AFO

Ankle-foot orthosis (AFO) is a brace worn on the lower leg and foot to support or align the ankle and foot and to influence gait. AFOs are prescribed for people with neurologic, orthopedic, or traumatic conditions that affect strength, sensation, range of motion, or stability around the ankle. Common indications include foot drop after stroke or brain injury, cerebral palsy, multiple sclerosis, spinal cord injury, ankle instability, arthritis, and recovery from foot or ankle surgery. They can help improve foot clearance during swing, stabilize the ankle during stance, reduce abnormal tone, and prevent contractures.

AFOs come in several designs and can be prefabricated or custom-made. Rigid or solid AFOs immobilize the ankle to provide maximal stability, often used after injury or surgery. Hinged AFOs allow controlled ankle motion within prescribed limits. Posterior leaf spring AFOs are more flexible and assist dorsiflexion during swing without fully immobilizing the ankle. Supramalleolar and other variants may extend above the ankle to control hindfoot alignment. Materials range from thermoplastics and carbon fiber composites to leather and metal components; carbon fiber and lightweight plastics are common for active users due to energy efficiency and reduced weight.

Fitting typically involves clinical assessment, gait analysis, and either a plaster cast or digital scan to create a custom device. Alignment is tailored to the individual’s needs, with gradual acclimation and follow-up adjustments. Care includes skin inspection, proper footwear compatibility, and routine cleaning. While AFOs improve stability and walking efficiency, they do not cure underlying conditions and may cause skin irritation or pressure points if ill-fitting.