Grace's new AFOs
11 September 2023
Grace was a premature baby (3 months) and was seriously ill at birth. Her Cerebral Palsy was diagnosed at the age of two. Cerebral Palsy (CP) is the term used to describe a group of conditions that affect the movement of muscles and the posture of the body. The term comes from the area of the brain affected, 'cerebral' refers to the brain (cerebrum) and 'palsy' is the disorder of movement or posture. It is estimated that one in 400 babies born in the UK has a type of cerebral palsy.
Grace has spastic quadriplegia which means all four limbs can be affected as well as the trunk. Once diagnosed, Grace was in the care of the NHS and prescribed splints (also known as Ankle Foot Orthoses) and blocks of physio to help with her condition. Life carried on until COVID struck. Because of her health, Grace had to shield. However because the NHS stopped face-to-face treatments, Grace developed contractures in her legs and had a lot of pain in her legs and hip.
Grace’s current splint was ill-fitting and causing blisters but the NHS said they could not be replaced for at least a year. At the same time, Grace’s parents were told that there was a 12-month waiting list for the surgery to sort out the contractures in her legs. By this stage, Grace was almost confined to her wheelchair. It was at this point that Grace’s parents sought private help.
Grace underwent surgery for tendon release at The Portland Hospital on 3 March this year. After the surgery, Grace was seen by Mr Norman Taylor, a consultant at Great Ormond Street Hospital, who said to Jeanette (Grace’s mum) “You need to see Sam at the London Orthotic Consultancy about Grace’s orthotics.” Jeanette duly rang up LOC and was delighted to find that LOC had a clinic in Cambridge, where the family live. Grace was assessed in May.
Jeanette takes up the story: “You could make a very long list of the differences in treatment Grace has received from LOC. First up, there is the Gait Laboratory which you don’t get on the NHS, Connor (who heads up LOC’s Cambridge clinic) immediately advised that Grace needed splints on both her legs as her CP was affecting both limbs and then he said she needed specialist shoes as Grace has abnormally small feet and to make room for her AFOs she needed shoes 2 sizes bigger than her current ones. And then there was no messing about with casting – Connor just scanned her legs and that was that.
On a very important level, Connor has been fantastic with Grace, who is autistic. She can communicate but she needs to be talked to in the right way to get her to respond properly. Connor just gets it and very quickly built up a rapport with Grace, he never speaks over her to me and communicates directly with her, so different to what Grace was used to elsewhere. And then we get to the end product, the AFOs themselves. There is no comparison, they are tailor-made, padded for comfort and fit properly – no rubbing. You can’t really believe the difference: Grace hardly uses her wheelchair anymore; she has full mobility and is pain-free.”
Our clinicians have extensive experience in improving mobility and independence in children with Cerebral Palsy.
Grace's new multi-coloured AFOs
If you think your child would benefit from an assessment with one of our specialist clinicians, please book an appointment using our contact form.
An AFO is an Ankle Foot Orthosis which as the name would suggest encompasses the ankle and foot. The objective is to control the position and movement of the ankle. AFOs are used to support weak limbs; they can also be used to immobilise the ankle and lower leg to correct foot drop. When set up correctly they can also have a great influence on the knee and hip joints. They are the most commonly used Orthoses.
The length of time that one needs to wear an AFO very much depends on the condition being treated. If it is a long-term condition like cerebral palsy or post-polio syndrome it is likely to be years as the condition cannot be cured. Your orthotist will advise you.
A patient’s comfort in their AFO is vital for compliance with the prescribed wearing regime.
So there are a number of steps the orthotist should take to ensure a comfortable fit: the patient’s heel should fit fully into the heel cup without excess space, the contours of the plantar surface of the AFO should match the patient’s foot, for children there needs to be up to half an inch growth room in the toe shelf length. At LOC we use our Gait Laboratories at our Kingston and Manchester clinics to fine-tune our bespoke orthotics.
A GRAFO is used to control instabilities in the lower limb by maintaining proper alignment of limbs and controlling their motion. It reaches around to the front of the knee extending down to the ankle. It works by altering a patient’s limb presentation to displace load and impact as well as offering further control to the knee.
The most flexible type of AFO is a Dynamic Ankle Foot Orthosis (DAFO). It is thin and provides flexible support to the foot and ankle.
We have the following facilities and amenities at our Kingston Upon Thames location:
We also have the Gait Laboratory for orthotics patients and Onsite Manufacturing for speedy turnarounds and adjustments whilst you wait.
