DAFO Indications
Dynamic AFO
Flexible Pes Planus
Mild to moderate spastic diplegic
Hemiplegic CP
Hypotonic CP
DAFO Contraindications
Rigid foot deformities
UCBL Indications
Pronation control, flexible pes planus, OA of the hindfoot, post tib dysfunction, tarsal coalition, rearfoot valgus/varus
UCBL Contraindications
Toe walker, mod-high tone, ankle arthritis (rigid foot deformities)
Supramaleolar Orthosis Indications
Severe Pes Planus, Mild Ankle instability, low tone (hypotonic), Intermittent toe walkers, mild to moderate CP, tarsal coalition, post tib dysfunction
Suprmaleolar Orthosis (SMO) Contraindications
high tone (hypertonicity), sagittal plane, weakness deformity, dominate toe walkers, equinovarus/valgus
Bilateral Metal Upright AFO Indications
Foot drop, post polio, neuropathic feet, ankle varus/valgus, foot drop with uncontrolled edema, poor skin below the knee
Bilateral Metal Upright AFRO Contraindications
patients concern with bulk/weight, limit shoe wear
Free motion/articulated/Hinge AFO Indications
posterior tib dysfunction
subtalar or talar joint instabilities
Free motion/articulated/Hinge AFO contraindications
Weak Quads, Sagital plane ankle weakness
high impact sports, too bulky
Dorisflexion assist AFO Indications
DF weakness, toe clearance while allowing some PF
DF assist AFO contraindications
moderate to severe tone levels
altered knee control - knee buckles/hyperextended
Posterior stops in AFO Indications
Structural collapse of the ankle foot, severe spasticity
immobilize ankle in swing and stance phase
Only PF stop/free DF then it facilitates knee flexion in early stance
Posterior stops in AFO Contraindications
inadequate hip strength, absent quads, fluctuating edema, spastic gastroc (pushes too hard against brace)
DF/anterior stop Indications
weak PF and weak quads
Facilitates knee extension and stiff ankle in late stance
DF/anterior stop contraindications
DF weakness, knee hyperextension, foot drop
Limited DF and PF atriculated AFO
limits both DF/PF to some degree
Pretty screwed up knee, needs control rolling over and with foot drop
Solid Ankle Foot Orthosis (SAFO) indications
Ankle instability/weakness in more than one plane, equino varus, moderate-severe pes plano valgus, mild-moderate genu recurvatum
Posterior Leaf Spring Indications
mild-moderate foot drop and knee hyperextension
Increase limits of PF. Patient needs adequate knee, hip, and ankle plantar flexion strength
Posterior Leaf Spring Contraindications
moderate to severe spasticity, coronal plane ankle instability, ankle dorsiflexion limitations/fused joint, severe knee instability
Spiral AFO Indications
Ankle DF weakness and/or PF ALONG with mild-moderate medial-lateral instability
Spiral AFO Contraindications
Inadequate hip strength, moderate-severe spasticity, severe medial lateral ankle instability, fluctuating edema
Ground Floor Reaction AFO Indications
crouched gait, foot drop with knee instability, quad weakness, MS, Spina Bifida patients
good alternative to KAFO if they have enough quad strength to maintain knee stability
FRO Contraindications
Genu recurvatum, ACL, severely ER feet, no enough trunk/quad strength, not good for knees moving into hyperextension
Helio SAFO FRO
Tri planar control
dynamic response with strapless design
AFO decision making prescription
Patient has decreased ankle strength OR impaired/absent proprioception at the ankle/knee OR ankle plantar flexor spasticity that my include varus
