Ankle Foot Orthosis

If you have a brain injury either a traumatic one like a car accident or being hit by a blunt object or an acute brain injury such as a stroke. The chances are you may be subjected to severe damage to your brain which leaves you disabled in either side f your body, thus your mobility severely affected and you may struggle to walk. When this happens it's most likely that you will need a wheelchair to move around, however, this all depends on the severity of your disability. If you still have some movement left after the injury it's most likely that you'll be given walking cane instead of a  wheelchair. When using the cane to walk, you will most likely use your functional side of the body to carry the stick and to project yourself forward when walking as well as aiding your body weight to maintain stability as you move. Thus this leaves your affected side virtually unattended and idle, which could cause it to wither away through muscular atrophy. The only way that you can prevent this to reduce the effects of atrophy is to try and use it more often. For most patients, this can be a difficult task as the affected side will be weak and have little or almost o strength at all to carry the body weight, however with a little bit of help from walking aids like an AFO (Ankle Foot Orthosis) patients are able to make use of their weaker side to carry the weight of their body. If you think you still have a bit of movement and strength in your affected leg then it's best that you inform your rehab doctor or anyone that is in charge in your war that you would like to request for an AFO to be made for your leg.

When creating the AFO, patients will be asked to have their leg cast for a mold, which will be used to create the AFO. During this process, clay will be placed and covered all over your leg and you would have to sit still for a few hours to wait for the mold to dry and harden. Once it has completely dried off and solidify, the mold will be removed and you can go back to your room. It takes about a week for the AFO to be completely formed using the mold. By the end of a week, you'll be able to try it on for a test walk. When trying this new device, be sure to wear your pressure stockings underneath to prevent blood clots and keep the circulation of blood going. The proper footwear is also needed when using the AFO especially shoes with a bigger size to allow both your feet and orthosis to fit in together which will help you give traction when walking. With the AFO firmly placed on your weaker leg, you would have more support now to take on the weight of your body using the weaker leg. Along with the walking stick, patents must learn how to shift their weight between legs. It's best that they put more emphasis and focus on the weaker one to strengthen both the neuronal connection to the weaker leg but to also strengthen, the muscles as a means of avoiding muscular atrophy.

Using both an AFO and a walking cane can be difficult a first, especially when patients don't know which limbs they should move first so they can walk. most physiotherapists would recommend placing the cane in front first to establish the distance that patients wish to make then move the affected leg the AFO forward to make the first step, then the unaffected leg can follow suit. When moving the healthy leg be sure to shift your weight on your affected leg and vice versa when moving. Try to swing both the healthy and affected leg using your hip and pelvis to ensure that they swing forwards instead of sideways, this will be difficult at first since the initial damage from the brain may affect the vestibular, part of the brain that controls balance and spatial awareness. however with a bit of practice, and getting used to the brain is able to readjust itself ad the vestibular can slowly recover its lost function. So to all patients out there who are struggling with their balance and not knowing where they are in space, I urge you all to keep trying and to keep pushing yourself to get your balance back on your feet. This may take several tries to accomplish and it's best that you're accompanied by a physiotherapist or doctor that could watch over you in case you ever fall down.

The device also comes in handy when trying to et upstairs, so if any of you stroke patients out there are having trouble going up and down the stairs then the AFO should help you a lot in making this task easier. If you are going upstairs then start first by using the healthy leg to put yourself on the first step then the affected leg can follow suit, do this for every time you are going upwards, however when you are going downstairs you should do the opposite, the affected leg goes first then the healthy leg follows suit. You should only practice going up and down the stairs under supervision to prevent any mishaps from happening, try this alone if you really feel confident with your affected side or if you have railings on the stairs that you can grab a hold of fo support and stabilize yourself when using the stairs. However, if there are no railings to grab on then it's best to use the walking cane as a substitute. When using the cane, the cane would have to be moved first for establishing the predicted distance or steps that would be taken, then the healthy leg can move to put you on the first step. The opposite is done when going downstairs, the cane is moved first to measure the distance and support then either leg can move to stabilize yourself when going downwards.         

It should be noted that when using the AFO for walking, the device has to be maintained properly after every use so that it remains durable for every use. This can be achieved by placing the device in a dry and clean area. Keeping the interior of the orthosis clean may require a small application of cleaning alcohol to clean the area that has been in contact with the skin, this is one to prevent any bacteria or fungus building in that area which may cause skin irritation when you wear it. However, this cleaning isn't necessary if you wear your pressure stockings all the time when using the AFO. Another way that you can get around this is by attaching a piece of styrofoam in the orthosis that can be used as a shock absorber that can soak up any sweat or moisture from your leg as you are using it all day. Another benefit of attaching styrofoam is that it strengthens the grip of the Orthosis when wearing it so that it won't detach itself easily when patients are moving around with it. It also allows blood circulation in your legs to take place easily when using the device as at times it's worn on the leg too tight and cause a blockage on the blood circulation of the leg, so styrofoam softens the grip of the device while being used. The cushioning with the foams should also be given on the straps that are keeping the device in place as these are areas where pressure is being exerted on the leg.

With the extra padding that is added, it should make it easier and much firm when walking with the device and patients should feel more confident at putting more weight on the weaker leg. Once you have the paddings attached, the structure of the orthosis becomes stronger and can even be functioned as a deterrent to anyone who passes you by in public to let them know that you have a disability. If they don't recognize your disability and disrespect you by going towards you at full speed you have every right to kick them in the shin or groin with your orthosis to let them know that they're being a dick. If you have a cane with you then you can use it to jab their foot to stop them from continuing to walk towards you or hit them in the head to make them stop completely.

To avoid the need of unnecessary hitting of civilians in the public, it's best to go to places that are not crowded to avoid harming anybody or request the hospital for a nurse or an allied health assistance to escort you as you explore the outside world to protect you from people. It's best to start training yourself with the AFO by walking around the hospital courtyard, this way it would be safer and you are already familiar with the hospital surroundings and can utilize the disability facilities if needed. When walking around the hospital with the AFO, always be mindful of your surroundings as you will most likely walk slowly and hit a few things along the way, so try to remember that there are other people in the vicinity that you have to respect and give way to especially if they are severely handicapped and using a wheelchair.