Guide to AFO Brace Selection
AFO brace selection guide to help patients/parents determine their child gait pattern and match their need for available braces.
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Solid AFO
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Knees, and sometimes hips, remain flexed when standing or walking
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Posture may be due to weakness or low muscle tone
Ground Reaction AFO
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Significant excess dorsiflexion and knee flexion: 15° or more
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Occurs constantly (100% of the time)
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Cannot correct when prompted
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Can be manually corrected with strong resistance or cannot be corrected
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Marked excess dorsiflexion and knee flexion: 5–15°
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Occurs frequently (more than 50% of the time)
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Can improve when prompted
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Can be manually corrected with mild/moderate resistance
EXCESSIVE DORSIFLEXION/CROUCHING
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Dynamic AFO
Pronation:
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Foot collapses and medial arch flattens
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Heel everted and forefoot abducted
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Supination:
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Weight bear on lateral side of the foot, high medial arch
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Heel inverted and forefoot adducted
High Cut Shoe
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Absent medial arch
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Strong heel eversion and forefoot abduction
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Cannot correct when prompted
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Can be manually corrected with strong resistance or cannot be corrected
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Visible/reduced medial arch
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Mild/moderate heel eversion and forefoot abduction
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Can improve when prompted
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Can be manually corrected with Mild/moderate resistance
HIGH TONE PRONATION OR SUPINATION
SMO
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Insole
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Foot collapses and medial arch flattens
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Heel everted
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Forefoot abducted
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Low muscle tone allows for easy correction
SMO
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Absent medial arch
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Strong heel eversion and forefoot abduction
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Cannot improve when prompted
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Can be manually corrected with moderate resistance
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Visible/reduced medial arch
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Mild/moderate heel eversion and forefoot abduction
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Can improve when prompted
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Can be manually corrected with mild resistance
LOW TONE PRONATION
UCBL insole
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Leafspring AFO
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Bears weight primarily on forefoot
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Toes point downward and heel does not touch ground when walking
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Excess muscle tone, range of motion, or habit results in toe walking
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Solid AFO
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Ankle plantarflexion: 2° or more
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Occurs constantly (100% of the time)
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Cannot correct when prompted
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Can be manually corrected with strong resistance or cannot be corrected
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Ankle plantarflexion: 0–2°
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Occurs frequently (more than 50% of the time)
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Can improve when prompted
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Can be manually corrected with moderate resistance
EXCESSIVE PLANTARFLEXION/TIP TOEING
Hinge AFO
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SOLID AFO
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Foot and ankle positions are uncomfortable and limit function
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Poor positions created by excess and unbalanced muscle tension
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To accommodate the ankle and foot deformity
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Accompanied by strong pronation/supination
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Assisted transfers only; or non-weight-bearing
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Cannot be manually corrected
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Accompanied by moderate pronation/supination
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Occasional assisted ambulation
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Can be manually improved
POSITIONING/LIMITED AMBULATION
Solid AFO with Heel Raise
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Knee locks backwards into extension
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Excess muscle tone or weakness create knee hyperextension
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Significant knee hyperextension: 5° or more
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Occurs constantly (100% of the time)
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Cannot correct when prompted
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Can be manually corrected with strong resistance
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Marked knee hyperextension: 2–5°
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Occurs frequently (more than 50% of the time)
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Can improve when prompted
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Can be manually corrected with moderate resistance
KNEE HYPEREXTENSION
Hinge AFO with Heel Raise
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Insole with Heel Raise