Definition: An ankle foot orthosis (AFO) is a semi-rigid to rigid brace that extends from the lower leg and ankle to the foot. An inability to flex the ankle or foot creates stability and gait issues that are moderated when the right kind of AFO is used. Among other conditions, AFOs are used to correct for conditions such as foot drop and posterior tibialis tendon dysfunction (PTTD).
Foot Drop AFO
Arizona AFO for PTTD
AFOs are available in prefabricated form or custom. Some wear them all the time and others use them intermittently or on a temporary basis only. Most are made quite thick at the ankle and when the hinge is below the ankle bone, shoe sizing is affected. This creates the need to have a wider or longer shoe than one normally wears to make room for the device. When this is the case, it creates stability issues in the unaffected foot. Extra depth or double depth shoes are needed as regular depth shoes cannot accommodate these braces. Of more concern is when different size shoes are needed because the unaffected shoe size is much smaller than that of the braced foot. Usually due to an inability to buy 2 pairs of shoes, many just wear the same size shoes and that puts them at risk of tripping and falling. As well, interest in walking diminishes because it isn’t comfortable and they feel unstable.
There are more of these devices coming on the market that are being made with less bulk and the hinge at the ankle bone or above that are lighter and eliminate the need to wear different size shoes:
Benefits: Many medical conditions contribute to instability at the ankle and foot, such as PTTD, multiple sclerosis, stroke, and complications from low back surgery, so there are fair numbers of people in need of the braces and shoes to accommodate them. The key is to match the brace with shoes that are not too wide or long since many of the braces are quite thick at the ankle.
Text: Copyright 2005- 2011 Carole Romig Image: 1- Orthocanada.com, 2 -customfootwear.com, 3-stjorthotic.com