Below Knee Orthosis
Ankle Foot Orthosis
Ankle Foot Orthosis (AFO): Are designed to offer maximum stability and support to the ankle foot complex. The A.F.O’s resist all movement allowing no planterflexion or dorsiflexion, and hence hold the foot in the position that it was cast in.
By maintaining total intimate contact the ‘point’ pressure, and hence rubbing is reduced.
The A.F.O’s are most commonly made of Polypropylene, Homopolymer and Subortholon.
They are used for any condition where the foot/ankle complex requires stabilisation.
Anterior Ground Reaction Orthosis
The Anterior Ground Reaction Orthosis, (A.G.R.O), is a variant of the standard fixed A.F.O, which was modified to allow greater control of the knee.
The plastic extends around the front of the leg, covering the Tibial tuberosity and the Patella. By ensuring contoured shaping a corrective force can be applied to ‘push’ the knee back into extension and hence improve the crouched gait pattern with conditions such as cerebral palsy.
Ankle Foot Orthosis
Hinged A.F.O’s were developed to overcome the problems created by using fixed A.F.O’s. Although fixed AFO’s controlled the foot it also meant all ankle movement was totally lost and prevented the child developing a true symmetrical gait pattern, making walking up a slope , climbing stairs and moving from sitting to standing extremely difficult.
A simple hinge lined up with the anatomical ankle joint allows the foot to Dorsiflex freely whilst controlling planterflexion and lateral movements of the ankle and foot.
There is now a large variety of joints available each one having different properties, allowing the hinged AFO to be far more effective.
By adding an adjustable motion stop (back stop), the amount of plantar-flexion can be further ‘fine tuned’. This refinement also allows more effective control of the knee allowing moderate Hyperextension to be controlled.
Hinged AFO’s are most commonly made of Polypropylene (coloured or white), or Homopolymer.
HAFO’s are used for a variety of conditions, most commonly for Cerebral Palsy, be it hemiplegic or diplegic. But are also used as ‘night-splints’ as they allow the amount of stretch to be increased gradually without different splints being made.
Dynamic Ankle Foot Orthosis - D.A.F.O
Dynamic Foot Orthosis - D.F.O
All Dynamic Orthotics are made far thinner than ‘standard’ Orthotics,
hence allowing the foot to move but always return to the corrected position.
Dynamic Orthotics provide ‘global’ tone changes and improved stability that allows for greater postural control and development of balance in all positions.
Even very severely handicapped children achieve improved symmetry and control in supported sitting and supported standing. When used in children who have more active movement possibilities, the movement quality and variety improves. In children who are ambulatory, dynamic Orthotics have provided significant improvement in active standing and walking balance, hip-knee-trunk control, leg separation and smoothness of gait.
Dynamic Orthotics are also being used to provide active foot-ankle stability in children with Hypertonia and Meningomyeloele. In these children, the improved stability of their base of standing provides more possibilities for active knee, hip and trunk control.
Dynamic Orthotics have been tried in a limited number of persons with head injuries and CVA. Correction and control to achieve neutral weight bearing in even severe spasticity is possible even in partially anaesthetic patients, though global tone changes are not as clearly seen.