Guide for Ankle Foot Orthosis (AFO)

An AFO is a brace that has been designed to provide extra support, to aid mobility, or to maintain the range of motion at the ankle joint. The AFO is prescribed specifically for one user, which means you should be the only one to wear it. When it is fitted, the clinician goes through the instructions and the goals of using this orthosis and it will only be an effective treatment if these instructions are followed carefully.

Fitting the AFO

It should always be worn over a thin pair of plain socks, preferably cotton. If you are helping someone else to put on an AFO, have them sit on a chair in front of you so you can support the leg.

The heel must be put into the back of the AFO; this is easier if you first bend the knee to 90 degrees. Holding the heel down and back with your thumb, fasten the ankle strap over to hold this position, ensuring that the pad is sat in the centre. Next, tighten the calf strap securely. Following this, any other straps can be securely fastened ensuring all pads are correctly (centrally) located.

Before using the AFO, check that the straps are secure but not too tight, and all pads haven’t slipped. If the straps are loose or the heel isn’t all the way back in the AFO, it will not be comfortable to use and could rub on the skin.

Fitting an AFO can take time. It is important not to rush and to make sure it will be safe and comfortable to use.

Wearing an AFO

You should always break in’ any new orthosis, starting with 30 minutes on the first day and increasing by an extra 30 minutes each day over the first few weeks. It should always be worn with footwear.

The times that the AFO is worn should be discussed with your clinician at the fitting appointment.

Footwear

Any footwear worn with an AFO should be wide and deep, with a form of front fastening. Trainers are generally well accommodating. Boots with a side zip can also be very helpful as it is easier to place the AFO inside. The orthosis can be taken shoe shopping to try in any new footwear you are considering, to ensure that it will both fit and be comfortable.

Removing the AFO

Checking the skin is important to ensure that rubs do not form. Initially, as the brace is a close fit to the skin, it can leave red marks. These should disappear within 20 minutes of removing the AFO. If the marks do not disappear, or there are blisters or pain, check that the AFO is fitted correctly. If the AFO is correctly fitted but still causing concerns, stop wearing the device and contact your orthotist.

Care of the brace

To clean the brace, wipe it down with a damp sponge and soapy water and leave to air dry. Do not dry with direct heat sources (such as a radiator), and do not put in a washing machine or tumble dryer. Check the brace for any signs of the padding wearing, the straps breaking or the plastic splitting; if so, contact the department for repairs or replacements.

On a child we would expect the brace to last from four months to a year before it is outgrown. Commonly if the AFO is too small it will mark over the ankle or the toes will come over the end of the foot plate.

Contact numbers

We hope that you have found this information useful. If you have any questions or are worried about anything, please speak to the Orthotic Department at Dorset County Hospital on 01305 254408.

About this leaflet

Author: Matthew Wood, Orthotist
Written: May 2020
Updated and approved: November 2021
Review date: November 2024
Edition: v2

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk