walking motion by coordinating the movement of the legs. So when one leg moves forward, the other moves backward, allowing for a smoother, more efficient walking pattern.
RGOs are equipped with hinges at the hip and knee joints, enabling dynamic movement and coordination. A locking mechanism provides added stability during standing or resting phases. The user initiates movement through weight shifting or by using assistive devices, with the RGO converting this motion into a coordinated walking pattern.
We specialise in the design and manufacture of bespoke RGOs particularly for spinal injury patients. Enhancing mobility and promoting greater independence in walking.
We’re happy to answer any questions you might have, with no commitment to proceed with treatment.
