Updated: Aug 17, 2018
You all must have seen Kyra wearing a leg brace in her affected hemi foot (left) and wondered why she needs it. You must have also seen her not wearing them and walking just fine and again thought whats the purpose of AFO braces to yourself.
Well I am here to explain just that today. Everything about AFO that I have learned over the years that my daughter has had them. I am not a medical expert so ask your doctor for proper advice, I can however explain in simpler English than them. Also I am a dentist and my medical background makes it a tad bit easier to understand the terminologies.
A-F-O also known as ankle-foot orthosis is a brace that supports weak limbs, or positions a limb with contracted muscles into a more normal position. The goal of AFO use is to stabilize the foot and ankle and provide toe clearance during the swing phase of gait. This helps decrease the risk of catching the toe and falling.
Now Kyra has spastic cerebral palsy, her normal position of the foot is always stretched straight like this picture. This is also referred to as foot drop. Foot drop is characterized by inability or impaired ability to raise the toes or raise the foot from the ankle (dorsiflexion).
Its important to know these medical terms to communicate with PTs/Orthotists.
Kyra is unable to lift her foot without the AFO because of her spastic tone, as a result often falls a lot. This is how the AFO helps her by keeping the foot in the normal position. This provides a stretch to the hamstring muscles which over the time starts to burn a bit and that's what children describe as pain.
Try it, stretch your hamstrings against your normal position, like downward dog yoga pose. Feel that burn, that's what these kiddos feel while wearing the brace since spasticity is the normal position for them.
There are different types of AFO braces depending on need of patient. As the need of your child changes so will the AFO. There are two different kinds of AFO. One needs to be worn while weight bearing, i.e while walking, jumping or doing some form of standing up. The other kind is where your child needs to be stationary, the night AFO which helps to position the muscles as your child sleeps. They are very heavy and needs a knee Immobilizer and hence they cannot walk in those at all.
We want to train the muscle and make it stronger so that one day it will not require the brace. That can only be achieved by doing exercises without the brace and walking with out the brace for sometime. Usually braces are worn for 4-5 hrs a day but can vary depending on the severity of tone. If your kid is wearing AFO and is able to do certain exercises without it, I would let them and also encourage it. I will be talking more about AFO's in depth, all the last ones we had, why they did not work out, what lead us to change AFO, what we discovered after each new AFO. Will also be talking about Tips and tricks to wear AFO, along with shoes that worked the best for us. I couldn't possibly write it in this one without making it a big yawn. Stay Tune