Patient information about ankle foot orthoses (AFO’s)

General information

The term AFO is an acronym that stands for ankle foot orthosis and describes the part of the body that the brace encompasses. An ankle foot orthosis (AFO) controls the range of motion in your foot and ankle and helps to stabilise its position. Good foot and ankle alignment is vital for balancing and distributing weight when you are standing and walking.

The AFO will be designed to meet your specific needs. As each person is unique, so is his or her response to treatment. As you adjust to this new and proper alignment, you may experience some discomfort. The adjustment period usually ranges from one to six weeks when the recommended wearing guidelines are followed.

Wearing

Your AFO has been prescribed for you and is intended for your use only.

Your AFO is designed to conform to the shape of your foot and ankle and may feel slightly ‘strange’ due to the realignment of your lower limb, and pressure redistribution. It will therefore require a gentle breaking-in period.

Wear time

When you are first fitted with your AFO you should wear into it gradually. This allows you to get used to wearing the AFO and allows the skin to gradually build up resistance to the pressures which the brace is applying. You should check your skin regularly during the first few weeks. You may experience some general muscle aches until you are used to wearing the AFO.

• Start slowly, only wearing your AFO for a maximum of one hour on the first day, with low to moderate activities.
• Increase the wearing time each day, by 30 minutes to one hour, until you are comfortable wearing your AFO all day.
• You should increase your activity level during this transition period.
• If you experience any pain or discomfort, remove the AFO from your shoes for at least two to four hours, and then try again. If pain persists, stop wearing the AFO and make an appointment to see your orthotist for an adjustment.
• You will achieve the greatest long-term benefits when you consistently wear your AFO every day.

There may be cases where your orthotist recommends a different wearing regime, such as only at night or for sessions with your physiotherapist. These instructions will be given to you when your AFO is fitted.

Shoes

• Select good shoes with proper support and always try them on with the AFO in place to ensure proper fit and comfort.
• The best type of shoes to wear with your AFO feature a closed back and toe, come up over the top of the foot like laced-up sport shoes, low heels, a removable innersole and a slightly wider width to accommodate the AFO.
• Be sure to wear stockings or long cotton socks (which are a little higher than the top of the AFO) to minimize the possibility of skin irritation.
• During use, ensure that footwear is secured as tightly as is comfortable.

Skin care

Your skin should be inspected regularly, especially in the first few weeks after you have been fitted with a new AFO. A close fitting orthosis can sometimes cause some redness on the skin around the edges of the orthosis and where the AFO is applying corrective pressures. Check your skin thoroughly especially over bony areas and around the edges of the AFO. If you see a red area that does not go away within 30 minutes of removing the AFO, or notice a break in the skin or blisters you should stop wearing the AFO and make an appointment with your orthotist to have it adjusted.

Caring for your AFO

Cleaning

Use an antibacterial soap and warm water to wipe the inside surfaces of your AFO. Towel dry the AFO completely before putting it back on. Avoid drying in direct sources of heat (such as on the heater or using a hair dryer) as this can deform the hard structures.

Straps and Padding

The straps and padding may become worn and can be replaced. To arrange repairs please contact the orthotic department.

Plastic / Carbon

Inspect the structure of the brace regularly, checking for any cracks or areas of fatigue. Never attempt to repair, trim or adjust the AFO yourself, if a problem arises contact the orthotics department immediately.

Joints

Some AFO’s may have joints at the ankle. These should be checked before each time the AFO is used looking for any dents or cracks and for making sure that all rivets and screws are secure.

Review

Following fitting of your AFO your orthotist may arrange an appointment for review. Minor adjustments can be made to your AFO and we would recommend that your brace is reviewed by an orthotist at least once every 12 months to ensure the device is still meeting your needs and to check for any wear and tear.

Children may need their AFO changed more often as they grow or gain weight. We would recommend that your brace is reviewed by an orthotist at least every six months.

Never attempt to repair or adjust your brace yourself. If you are experiencing any problems or have questions regarding your brace, please contact your orthotist.

Remember

If you have any questions about the type of AFO you have been recommended, please talk to your orthotist. Your orthotist is there to work with you to choose the best approach and ensure your comfort and safety.

Please remember to bring your AFO, when attending appointments with your orthotist even if it is broken or no longer fits.

If you are from outside the Cambridge area and wish to receive future orthotic treatment from a more local service you should contact your GP.

The contact details for the department are:

Addenbrooke’s Rehabilitation Clinic
Clinic 9
Cambridge University Hospitals NHS Foundation Trust
Box 120
Addenbrooke’s Hospital
Hills Road
Cambridge
CB2 0QQ
Telephone Number: 01223 217859