Orthotic devices, also called orthoses, are braces that help support weakened muscles while walking. They also enhance comfort and help slow the progress of contractures (tightened muscles or tendons that become shorter over time).
Orthotic devices can be worn at any time of the day or night. Use of a specific orthotic device depends on the patient’s type of muscular dystrophy and muscles affected.
Types of orthotic devices
The main types of orthotic devices include ankle-foot orthoses and knee-ankle-foot orthoses. There are also wrist and thumb splints that can be used to enable those with weak hands to grasp small objects. A shoulder sling can help in supporting arms and ligaments for those with weak shoulders.
Ankle-foot orthoses (AFOs) are devices that cover the ankle, foot, and the leg below the knee. AFOs are highly durable and are custom-made to the individual’s requirements. AFOs help increase mobility and reduce pain while walking.
AFOs are designed by first taking a cast of the leg. The process of fabricating an AFO from this cast typically takes between three to four weeks, followed by a fitting appointment where the device is tested for comfort and function.
While fitting the AFO, it is recommended that the patient wear clothing that either exposes the lower leg or can be rolled up, and knee-high socks that fit well and are fairly wrinkle-free to reduce rubbing. Commonly used shoes or sneakers should also be taken to the fitting, as adjustments are made.
Knee-ankle-foot orthoses (KAFOs) are similar to AFOs but also cover the knee joint. KAFOs help in preventing excessive joint motion so to lessen joint pain. They also help with joint alignment and stability.
KAFOs are customized for each individual and usually made of metal or plastic. Newer KAFO varieties are made of carbon fiber, and are lightweight while still offering the support needed to complete the gait cycle.
Using KAFOs can be strenuous, and it is important that patients be given time to adjust in a safe (indoor) environment. With a KAFO, the movement of the knee is restricted and walking requires a greater expenditure of energy. To ease movement, electronic or electromagnetic controlled knee joints can be installed onto a KAFO.
While wearing AFOs or KAFOs, it is important to periodically check for signs of excessive rubbing, skin marks, or bruises, especially if painful. If any do not subside after a short period, patients are advised to contact their orthotist or clinician as soon as possible.
Last updated: 07/19/2019
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