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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.

Arts & Crafts
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Solid AFO

  • Knees, and sometimes hips, remain flexed when standing or walking

  • Posture may be due to weakness or low muscle tone

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Ground Reaction AFO

  • Significant excess dorsiflexion and knee flexion: 15° or more

  • Occurs constantly (100% of the time)

  • Cannot correct when prompted

  • Can be manually corrected with strong resistance or cannot be corrected

  • Marked excess dorsiflexion and knee flexion: 5–15°

  • Occurs frequently (more than 50% of the time)

  • Can improve when prompted

  • Can be manually corrected with mild/moderate resistance

EXCESSIVE DORSIFLEXION/CROUCHING

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Dynamic AFO

Pronation:

  • Foot collapses and medial arch flattens

  • Heel everted and forefoot abducted

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Supination:

  • Weight bear on lateral side of the foot, high medial arch

  • Heel inverted and forefoot adducted

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High Cut Shoe

  • Absent medial arch

  • Strong heel eversion and forefoot abduction

  • Cannot correct when prompted

  • Can be manually corrected with strong resistance or cannot be corrected

  • Visible/reduced medial arch

  • Mild/moderate heel eversion and forefoot abduction

  • Can improve when prompted

  • Can be manually corrected with Mild/moderate resistance

HIGH TONE PRONATION OR SUPINATION

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SMO

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Insole

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  • Foot collapses and medial arch flattens

  • Heel everted

  • Forefoot abducted

  • Low muscle tone allows for easy correction

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SMO

  • Absent medial arch

  • Strong heel eversion and forefoot abduction

  • Cannot improve when prompted

  • Can be manually corrected with moderate resistance

  • Visible/reduced medial arch

  • Mild/moderate heel eversion and forefoot abduction

  • Can improve when prompted

  • Can be manually corrected with mild resistance

LOW TONE PRONATION

UCBL insole

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Leafspring AFO

  • Bears weight primarily on forefoot

  • Toes point downward and heel does not touch ground when walking

  • Excess muscle tone, range of motion, or habit results in toe walking

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Solid AFO

  • Ankle plantarflexion: 2° or more

  • Occurs constantly (100% of the time)

  • Cannot correct when prompted

  • Can be manually corrected with strong resistance or cannot be corrected

  • Ankle plantarflexion: 0–2°

  • Occurs frequently (more than 50% of the time)

  • Can improve when prompted

  • Can be manually corrected with moderate resistance

EXCESSIVE PLANTARFLEXION/TIP TOEING

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Hinge AFO

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SOLID AFO

  • Foot and ankle positions are uncomfortable and limit function

  • Poor positions created by excess and unbalanced muscle tension

  • To accommodate the ankle and foot deformity 

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  • Accompanied by strong pronation/supination

  • Assisted transfers only; or non-weight-bearing

  • Cannot be manually corrected

  • Accompanied by moderate pronation/supination

  • Occasional assisted ambulation

  • Can be manually improved

POSITIONING/LIMITED AMBULATION

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Solid AFO with Heel Raise

  • Knee locks backwards into extension

  • Excess muscle tone or weakness create knee hyperextension

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  • Significant knee hyperextension: 5° or more

  • Occurs constantly (100% of the time)

  • Cannot correct when prompted

  • Can be manually corrected with strong resistance

  • Marked knee hyperextension: 2–5°

  • Occurs frequently (more than 50% of the time)

  • Can improve when prompted

  • Can be manually corrected with moderate resistance

KNEE HYPEREXTENSION

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Hinge AFO with Heel Raise

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Insole with Heel Raise

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