Friday, July 12, 2024

Re: DAFOs

Phil Heberer

Hello Carol,

> While we are on the DAFO thread, have any of you seen a great improvement
> with DAFO’s over a solid ankle AFO? Although I provide DAFO’s (both made in
> house and at Cascade) I don’t think they do that much to contain the foot in
> the orthosis. They are bulkier, require greater effort to don, and often
> result in needing a much larger shoe. As far as the foot plate design, that
> can be incorporated in any AFO. Ultimately, the best control I have ever
> achieved has been with a bivalve, full contact AFO. I feel ankle straps
> properly placed do a better job than the dorsal flanges of the DAFO.

I have had some quite remarkable results in the past by using the DAFO footplate
in an articulated ankle design with adjustable PF stop, all molded over a thin
(2-3 oz) leather lacer ankle support molded to the plaster model. While about
size and a half larger shoes were needed, the parents liked them as the leather
lacer maintained foot/ankle position while they donned the shoes (soft-sided,
K-mart tennis shoes worked great!) I had used Cascade DAFO’s as well, but had
complaints of the bulkiness of the straps and loops, and sometimes pressure
problems at the transition of the instep on the dorsum of the foot. The leather
lacers distributed the pressure over a broader area, and also had better
intimate contact with the foot resulting in less friction-induced problems,
FWIW.

Best regards,
Phil Heberer, L.O.

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