Review and resources
Ankle Foot Orthoses (AFOs) can help significantly with mobility for many with HSP. Following is a look at what’s available.
Orthosis (pl.Orthoses): An externally applied device used to modify the structural or functional characteristics of the neuro- muscular-skeletal systems. Orthoses may be Prefabricated, Customised or Custom Made. Orthoses are made for different body uses, not just ankle-foot, but knee, hip and upper body as well.
Orthotist (pron: Ortho-tist): An allied health professional who is clinically responsible for the assessment, design, manufacture and provision of all types of Orthoses.
Function of an Orthosis
- Restriction of Motion (ROM)
- Enhance Biomechanics
- Force Re-distribution.
The common use for many HSPers is to aid in toe lifting, swing through and better aligned foot placement. There are lots of different AFOs available these days. (Electrically powered AFOs even exist for conditions different than HSP). Over time there has been an important advance in the super strong and lightweight materials used. Size is important because of the need to fit a portion of the AFO into the wearer’s shoe.
AFOs can be custom made or bought off the shelf (or off the website) at a wide range of prices ($37.30-$690 in my small sample) but while many of the sites look like you can self-order AFOs, I’ve been told by some of the providers below, “We do not sell this item direct to the public, it is to be recommended to the patient by an Orthotist” or “We do allow members of public to order AFOs from our website without professional consultation. However, we do recommend they seek health professional advice before doing so”. That’s not surprising. With the different choices in materials, weight and support structure, its not a simple thing especially since HSPers can have such different gait characteristics and needs.
It is recommended that you get the advice of a professional who understands your specific needs. In the end some HSPers find their AFOs most helpful, others, less so. Driving while wearing AFOs can be another concern.
Novita Children’s Services has an informational fact sheet on AFOs.
The Royal Children’s Hospital Melbourne website article on AFOs and casting.
Orthokids – Children’s Orthotic Specialists provides AFOs (has 2 locations in Victoria)
Korthotics can do custom-made, static and dynamic AFOs (They are in NSW)
Australian Orthotic Technologies Here you can see their: AFO Leafspring, AFO Dynamic, AFO Light and AFO Foot Up. They are in Victoria.
Access Health – Physical Therapy Supplies (in Victoria)
Their website says: The General public are welcome to call us to make an appointment to come and try on bracing and view other products. Practitioners can refer patient direct to us for fitting braces and viewing products. Please indicate to the patient which type of brace/product they require. Here you can see their: Ossur Spring Leaf AFO, Ossur AFO Dynamic, Ossur AFO Lite, Oapl AFO Spring Leaf Polyprop, AFB Polypropylene AFO and Supralite Polypropylene AFO.
Australian Physiotherapy Equipment APE (in WA)
Offers the Foot Up and the Ossur AFO Spring Leaf
Full range of AFOs https://www.bodyheal.com.au/collections/ankle-support-braces
CW Club Warehouse has a pre-formed Foot Orthosis
Whiteley Allcare carries what they call the AFO-Delux-Allcare (lowest price in my research $37.30) with distribution centers in Sydney and Perth.
Orthotic Technical Services is a practice based in Victoria. OTS is owned and run by current practising clinicians, including physiotherapists, orthotists and podiatrists and offer several different AFOs.
OPC Health offers a Professional Orthotic service across a number of clinics in Metropolitan Melbourne and rural Victoria. They offer 4 different AFOs including the more unusual Matrix Split Toe, Matrix Max and Matrix Curve. Descriptions of the Matrix models include: front mounted shell, split toe (acting as a natural spring) and energy storing foot plates.
SmartKnit Seamless AFO and KAFO Socks. They offer brace liners for more comfortable AFO wear.
Here are even more types of AFO which may or may not be available in Australia at the moment and of course that’s subject to change.