Keys To Prescribing AFOs For Senior Patients
The goal of any AFO for this condition is to promote toe clearance while limiting the speed at which the foot plantarflexes. In short, the goal is to prevent the foot from dropping during the swing phase of gait (drop foot).
Typically, the drop foot AFO will extend from distal to the metatarsal heads to just distal to the head of the fibula. In the PDAC definition of an L1960 AFO, the proximal edge cannot be higher than 1½ inches below the head of the fibula. In some cases, the foot plate may extend to the entire length of the foot. Topcover materials for the foot are optional but can be advantageous for those (the majority) who may be at risk for skin breakdown.
While most AFO manufacturers make some version of a posterior leaf style AFO, choosing between a simple posterior leaf design versus a dorsiflex assist device is critical.