Children's ankle foot orthosis (AFO)

Sit your child in  front of you with their hip and knee bent. Pull up their socks and make sure there are no wrinkles in them.

Turn your child’s foot towards the middle before bringing the foot up.

Place your child’s heel at the back of the AFO,then fasten the heel retaining strap snugly. Check that your child’s heel is in place by lifting his or her toes to see.

Finally, fasten the top strap and put on your child’s shoe.

There may be additional straps and your orthotist will show you how to fasten them.

Finding footwear

The footwear that is worn with your AFO is very important.  There are a few things that you should consider when deciding on footwear.

• If you are buying footwear always take the AFO with you
• You will need to consider at least one shoe size increase for fitting
• Lace ups and velcro are preferable as they give the most adjustment.  The lower they open down the tongue of the shoe the better
• A removable inlay is very useful. By removing this you can create more space for your AFO
• High heels are not desirable, 1 to 1.5cm maximum. As the splint is set at a specific angle too high a heel can tip the knee forward too much.

If you have any difficulties finding footwear, please speak with your orthotist.

How long should they be worn?

At first, the AFO may feel uncomfortable so they should be worn gradually using the following schedule.

• Day one: 30 to 60 mins   
• Day four: 4 to 5 hours
• Day three: 3 to 4 hours
• Day two: 1 to 2 hours     

Your orthotist or physiotherapist will advise you how long you should build up to, or what activities to wear them for.

What about red marks?

• You should check the skin around the foot and ankle every time you take the splints off
• It is normal to see red marks where pressure has been applied. These should disappear within 30 minutes
• If you notice any sores or blistering, you should stop using the splints and contact your physiotherapist or orthotist for advice as they may need adjusting
• Long socks can help with protecting the skin.

Cleaning

The AFO should be cleaned with a damp cloth and towel dried, heat will distort the shape. Do not soak it or use any detergents.  Any fluff or hair can be picked out of the velcro straps.

Eligibility 

You are entitled to two pairs / items at any given time. If you wish to purchase more splints above your NHS entitlement, you may do so by paying. Please contact the department for a quote and advice.

Useful contacts

• British Association of Prosthetists and Orthotists (BAPO)
• SCOPE, for disabled people achieving equality

Telephone: 0808 800 3333

• HemiHelp for children and young people with hemiplegia

Telephone: 0845 123 2372