When it comes to maintaining proper knee-ankle-foot alignment, controlling motion, and minimizing pain associated with various lower extremity injuries or conditions, there are a variety of effective treatment options, including surgery.
However, other effective treatment options are available for your patients who are candidates for less invasive means of treatment.
One such option we recommend to physicians is the Knee-Ankle-Foot Orthosis (KAFO), which is used to treat various lower extremity ailments. When selecting the right KAFO for your patients, there are many things to consider, including when to prescribe a KAFO, the main types, wear requirements, patient skin care and KAFO device care. This blog will discuss some of these considerations and serve as a KAFO buyer’s guide resource.
What is a KAFO?
A knee-ankle-foot orthosis (KAFO) is a leg brace customized to an individual's specific needs. It spans the length from above the knee to the ankle and foot to support the muscles, stabilize the joints and assist safe movement.
The KAFO delivers versatility that’s particularly needed in the early stages of neurological rehabilitation patient management. They can also be beneficial in recovery from all sorts of lower extremity issues.
KAFOs help compensate for muscle weakness, paralysis, or skeletal problems that cause lower limb instability. The KAFO helps to make standing and walking easier by:
- Reducing joint paint
- Improving joint alignment
- Preventing excess joint movement
- Controlling joint instability
It ensures superior mobility and a comfortable fit, providing better limb control. Produced from thermoplastics or carbon fiber composites, it is lightweight and fits closely. Each component, including the knee joint, knee locking mechanism, knee pads and bands, and whether or not there is a frontal plane control, is determined by an individual's unique condition.
When to Prescribe at KAFO
A KAFO is used as a walking aid for those with difficulty for various reasons. The most common are polio, partial spinal cord lesions, nerve injuries, and stroke.
The most common causes of muscle weakness that require KAFO usage are:
- Muscular Dystrophy
- Spinal Cord Injury
- Multiple Sclerosis
- Cerebral Vascular Accident (CVA/Stroke)
There are many factors to consider when prescribing and fitting the device on an individual. These include the type of deformity, the biomechanical deficit to be addressed, an individual's weight and activity level, and lifestyle issues.
Individuals experiencing significant fixed deformity may benefit from a weight-relieving brim in the orthosis, in which the individual's weight can be migrated from the affected extremity.
Types of KAFOs
KAFOs are complex devices, so their designs vary according to the patient's needs. There are two main types:
- Metal KAFO with side steels that insert into the shoe heel with leather thigh section and calf band.
- Plastic KAFO with molded thigh and calf sections that fit inside the shoe, connected by metal side bars.
KAFO Wear Time
When instructing your patients about KAFO wear time, remember that they should gradually increase the wear time. This allows their skin to adjust to the supportive pressures that the KAFO applies.
Make sure your patients understand that If their KAFO becomes uncomfortable, they should discontinue use and consult you.
Footwear with KAFO
Some instructions for your patients regarding footwear, When selecting shoes to wear with their KAFO, they should look for the following features:
- Enclosed heel and toe
- Secure lace or velcro fastening
- Removable insole
- Heel height recommended by your orthotist
They should select comfortable, supportive shoes to maximize the benefits of the KAFO.
KAFO Care Recommendations
Once individuals begin wearing their KAFO, they should wear socks and shoes, which will serve as a barrier between the brace and skin to reduce any friction and improve comfort when perspiration occurs. It's recommended to wear a basic athletic shoe with laces or Velcro closures. This allows for adjustments to be made more easily when needed.
Each time it is removed, the wearer of the brace should check their skin for any signs of marking or redness. If red marks persist for longer than 30 minutes or the skin breaks down or blisters, the individual should discontinue the use of the brace and contact their doctor.
KAFO Designed for Mobility and Comfort
In the past, the best option to treat lower extremities with an orthosis would be to wear a KAFO with a locked knee joint. While this provided the necessary stability and support of the knee to prevent involuntary flexion, it also caused muscle atrophy, increased energy expenditure in gait, and a non-cosmetic walk.
Today's KAFO technology has been re-engineered with an enhanced design that can automatically lock and unlock at the appropriate times in the gait cycle. This allows for a more fluid walking style and promotes muscle strengthening.
Anatomical Concepts KAFO Options
Prefabricated Knee Ankle Foot Orthoses (KAFO Brace)
Our Prefabricated KAFO and AFO modular orthotic systems are in stock and cost-effective compared to custom-made or hybrid-type designs.
They offer the versatility needed, particularly in the early stages of neuro-rehab patient management. Studies have proven the value of early mobilization and proper anatomical positioning.
Learn more about this brace here.
Custom Adult V-VAS™ Knee Ankle Foot Orthosis
This device is a unique KAFO custom-fabricated for those who present or require treatment of various knee arthropathies and/or bowing of the lower extremity. The dynamic V-Vas™ joint system allows for sequential deformity correction and creates a precise offloading effect.
Learn more about this brace here.