For many individuals, AFOs and KAFOs enable users to stand and walk comfortably, helping them to continue with their daily life. When prescribed an AFO or KAFO patients often have many questions, see below some of our most common FAQ’s regarding your new orthosis.

Orthotic AFO and KAFO Frequently Asked Questions

What is an AFO?
An Ankle Foot Orthosis (or AFO) is a plastic or carbon fibre splint which is designed to keep feet and ankles in an optimal position for standing and walking. AFO’s can be manufactured with a joint or hinge at the ankle or can be fixed in one position, and can be worn on one foot or both feet.

Why is an AFO prescribed?
An Ankle Foot Orthosis or AFO is prescribed for several reasons which include:
  • To hold the ankle or/and foot joints in an ideal position to limit movement which reduces stress and pain on the joints.
  • To provide support and protection to weak joints and provide stability.
  • To prevent excessive movement which can lead to pain and instability.
  • To improve your walking pattern.
  • To control increased muscle tone.
What is a KAFO?
There are two types of Knee Ankle Foot Orthoses (KAFO); cosmetic and conventional.

Cosmetic KAFOs are made of plastic or carbon fibre and are divided into two sections which are connected by metal side members with knee joints. The lower section encompasses the back of the calf, around the ankle and under the foot and the upper section encompasses the back and side of the thigh.

Cosmetic KAFOs are designed to fit inside a shoe, whereas conventional KAFOs connect the two sections in the same way but the lower and upper sections are made of leather and metal. The lower section has a leather band around the top of the calf and the upper section has one or two around the thigh. The connecting metal sides attach to the sockets in the shoe.
Both types or KAFO are usually held in place by Velcro™ straps and are close fitting to ensure support and aid control.

What is a KAFO prescribed for?
A Knee Ankle Foot Orthoses or KAFO can be referred to as a calliper. KAFOs are usually prescribed for several reasons and are custom manufactured. These include:
  • To align some or all the joints in your lower limb or limbs to reduce stress on the joints, reduce pain and improve ambulation.
  • To provide support and protection to weak joints and provide stability.
  • To prevent excessive movement which can lead to pain and instability.
  • To improve your walking pattern.

Who are AFO and KAFO’s for?
AFO’s are often used to treat conditions including; chronic ankle instability, arthritis, neuromuscular conditions, tendonitis of the ankle or heel, severe pain in the ankle or heel, collapse of the ankle or foot and arch pain. Often other less invasive treatments are prescribed initially and in instances where further treatment is needed, these orthoses will be fitted.
AFO’s and KAFO’s can be fitted on both children and adults, they can be extremely lightweight and low profile. The following case studies highlight the different uses for AFO’s and KAFO’s.

Isaac’s story    Leon’s story    Alfie’s story

How long should you wear an AFO?
The AFO should be used for short supervised periods to begin with and the skin checked for pressure redness after each wearing session. It is not unusual for the AFO to feel uncomfortable to begin with and therefore we suggest you break it in slowly with the length of each session gradually increasing. If you notice any of the following, please contact the orthotic department as soon as possible:
  • Skin redness that doesn’t fade after 15 minutes.
  • Skin breakdown e.g. sores and blisters.
  • Pain, irritation or rubbing.
  • Any damage to the AFO.
How long should you wear a KAFO for?
We recommend you gradually increase the amount of time you use your KAFO for to allow your skin to adapt to the new pressure – your orthotist will provide you a timeline for doing this at your fitting. All close-fitting orthoses can cause mild redness on the skin which normally resolves within 30 minutes of taking the device off. If the marking persists or sores/blisters appear stop using your KAFO and contact the orthotics department for advice. Top tip: some patient’s find that the use of an interface such us Tubigrip or long leg socks make the KAFO more comfortable to wear.

How do I put on an AFO?
Before you begin it is important to check your AFO for any damage and that all parts/straps are working correctly.
Putting an AFO on your child:
  • We recommend you sit your child in front of you and keep their knees and hips bent at 90 degrees at least for easier donning.
  • The heel should be placed at the back of the AFO and the heel strap should be fastened securely so that there is no movement between the heel and the AFO. Sometimes it is easier to rotate the front of their foot outwards before bringing the foot upwards. If in doubt, please ask your Orthotist and Physiotherapist to show you.
  • AFOs should be worn inside footwear and never on their own.
View AFO Fitting Video 

Putting an AFO on yourself:
  • Whilst seated on a bed or chair place your leg in the AFO ensuring the bottom of your foot is in contact with the foot plate.
  • Fasten all straps securely.
  • Apply your shoe (low healed, laced casuals are most appropriate).
Top Tips
  • Always ensure that socks are worn between the skin and the AFO. Long cotton socks should be plain with no ribbing.
  • Clean the AFO with warm soapy water. If the AFO has metal joints check them regularly and lubricate with Vaseline.
How do I put on an KAFO?
Remember before you put your KAFO on to always inspect the orthosis to ensure the knee joints move as they should, freely without resistance, unless you have a lock, in which case it should engage and lock securely when the knee is extended. Check that all the straps and buckles are in good condition and that they fasten securely.
As all KAFO’s are created for specific requirements, your Orthotist will guide you on the correct fitting process.

What footwear should I wear with an AFO/KAFO?
We recommend you buy low opening footwear to make it easier accommodate the AFO. Velcro or lace fastening shoes or trainers are best, and those with removable innersoles will provide extra depth needed to accommodate the thickness of the AFO.
Ideally, the heel height of your shoe or trainer should not exceed 15mm as shoes with high heels will cause your knee to bend making you more unstable. Your Orthotist will be able to advise on the recommended maximum height.

Why is my AFO bulky?
AFOs are designed to provide large amounts of force. The larger surface area the less pressure they will apply on the skin. They are also designed to sustain large forces and therefore must be made from thicker stronger materials. Every attempt is made to ensure the AFO is as cosmetically appealing as possible, but in some instances, they may be more bulky than expected.
Is my AFO too small?
Ideally, AFOs should have 9-10mm of space on the footplate and be long enough on the calf so that you can sit at 90 degrees without it digging at the back of your thigh. If your toes are at the end of the footplate or the calf section is very low, the AFO will still be doing its job but more forces will be put through your skin that potentially can cause problems or/and discomfort. We recommend you get your AFO checked regularly regardless of if you are having any issues.