For clinicians, prescribing orthotic devices is only the first step. Ensuring patients understand how to properly wear, care for, and integrate these devices into their daily routines is essential for successful outcomes. 

Whether prescribing custom orthotics or prefabricated systems like AFOs, KAFOs, or upper-extremity orthoses, clinicians can significantly enhance patient adherence and long-term device performance by offering clear, actionable guidance.

This overview integrates best practices from Anatomical Concepts, Inc. (ACI) and covers wear schedules, cleaning instructions, fit considerations, and patient lifestyle advice—enabling you to confidently assist patients in maximizing the effectiveness of their orthotic devices. 

1) Start with Proper Fit and Education

A clinician-led fitting is required to ensure an orthotic device works as intended. ACI orthoses are designed to be trimmed, bent, and custom-adjusted only by licensed medical professionals; improper fitting voids the device warranty and compromises safety.

During fitting, reinforce key points such as:

• Proper extremity positioning during donning (e.g., hip and knee flexed ~60° to reduce extensor tone).
• Correct strap-tightening sequence (middle strap first, then remaining dorsal and calf straps).
• Importance of periodic screw checks, especially on walking bases, to prevent loosening.
• Clinician-guided application training sets the foundation for patient compliance and device durability. 

2) Establish Wear Schedules that Prioritize Skin Integrity

ACI recommends that the ordering physician set wear schedules, but patients should be taught how to monitor tolerance and skin response.

General guidelines include:

• Build tolerance gradually: begin with one hour, then increase by two-hour increments if no pressure, redness, or swelling is observed (not exceeding 6 hours without removal).
• In patients with compromised sensation or soft tissue viability, emphasize frequent skin checks and shorter intervals.
• Reinforce that any skin discoloration, pain, warmth, or persistent redness warrants immediate clinical review.

3) Teach Cleaning, Liner Care, and Replacement Expectations

Device upkeep has a direct impact on comfort, hygiene, and wear-life. Patients often do not realize that liners degrade over time, affecting effectiveness. 

ACI provides the following cleaning recommendations: 

• Liners are machine-washable on delicate or hand-washed at 150°F or lower, and dried on a cool setting or air-dried.
• Liners will thin and lose effectiveness over time, so clinicians should advise on expected replacement intervals.
• If infection (e.g., MRSA) is present or suspected, remove the liner, thoroughly disinfect the plastic/aluminum frame, lightly mist the liner surfaces with Lysol®, allow to dry, then machine wash.
• Replacement liners are available in multiple material options (Kodel®, Fleece, Terry Cloth, Pad & Strap).

Discussing liner options empowers patients to choose comfortable upgrades, particularly if they have sensitive skin or moisture issues.

4) Guide Patients Through Lifestyle Adjustments for Optimal Outcomes

Orthotic devices frequently enhance mobility, joint alignment, and independence. Helping patients anticipate lifestyle changes improves adherence and satisfaction. 

Activity Level and Mobility

Many AFOs—including the PRAFO®, APU®, EV™, Dual Action, and ABBY™ Orthoses—support both ambulatory and recumbent patients by maintaining alignment, controlling dorsi/plantar flexion, and improving gait clearance. 

Patients may experience: 

• Increased stability during ambulation
• Improved swing-phase clearance
• Reduced fatigue due to improved biomechanics

Encourage patients to gradually reintroduce standing and walking activities as appropriate for their diagnosis. 

Daily Routines

Help patients consider: 

• Clothing choices that accommodate straps and uprights
• Footwear needs for articulating devices or orthoses with walking bases
• Adapting home environments for safer navigation

Skin & Soft Tissue Care

Because AFOs and KAFOs manage deformity and prevent contractures, patients should be reminded that: 

• Moisture-wicking socks may reduce skin friction
• Hot environments may require more frequent liner washing
• Any change in swelling, circulation, or wound status requires evaluation

5) Encourage Consistent Follow-Up and Monitoring

Orthotic devices require ongoing oversight, not only to adjust fit but also to align with a patient’s evolving functional status. 

Follow-up enables clinicians to: 

• Adjust dorsi/plantar flexion angles, inversion/eversion, or rotation control features as patient mobility improves 
• Reassess skin integrity and modify padding or liners when needed
• Monitor spasticity changes, joint ROM, or weight changes that may affect fit
• Document gait improvements or alignment corrections

Many ACI devices, such as the APU®, EV™, and Tri-Planar Orthosis, are designed for infinite adjustability in the sagittal, coronal, or transverse planes, allowing ongoing optimization as rehabilitation progresses. 

6) Provide Clear Instructions for When to Seek Medical Help

Patients should be advised to contact their provider if they experience: 

• Increased pain, pressure points, or changes in skin color 
• Mechanical issues such as loose screws or damaged components
• Difficulty donning/doffing the orthosis
• Any unexpected decrease in mobility or comfort

Patient safety relies on early clinician intervention. 

7) Reinforce How Proper Use Enhances Quality of Life

Orthotic devices, especially custom orthotics, do more than stabilize and protect. They help patients regain independence, resume daily motions, and engage more confidently in rehabilitation.

When clinicians frame bracing as a positive lifestyle enhancer rather than a limitation, patients are more motivated to adhere to device guidelines.

Supporting Better Patient Outcomes Through Proper Orthotic Device Use

Supporting patients in wearing and maintaining their orthotic devices effectively is a vital extension of clinical care. By educating patients on fit, cleaning, wear schedules, and lifestyle integration, medical professionals help ensure that orthotic devices deliver their full therapeutic potential. 
  
Anatomical Concepts, Inc. provides high-quality orthotic solutions—supported by replaceable liners, adjustable components, and evidence-based design—to help your patients achieve meaningful improvements in mobility, comfort, and overall function. 
  
If you’d like assistance selecting the most appropriate custom orthotics or prefabricated systems for your patients, ACI’s support team is available to help. Contact us today!