Ankle Foot Orthoses

1. What are the three different types of plastic AFOs?
2. What are indications for using a metal AFO over a plastic AFO?
3. What are indications for an AFO?

Answers:
1. Posterior leaf spring has a plastic band behind the ankle that allows the patient to overpower the brace during push-off, used for flaccid foot drop. Semi-rigid allows less motion, providing mediolateral stability, used for foot drop with extensor tone or mediolateral instability. Rigid (or solid) is used for high level of spasticity, where complete immobilization of the ankle is necessary.
2. Risk of excessive pressure or skin breakdown on the leg or foot, insensate foot, fluctuating edema.
3. Paralysis of ankle motion, prevention and correctio of deformities, reduction of WBing, reduce energy cost of ambulation.