Online Tutoring Solution on AFO Theory and Critique

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 (Icrc.org., 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. It is essential that the AFO is well-fitted, otherwise, they might cause further damage to the gait of the patient. The gapping and contour of the device has a very high influence on the gait of the patients. If there are problems with the fit or the texture of the AFO, it can have severe effects on the gait of the patient. The potential problems may 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 scenario, the AFOs are fitted, and the critique has been done. Mr C may have some potential problems with the AFO and the carer being inexperienced is unable to assess them. The critique has been done in the AFO Critique Sheet.

Reference

Armand, S., Decoulon, G., & Bonnefoy-Mazure, A. (2016). Gait analysis in children with cerebral palsy. EFORT open reviews, 1(12), 448–460. https://doi.org/10.1302/2058-5241.1.000052

Children’s Health Queensland. (2020). Ankle Foot Orthosis – R-wrap fact sheet | Children’s Health Queensland. Retrieved 9 April 2020, from https://www.childrens.health.qld.gov.au/fact-sheet-ankle-foot-orthosis-r-wrap/.

Children’s Health Queensland. (2020). Ankle Foot Orthosis fact sheet | Children’s Health Queensland. Retrieved 9 April 2020, from https://www.childrens.health.qld.gov.au/fact-sheet-ankle-foot-orthosis/.

Icrc.org. (2020). Retrieved 9 April 2020, from https://www.icrc.org/en/doc/assets/files/other/eng-afo.pdf.

Physiopedia. (2020). Classification of Gait Patterns in Cerebral Palsy. Retrieved 9 April 2020, from https://www.physio-pedia.com/Classification_of_Gait_Patterns_in_Cerebral_Palsy.

Pongpipatpaiboon, K., Mukaino, M., Matsuda, F., Ohtsuka, K., Tanikawa, H., Yamada, J., Tsuchiyama, K., & Saitoh, E. (2018). The impact of ankle-foot orthoses on toe clearance strategy in hemiparetic gait: a cross-sectional study. Journal of neuroengineering and rehabilitation, 15(1), 41. https://doi.org/10.1186/s12984-018-0382-y

Stott, N. (2015). Cerebral Palsy. Management Of Chronic Conditions In The Foot And Lower Leg, 214-250. https://doi.org/10.1016/b978-0-7020-4769-5.00008-x