Everyone agrees that not all Ankle Foot Orthoses (AFOs) are the same and they do not treat the same pathologies. Also different designs have varying effects on biomechanical function. However, the terms used to describe the different types of AFOs have not been fully classified and defined. This has led to the use of varying descriptions and acronyms resulting in poorly designed research studies (1,2) and a misunderstanding of research outcomes. The lack of classification has also resulted in generalisation on the effects of AFOs from research studies which have not been clear on the design of the AFO used or the presenting pathology it was used for (2), with some studies describing the AFO as “a standard AFO”, for which there is no definition. Standardised terminology and definitions for AFOs are critical in clinical practice, without these, there may be serious negative consequences, with the potential to cause harm.
We have now developed and validated a new classification system for different designs of bespoke thermoplastic AFOs.
Figure 1: Bespoke thermoplastic AFO classification chart.
The proposed classification system for bespoke thermoplastic AFOs, has an excellent inter- and intra-observer agreement. It will reduce the ambiguity of the description of the type of AFOs used in clinical practice and research. Furthermore, it makes reproducible comparisons between groups possible, which are essential for future evaluations of evidence-based orthotic care.
Read the full paper at:
- Figueiredo EM, Ferreira GB, Maia Moreira RC, Kirkwood RN, Fetters L, Figueiredo E, Ferreira G, Moreira R, Kirkwood R FL. Efficacy of Ankle-Foot Orthoses on Gait of Children with Cerebral Palsy: Systematic Review of Literature. Pediatr Phys Ther. 2008;20(3):207-223. doi:10.1097/PEP.0b013e318181fb34
- Eddison N, Mulholland M, Chockalingam N. Do research papers provide enough information on design and material used in ankle foot orthoses for children with cerebral palsy? A systematic review. J Child Orthop. Published online July 3, 2017:1-9. doi:10.1302/1863-2548.11.160256