Ground-reaction / floor-reaction AFO
Draft — clinical review requiredA ground-reaction (floor-reaction) AFO uses an anterior shell to resist the tibia moving forward, influencing the knee in stance.
Foot clearance
Toes may catch in swing when the ankle cannot dorsiflex.
Mechanism: The orthosis resists plantarflexion during swing.Ankle position at contact
Flat or toes-first contact is possible.
Mechanism: Ankle held by a rigid design.Tibial progression
Tibia advances freely or is limited by tone.
Mechanism: Stiffness and alignment determine how much the tibia can move over the foot.Knee behaviour
Depends on ankle and muscle control.
Mechanism: Changing ankle motion alters the ground reaction force line relative to the knee.Qualitative only — possible changes, not predicted angles or effectiveness. Stiffness, alignment, footwear, available range, strength and motor control all influence the response.
Go deeper
Open each part when you are ready.
Where it sits
- Anterior shell over the front of the shin and a foot plate.
Joints crossed
- Ankle and foot (influences knee).
Movements it may allow, resist or constrain
- Resists dorsiflexion (forward tibial movement) in stance.
Intended functional goals
- Encourage knee extension in stance in people with excessive knee flexion — after assessment.
Potential applications
- Crouch-type gait in some children with cerebral palsy, when range allows.
Limitations, tradeoffs and precautions
- Ineffective or harmful with significant knee or hip flexion contractures.
- Pressure on the shin.
Individual assessment and fitting
- Passive knee and hip extension, footwear and alignment.
- Response depends on stiffness, alignment, footwear, available range, strength and motor control. No device produces the same result in every patient.
What additional information would you need before considering this device?
- Range of motion at the ankle, knee and hip.
- Strength and motor control.
- Tone and spasticity.
- Sensation and skin integrity.
- Footwear, goals, cognition and ability to don/doff.
- Who will review fit and response over time.
Apply it
A ground-reaction AFO requires which finding before use?
Sources and review status
Draft — clinical review required
Starting points for verification. Validated protocols are linked where available; clinical content has not yet been reviewed.
Learning objectives
- Identify where a Ground-reaction / floor-reaction AFO sits and which joints it crosses.
- Explain which movements it may allow, resist or constrain.
- List factors that require individual assessment and fitting.