Orthosis or brace is an orthopedic appliance that patients can use to prevent, support, align, or correct deformities of their body parts or enhances the function of movable parts of their body. Varieties of these orthoses are available depending on one’s physical and diagnosis needs, which include braces for the ankle, knee, foot, hand, elbow and even the back. Ankle-foot Orthosis (AFO) is a shoe insert device that extends from just below the knee downward to include the foot. These braces can support your ankle and foot, enabling you to maintain proper alignment and control motion in order to regulate instabilities in the lower limb. Also, they can provide proprioceptive feedbacks that allow you to know where your feet are in the space. This is of great importance especially if you have peripheral neuropathy related to diseases such as Charcot Marie Tooth and diabetes mellitus.
A drop foot or foot drop is a muscular or permanent anatomical problem where you struggle to lift the foot from the ankle joint. This condition can force you to drag your foot while walking, coupled with numbness or acute pain in the foot. Your drop foot condition may be a permanent one that you suffered from birth like in the case of a muscular dystrophy or caused by neurodegenerative disorders such as spinal injury and stroke. Many people suffering from this condition use drop foot braces for supporting a better posture while walking and holding their foot in the normal position. You can combine the braces with other treatments such as electric stimulation of nerves, physiotherapy, and surgery. For a permanent foot drop, you can consider surgery to make the foot stronger and braces to restore normal gait.
Leaf Spring Orthosis (LSO) is a prefabricated polypropylene AFO designed for people with flaccid drop foot. The purpose of this brace is to hold your foot and ankle in a desired position while still allowing some flexibility of the ankle. The semi-rigid section for support and toe clearance and the thin, flexible footplate enable this functionality. Besides, LSO has no heel section that makes it more comfortable to wear while ensuring a better fit in your shoes. This AFO can help fight with weak dorsiflexion or foot drop caused by multiple sclerosis, diabetes, CVA, spinal stenosis, trauma and many other neurological pathologies.
Various types of braces are available to cater for the differing types of foot drop among patients. The short leg foot braces are the best option for patients who are short and have a flat foot. People who weigh less than 225lbs can consider dorsiflexion assist foot that supports their ankle though a spring action, helping them to lift their foot while walking. Patients who have a severe drop foot are recommended to use plantar flexion assist foot that enables them to control foot drop in the forward direction. However, very serious conditions, where both the plantar flexion and dorsal are limited, may demand the use of solid foot brace. Many doctors do not recommend the traditional posterior leaf foot braces due to its old design but patients with knee problems can use it as well. You may need you doctor recommendation to choose the right braces for your drop foot condition and the correct shoes and socks to wear along with the foot braces.
Furthermore, many different styles of AFO’s are available to meet specific needs of every individual. Here are some of the main categories designed to solve the environmental, biomechanical and medical needs of each person.
Hinged AFO
You need hinged ankle foot to control any plantar, up and sown movement (dorsiflexion), and side-to-side movement of the foot. Besides, you can choose the joints or hinges that perfectly fits your foot as well as matching your weight from the several designs available including the plastic ones. The hinged AFO is the best device for you in case you have a foot drop caused by issues such as Cerebral Palsy or stroke (CVA).
Flexible AFO
This AFO is a lightweight easy to use a design that can effectively prevent your foot from plantar dropping. It allows you to have a smooth swing of the foot with your toes not catching the ground. Based on your specific needs, you need to make a choice from the wide variations in the strapping and shape in the market. Most of the manufacturers make Flexible AFO’s from polypropylene plastic with Velcro (hook and loop) for the strap. This ankle foot orthosis is most effective braces for you if you have plantar flexing due to Multiple Sclerosis, poliomyelitis, stroke (CVA), and other nerve injuries.
Tubular AFO
A tubular or circumferential AFO will enclose your entire foot and lower leg. This removable, cast-like orthosis ensures an ultimate protection and stability for both your leg and foot. Furthermore, the present of a foam and leather lining gives an added protection in case you have sensitive skin. You need this device if you are experiencing complications brought by Peripheral Neuropathies such as Diabetes Mellitus.
Charcot Restraint Orthotic Walker (CROW)
This custom made brace will offload pressure from your foot and ankle by immobilizing them, and you need no shoe to wear it. The CROW come fitted with a rocker shaped regular sole on the bottom to allow for a smooth walk. You will find this device useful for helping you to cope with complications resulting from diabetic neuropathy such as a Charcot Joint and diabetic ulcers.
Silicone AFO
This circumferential design provides optimal proprioception with excellent plantar drop foot control, allowing you to know exactly where your feet are in space. Users can wear this orthosis either with shoes or without them. SAFO is a recent design suitable for individuals who are experiencing a flaccid paralysis of the feet due to pathologies such as Poliomyelitis, Stroke, Charcot Marie Tooth Disease, Spinal Cord Injury and Multiple Sclerosis.
Plantar Fasciitis Night Split
The night splint is the best device for stretching out Achilles' tendon. You need to use it if suffering from tight Achilles tendons because of bed rest or inactivity, or to minimize forces at the plantar fascia in case you have chronic fasciitis.
