Children with developmental delay can find it hard to get past pulling-to-stand due to low muscle tone in their core and leg muscles. The muscles controlling the ankle, knees and/or hips may not be strong enough to support body weight and everything will collapse. Foot and ankle orthoses can improve the stability of the limb, allowing core muscle strength to be improved by due a stable base of support.
Orthoses such as foot orthoses, Supra-Malleolar Orthoses (SMOs) and Ankle-Foot Orthoses (AFOs) are used to provide a good base of support and to control poor posture of the lower limb. This in turn makes it much easier for children be more stable in their overall posture.
It is often the case that as gross motor skills improve, less support is needed.
Often a child may need strong support in the form of solid AFOs to begin standing, but once standing independently, solid AFOs will hinder stepping.
AFOs can be hinged, allowing free ankle motion but keeping the foot in a good posture, or they can be cut down below the ankle to provide foot support.
After stepping and walking is learned, only foot orthoses may be needed to improve balance and endurance. It is our goal to reduce the level of support down to nothing, so that the child eventually has all the strength to walk and run unsupported.
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A very pronated foot supported by a hinged AFO