AFO Theory and Critique

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Part A: Content, Biomechanics and Theory

Ankle-Foot Orthosis, also abbreviated as AFO, is a device used for the purpose of supporting a weak foot or repositioning the limb into a normal position after some sort of contraction. Orthosis is an externally applied device used for the repositioning of the neuromuscular and skeletal systems into place for the proper functioning. This may include controlling or guiding the movement of the limb as well. These devices are usually made of polypropylene-based plastic which is lightweight. They may be of a few types and often used for the patients suffering from a variety of ailments. They are often used for patients suffering from Cerebral Palsy as in the current scenario. The Ankle Foot Orthosis is optimized in accordance with their gait and the deformity in the limbs. It is usually used in patients of cerebral palsy to reduce muscle contractures and improve stance position (Stott, 2015). Overall, AFO can be used to correct a variety of gait deformities (Pongpipatpaiboon et al., 2018).

Cerebral Palsy is one of the most common causes of physical deformity, and it is imperative to understand the biomechanical gait patterns of the patients to properly do the fitting of the Ankle Foot Orthosis. The common Gait patterns can be clarified into spastic hemiplegia, which includes drop foot and equinus with variable positions of the knee, as well as spastic diplegia, which includes true equinus, apparent equinus, jump, and crouch (Armand, Decoulon & Bonnefoy-Mazure, 2016).

True equinus can be described by the ankle remaining in plantarflexion all through the stance and the considerable extension of hip and knees (Armand, Decoulon & Bonnefoy-Mazure, 2016). An Ankle-Foot Orthosis can be used on patients with this gait pattern to prevent plantarflexion. This improves the stability of the person during the act of walking or repositioning the foot and corrects the swing of the leg during gait. This, in turn, helps in conserving energy during walking and increases the speed and length of each step (Physiopedia, 2020). A solid AFO can be used in this case because it tends to block the movement of the ankle (, 2020). In the current study, Mr C has a true equinus gait and is used bipedal solid AFOs, the right AFO is new, while the left AFO is old. The potential problems that may occur due to AFO include the discrepancy between the tone of the muscle and the mould, wrong angles and ill-fitting devices (Children’s Health Queensland, 2020). In the present case, AFO 1 was better fitted on Mr C, more than that of AFO 2. Since AFO has been given to him to prevent his plantarflexion, without the proper fit, his gait will not be fixed, his ankle will continue to rotate, giving him an unstable gait. An AFO will provide a resiting motion against the plantarflexion, correcting his gait and stabilizing him (Alam, Choudhury & Mamat, 2014).

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