AFOs are used by a large number of people with cerebral palsy for a variety of different reasons, whether it is positioning, deformity management, or to improve standing or walking. AFOs are worn for short to extended periods each day, depending on the goal for AFO use. There is no one size fits all when it comes to the amount that AFOs are used.
Young children with cerebral palsy or developmental delay may not be able to stand due to high or low muscle tone affecting their foot and ankle position. AFOs can be used to improve weight-bearing posture, helping children to learn to hold themselves upright.
Walking may seem the easiest thing in the world to most, but it is an extra-ordinary complex series of motions with which cerebral palsy may interfere with at many levels.
For weakness of the dorsiflexors causing a foot drop and/or tripping, a lightweight carbon-fibre AFO may be used. When these are not appropriate, a custom leaf-spring AFO is an alternative. We also use a pre-manufactured device, similiar to a Dictus band, to provide toe clearance for people with very minor dropfoot.
For more support for dropfoot or where there is tightness in the calf, a hinged AFO may be used. This strongly prevents toe walking commonly seen in CP.
When there is more involvement with tone or more difficult foot postures, solid AFOs (SAFOs) may be used. These are able to influence the knee and hip motion and are made in a variety of setups to best influence the motion of the limb.
AFOs are also used to improve stability in wheelchairs where a difficult foot posture is causing problems. AFOs can help position the feet, protect them and provide support for standing transfers.
Difficult to fit feet or children affected by athetosis or strong extensor tone may be able to use less rigid circumferential designs of AFOs. These allow some movement without giving up overall stability. They may be a single design or a hybrid two-part AFO.