Ankle-Foot Orthosis (AFO) Types for Foot Drop

An ankle-foot orthosis (AFO) is a hard brace worn on the lower leg that improves overall walking safety and efficiency for people with certain medical conditions. AFOs provide gait stability, keep joints properly aligned, and help compensate for muscle weakness.

Different types of AFOs have been developed to address a patient's individual needs. Generally, a healthcare provider or physical therapist will evaluate you to determine if an AFO is needed and what type to prescribe.

Uses

The most common reason you may need an AFO is foot drop, an inability to raise one foot while walking, which results in toes dragging on the ground. Foot drop is caused by weakness or paralysis on one side of the body, usually from a brain or nerve condition.

Healthcare providers call weakness or slight paralysis on one side of the body hemiparesis, while total paralysis on one side of the body is called hemiplegia. Conditions that may produce either of these and result in foot drop include:

• Stroke
• Multiple sclerosis
• Cerebral palsy
• Traumatic brain injury (TBI)
• Neck or spinal cord injury
• Sciatica
• Muscular dystrophy
• Lower leg (peroneal) nerve injury
• Charcot foot
• Posterior tibial tendon dysfunction
• Severe adult acquired flatfoot
• Poor ambulation, fall risk, balance issues
• Lateral ankle instability
• Severe ankle arthritis

AFOs are a common option, as studies have shown that they help improve gait and toe clearance in patients with hemiplegia.

Types of Ankle Foot Orthoses

Your healthcare provider can help assess your gait (often people with foot drop exhibit a high steppage gait pattern) and choose the best AFO for your specific condition.

If your foot drop is temporary, a non-custom, off-the-shelf AFO may be sufficient. If it appears your condition is permanent, a custom-molded ankle-foot orthosis may be warranted. Technologies have advanced to where custom orthotics can be created via three-dimensional (3D) printing.

Some differences among the options:

• A solid AFO that offers no ankle movement can be large and clunky but may be necessary to stabilize your ankle and foot while walking.
• A hinged (articulated) model contains mechanical joints comprised of springs to resist or assist ankle movement. This ensures the toe will not drag while walking.
• A smaller, more mobile AFO can include a posterior leaf spring. This type of AFO has a rigid front toe plate with a flexible posterior footplate that bends and stores energy when you step. As you raise your foot off the ground, the spring adds a little boost to your step, quickly raising your foot and toes off the ground.

A Word From Verywell

An improperly fitted ankle-foot orthosis may rub your foot and ankle, leading to redness and possibly bleeding. Check your foot daily for any signs of skin irritation, as this could lead to infection. If you notice problems, discontinue use of your ankle-foot orthosis and see your healthcare provider right away. You may need to have your AFO adjusted.