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Guide to lower limb orthotics

Guide to lower limb orthotics

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Guide to lower limb orthotics

BY Daisy

19 August 2024

We're often asked to explain what lower limb orthotics are and what they can do to improve a person’s mobility and reduce pain. Here's a brief summary of some of the most common lower limb devices we prescribe.

Lower limb orthotics are devices designed to support, align, or improve the function of the lower extremities, which include the legs, knees, ankles, and feet. These orthotics can range from simple foot inserts to complex braces that extend from the foot up to the thigh or even the waist.

Lower limb orthotics are used for a variety of medical and rehabilitative purposes and are often prescribed by healthcare professionals like orthotists, physical therapists, or orthopaedic surgeons.

 

Types of Lower Limb Orthotics

 

Foot Orthotics (FO):

  • Insoles or shoe inserts that provide support and alignment for the foot.
  • They are used to treat conditions like flat feet, plantar fasciitis, and high arches.

Ankle-Foot Orthosis (AFO):

  • AFOs extend from the foot up to just below the knee, providing support to the ankle and foot.
  • They are commonly used for conditions like foot drop, cerebral palsy, and post-stroke rehabilitation.
  • AFOs can either be solid and fixed at the ankle, which allows us to fine-tune a patient’s gait more effectively, or hinged (also called articulated AFOs), which allows for a limited range of movement in one plane. 

 

 

Fixed Ankle Foot Orthosis (AFO)

Fixed Ankle Foot Orthosis (AFO)

Hinged Ankle Foot Orthosis

Hinged Ankle Foot Orthosis (AFO)

Patient's AFO stories:

Natasha can walk again thanks to her new orthotics
Lucas's walking improves after just six months in his new AFOs
AFOs help Liberty to ride and walk pain-free
Bespoke AFOs help Flora learn to walk
Bespoke AFOs help Gus with his severe hypermobility

 

Supramalleolar Orthosis (SMO):

  • Similar to AFOs but not as tall, SMOs support the area just above the foot ankle bones (malleoli).
  • commonly prescribed for children with developmental conditions like cerebral palsy or Down syndrome, as well as for individuals with neuromuscular disorders, flat feet, or other biomechanical issues.
  • SMOs provide more freedom of movement while still offering the necessary support to the ankle and foot. This makes them suitable for individuals who need stability but also require greater mobility in the lower leg.

 

 

 

Hinged Supramalleolar Orthosis (SMO)

Hinged Supramalleolar Orthosis (SMO)

 

 

 

 

Knee-Ankle-Foot Orthosis (KAFO):

  • KAFOs extend from the foot to the thigh, providing support for the knee, ankle, and foot.
  • They are used in cases of severe muscle weakness, paralysis, or joint instability, such as in polio survivors or individuals with spinal cord injuries.
Carbon Knee Ankle Foot Orthosis (KAFO)

Carbon Fibre Knee Ankle Foot Orthosis (KAFO)

 

 

 

 

Hip-Knee-Ankle-Foot Orthosis (HKAFO):

  • HKAFOs are more extensive, supporting the hip, knee, ankle, and foot.
  • These are used in cases of severe lower limb weakness or paralysis, often in conditions like spina bifida or spinal cord injuries.

 

Knee Orthosis (KO):

  • KOs are braces that support and stabilise the knee joint.
  • They are used for conditions like ligament injuries (e.g. ACL tears), osteoarthritis, and post-surgical recovery.

 

 

 

 

Hip Orthosis:

  • These braces stabilise and support the hip joint.
  • They are often used after hip surgery or in conditions like hip dysplasia.

 

 

 

Reciprocating Gait Orthosis (RGO):

  • A Reciprocating Gait Orthosis (RGO) is a type of orthopaedic device used to help individuals with mobility impairments, particularly those with lower limb weaknesses or paralysis.
  • The device typically consists of jointed metal frames, straps, and other components that attach to the user's legs and torso.
  • RGOs include hinges at the hip and knee joints, allowing for a more dynamic and coordinated movement. They also incorporate a locking mechanism, providing stability during standing or resting phases.

Read about how a Reciprocating Gait Orthosis helped get our patient Ted back on his feet again.

 

 

 

 

 

Reciprocating Gait Orthosis or RGO

Reciprocating Gait Orthosis (RGO)

 

 

Uses of Lower Limb Orthotics

Lower limb orthotics serve several important functions depending on the condition being treated:


1. Support and stability:

  • Joint stability: Orthotics provide support to weakened or unstable joints, helping patients with conditions like arthritis, ligament injuries, or post-surgical recovery.
  • Muscle weakness: In cases of muscle weakness or paralysis, such as in stroke survivors or those with muscular dystrophy, orthotics help maintain proper alignment and prevent deformities.

2. Correcting deformities:

  • Alignment issues: Orthotics can correct or manage deformities like clubfoot, knock knees, or bowlegs.
  • Gait abnormalities: They assist in correcting abnormal walking patterns (gait) caused by neurological or muscular disorders.

3. Pain relief:

By improving alignment and reducing pressure on specific joints, orthotics can alleviate pain in the knees, hips, and lower back.

 

4. Rehabilitation:

  • After injury or surgery, lower limb orthotics are often used as part of the rehabilitation process to support healing and prevent further damage.
  • They help patients regain mobility and independence by providing necessary support.

5. Injury prevention:

Athletes or individuals at risk of injury may use orthotics to prevent conditions like sprains, stress fractures, or overuse injuries by ensuring proper joint alignment and function.

6. Improved mobility:

Orthotics enable people with physical disabilities to achieve better mobility, enhancing their quality of life. For example, a person with drop foot (or foot drop) might use an AFO to help lift the foot while walking, preventing trips and falls.

 

 

Lower limb orthotics are essential tools in the management and treatment of a wide range of conditions affecting the lower extremities. They help in providing stability, correcting deformities, relieving pain, and improving overall mobility.

At the London Orthotic Consultancy, an essential additional ingredient to the design and fine-tuning of our bespoke orthotics is our gait laboratories. Also known as a video vector gait laboratory or motion analysis laboratory, our gait labs provide precise and detailed measurements of joint angles, muscle activity and ground reaction forces. All of which are important for understanding and improving a patient’s gait patterns. The data produced helps us to objectively measure a patient’s progress over time.

If you would like to know if bespoke orthotics can help you with your mobility goals, contact us to book a free consultation with one of our orthotists.

 

 

 

 

Conditions treated with lower limb orthotics

  • Neurological disorders: Such as cerebral palsy, multiple sclerosis, and stroke.
  • Musculoskeletal conditions: Including osteoarthritis, rheumatoid arthritis, and scoliosis.
  • Trauma or surgery recovery: Support after fractures, ligament tears, or joint replacement surgeries.
  • Congenital disorders: Like spina bifida or club foot.
  • Chronic pain conditions: Such as lower back pain or knee pain due to alignment issues.

 

 

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