AFO vs KAFO: What’s the Difference and Who Uses Them?
If you have been told you might benefit from an AFO or a KAFO, the acronyms can feel like a lot. Here is what they mean, how they differ, and what goes into choosing and making one.
What Is an AFO?
An AFO is an ankle foot orthosis. It is a brace that supports the foot and ankle, and it sits inside a shoe. It can hold the foot at a useful angle, help lift the toes during the swing phase of a step, limit unwanted movement or allow controlled movement, depending on its design.
AFOs are often used by people whose muscles around the ankle are weak or difficult to control, which can happen with conditions such as drop foot, stroke, cerebral palsy, multiple sclerosis, spina bifida, nerve injury and other neurological or neuromuscular conditions. They are also used with children as they grow. Whether an AFO is suitable for you is a matter for your treating team, and we work alongside them.
What Is a KAFO?
A KAFO is a knee ankle foot orthosis. It includes everything an AFO does and extends up the leg to support the knee, often to the thigh. KAFOs are considered when the knee needs support in addition to the ankle and foot, for example when muscles around the knee are not strong enough to keep it stable when standing or walking.
Some KAFOs use a knee joint that locks and unlocks, while others use joints that respond to movement. For example, we have made carbon fibre KAFOs that incorporate a powered knee component to lock and release as the wearer walks, and designs using the Ottobock C-Brace, a microprocessor-controlled knee joint. The right choice depends on the individual.
AFO vs KAFO at a Glance
Area supported: An AFO supports the foot and ankle. A KAFO supports the foot, ankle and knee.
Length: An AFO usually finishes below the knee. A KAFO extends above the knee.
Typically considered when: An AFO may be considered when the ankle and foot need support or control. A KAFO may be considered when the knee also needs support.
Design: Both can be made in a range of materials and with a range of joints, and both can be customised to the wearer.
Custom-Made or Off-the-Shelf?
Off-the-shelf braces are available in standard sizes and can be suitable for some people. A custom-made orthosis is made from a scan or cast of your leg, so it is shaped to your anatomy and to the way you move. Custom devices are commonly considered when a standard fit is not comfortable or effective, when there are unusual shape or alignment considerations, or when the wearer needs specific features.
At XPO, we design and make orthoses in our own workshop in Huskisson, using materials that include carbon fibre, thermoplastics and silicone. Carbon fibre is a popular choice because it is light and strong. Silicone options can suit people who want a device that is easy to clean and waterproof.
What Happens at an Assessment
A conversation about your goals. What you want to do, where you want to do it and what is getting in the way.
A physical assessment. Your orthotist looks at your strength, range of movement, alignment, skin and how you stand and walk.
Scanning or casting. We take a 3D scan or cast of your leg.
Design and fabrication. Your device is designed and made, including the choice of materials, joints, colours and finish.
Fitting and review. We check fit and function, make adjustments and plan follow-up.
Footwear for AFOs and KAFOs
Shoes matter more than most people expect. Because an AFO or KAFO sits inside the shoe, you usually need a shoe with enough depth and width, a firm heel and a secure fastening such as laces or hook-and-loop straps. It often helps to buy shoes with the orthosis in, and to bring your device to the shop. Some people need shoes in a slightly larger size, and some benefit from shoe modifications. Your orthotist can advise on this.
Questions to Ask Your Orthotist
Why do you recommend this type of orthosis for me, and what are the alternatives?
What materials and joints could be used, and what are the trade-offs?
How should I build up wear time, and what should I watch for on my skin?
How will it work with my shoes and my clothing?
How often should it be reviewed, and what should I do if it stops fitting?
Children and Growing Legs
Children grow, so orthoses are reviewed and replaced more often than for adults. Many families enjoy involving their child in the design. We have made AFOs in colours and finishes chosen by the child, including metallic paint and glitter, and every device is still made to the child's own shape and needs.
Funding and Referrals
Funding for orthoses can come through several pathways, including the NDIS, DVA and private funding, depending on your circumstances. Ask us about what is needed for your situation, including whether a referral or supporting documents will help.
Frequently Asked Questions
What does AFO stand for?
AFO stands for ankle foot orthosis, a brace that supports the foot and ankle.
What does KAFO stand for?
KAFO stands for knee ankle foot orthosis, a brace that supports the knee, ankle and foot.
Can an AFO be worn in normal shoes?
Many AFOs are designed to fit inside a shoe, though you may need a slightly larger or more accommodating shoe. Your orthotist can advise on footwear.
Next Step
Curious whether an AFO or KAFO might suit you or your child? Contact our team on (02) 4415 9510 or visit x-tremity.com to arrange an assessment. Referrers can find our referral information on the website.