Orthotics

Orthotics come in many different forms as described below. They can be both “off the shelf” or custom made and are usually externally worn devices that aim to treat, prevent or support the position of the foot or lower limb.

• Custom insoles​
• AFO's​
• KAFO's​
• GRAFO's​
• Shoe raises​   
• Rocker soles ​
• Gaiters​
• Night/resting splints​
• Off the shelf orthosis

AFO 

An Ankle Foot Orthosis or AFO is a custom splint for your lower leg.  It is designed to control the movement in the foot and ankle.  

AFO’s can be prescribed for a number of reasons:  

• To make walking easier  
• Keep your foot/ankle in a better position  
• To support a weakened or affected muscle/s  
• To reduce the risk of falls  
• To reduce pain

KAFO 

If your child requires more support, they might benefit from a KAFO (knee, ankle foot orthosis). As the name suggests, a KAFO comes up over the knee, providing more stability while still allowing movement of the knee joint.  

DAFO 

A DAFO (dynamic ankle foot orthosis) is an orthotic that supports the foot and ankle only. They typically fit like an ankle boot, providing flexible and thin external support for the ankle.  

Insoles 

·       Your child will only be seen in this clinic if open to the Physiotherapy Service.

·       Your child will be referred to this clinic by their Physiotherapist.

·       This clinic is run in conjunction with an external orthotics company. Your child will be seen in clinic by an orthotist and physiotherapist. This joint approach allows us to provide the best orthosis to fit the child/young person's functional needs.

·       Clinic is run every 2 weeks on a Tuesday between 9:00 and 16:00. You will receive an appointment via appointment letter, should you not be able to attend this appointment, please contact Therapy admin via 0300 555 5965.

·       Your child will have 2 appointments, the first of which is an initial assessment and casting/impressions taking and the second is a fitting appointment.

·       As mentioned above will be an Orthotist and Physiotherapist in this appointment. The physio may not be your child’s named therapist, however, is in the same team and will receive information about the required provision from the named therapist prior to the appointment.

·       In their initial appointment your child will have an assessment which will consist of some or all of the following:

§  Discussion with parent and child about current mobility skills and relevant equipment.

§  Review of lower limb joint ranges.

§  If your child is mobile a review of their standing posture and gait pattern.

§  If your child has previous orthotic provision, a review of this will be completed.

·       During the initial appointment your child may have an impression of their feet or casting (using plaster cast) completed. This will then be sent off to the factory for their orthosis to be made. Please see casting section below for further information on this.

·       Your child will then have a further appointment for fitting of their orthosis.

Casting for AFO

1. Your child will be sitting in their wheelchair or on a plinth. If your child is small enough, they can also sit on the lap of their parent/carer. You may need to distract your child during this process to keep them calm and still.

2. A tubigrip sock will be placed on one or both legs, depending on which leg/s need orthotics. A flexible plastic strip is then passed down the front of the sock, this acts as a protective barrier so that the cast can be cut off later.

3. The orthotist will place rolls of plaster in warm water. Once they have soaked for a short time, the orthotist will begin wrapping the plaster around your child’s leg. This will not be painful. The orthotist or physiotherapist may also need to hold your child’s leg in a certain position to ensure sure the casts are taken at the correct angle.

4. Once the plaster is dry, the orthotist will use a scalpel to cut it off, this will run along the line of the plastic strip placed into the sock earlier in the process. The blade will not go near your child’s skin or hurt them, but they may need reassurance about this.  

What should my child wear for Orthotics clinic appointment?

·       We recommend shorts or leggings. Or if they are wearing trousers, those that can be easily rolled up to allow the Physiotherapist and Orthotist to review foot posture and position.

·       We will ask your child to remove their shoes and socks during this assessment.

What to bring to my orthotics appointment?

·       Any current orthosis​

·       Mobility aids if used​

·       Suitable clothing (shorts where possible)​

How quickly will my child receive their orthotic provision?

·       For most orthotic provision you should expect a 2 week turn around between the initial casting appointment and the fitting appointment.

·       Should your child’s orthotic provision however be more complex there may be an additional 2 weeks added to this to ensure that the factory have adequate time to produce this to a high standard.

·       Please note for KAFO provision, there will be 2 fitting appointments.

Will my child needs orthotics forever?

·       Every child is different. Your child’s need for orthotic provision is likely to change throughout their life. Some children only require orthotics for a short period of time and others need them into their adulthood.

·       Questions about your child specifically should be taken to your child’s therapist, however, as mentioned above the need for orthotics can change.  

My child has grown out of their splints/insoles, what do I do? 

·       If your child is under the care of a Physiotherapist at the Child Development Centre, you should contact them as soon as possible to let them know. They will add your child to the waiting list to be seen in clinic for new splints. 

What happens if my child has Orthotics and is discharged from Physiotherapy?

·       Should your child be discharged from the Physiotherapy service, your child’s orthotic provision will no longer be completed at the Child Development Centre. Upon discussion with your Physiotherapist a referral will either be completed by them, or GP to the Orthotic service at Peterborough City Hospital.

My child’s splints are really uncomfortable and/or causing red marks, what do I do? 

·       If your child has attempted to wear their new splints a few times and is finding them really uncomfortable and complaining of pain, let your child’s therapist know. The same can be said about splints leaving marks. Some redness after taking the splints off is normal, however this should disappear within 5-10mins. If the redness continues or the splints cause blistering/skin breakdown, inform your child’s therapist as soon as possible.