Ankle foot orthosis guide
Reasons for wearing an ankle foot orthosis
An ankle Foot orthosis (AFO) is a brace that has been designed to provide extra support, to aid mobility, or to maintain the range of motion at the ankle joint. The AFO is prescribed specifically for one user, which means you should be the only one to wear it. The clinician will through how to wear the AFO, Care for the device,
These instructions are to be followed carefully for treatment to be effective.
Fitting the AFO
It should always be worn over a thin pair of plain socks, preferably cotton. If you are helping someone else to put on an AFO, have them sit on a chair in front of you so you can support the leg.
- The heel must be put into the back of the AFO. This is easier if you first bend the knee to 90 degrees. Holding the heel down and back with your thumb, fasten the ankle strap over to hold this position, ensuring that the pad is sat in the centre.
- Next, tighten the calf strap securely. Following this, any other straps can be securely fastened ensuring all pads are correctly (centrally) located.
- Before using the AFO, check that the straps are secure but not too tight, and all pads haven’t slipped.
- If the straps are loose or the heel isn’t all the way back in the AFO, it will not be comfortable to use and could rub on the skin.
- Fitting an AFO can take time. It is important not to rush and to make sure it will be safe and comfortable to use.
Wearing an AFO
This will be individual to each patient. Please follow the instructions given by your orthotist. Upon initial wear of your AFO you may experience some aching in your knees, hips, thighs, lower legs, back or soles of your feet. We advise ‘breaking in’ of your AFO, in order to gradually build up your tolerance as follows.
Day 1 Up to 1hour/ Until starts to ache.
Day 2 1- 2 Hours / Until starts to ache.
Day 3 2-3 Hours / Until starts to ache.
Day 4 3-4 Hours / Until starts to ache.
Day 5 4-5 Hours / Until starts to ache.
Footwear
The footwear that is worn with your AFO is very important. Things that you should consider when deciding on footwear:
- if you are buying footwear, always take the AFO with you
- you will need to consider at least one shoe size increase for the fitting
- lace ups and Velcro are preferable as they give the most adjustment
- a removable inlay is very useful. By removing this you can create more space for your AFO
- high heels are not desirable, 1-1.5cm maximum.
If you have any difficulties finding footwear, then please speak with your orthotist.
Removing the AFO
Checking the skin is important to ensure that rubs do not form. Initially, as the brace is a close fit to the skin, it can leave red marks. These should disappear within 20/30 minutes of removing the AFO. If the marks do not disappear, or there are blisters or pain, check that the AFO is fitted correctly. If the AFO is correctly fitted but still causing concerns, stop wearing the device and contact your orthotist.
Care of the AFO
To clean the brace, wipe it down with a damp sponge and soapy water and leave to air dry. Do not dry with direct heat sources (such as a radiator), and do not put in a washing machine or tumble dryer. Check the brace for any signs of the padding wearing, the straps breaking or the plastic splitting; if so, contact the department for repairs or replacements.
What happens next?
The AFO has been clinically prescribed by the orthotist specifically for your foot/ankle presentation. The AFO is NHS property, so please do not adjust the orthotic device yourself.
Children's AFOs
On a child we would expect the brace to last from four months to a year before it is outgrown. Commonly if the AFO is too small it will mark over the ankle, or the toes will come over the end of the foot plate.
If the AFO is correctly fitted but still causing concerns, stop wearing the device and contact your Orthotics Department.
If you have not attended or attempted to contact the department within twio years, you may have been discharged and will require a new referral.