Ankle-Foot Orthosis (AFO) Types

These devices can keep your ankle in a neutral position while walking

An ankle-foot orthosis (AFO) is a hard brace worn on the lower leg that improves overall walking safety and efficiency for people with certain medical conditions. AFOs provide gait stability, keep joints properly aligned, and help compensate for muscle weakness.

Different types of AFOs have been developed to address a patient's individual needs. Generally, a healthcare provider or physical therapist will evaluate you to determine if an AFO is needed and what type to prescribe.

Ankle foot orthosis being used outside
Raif Geithe / Getty Images 


The most common reason you may need an AFO is foot drop, an inability to raise one foot while walking, which results in toes dragging on the ground. Foot drop is caused by weakness or paralysis on one side of the body, usually from a brain or nerve condition.

Healthcare providers call weakness or slight paralysis on one side of the body hemiparesis, while total paralysis on one side of the body is called hemiplegia. Conditions that may produce either of these and result in foot drop include:

  • Stroke
  • Multiple sclerosis
  • Cerebral palsy
  • Traumatic brain injury (TBI)
  • Neck or spinal cord injury
  • Sciatica
  • Muscular dystrophy
  • Lower leg (peroneal) nerve injury

AFOs are a common option, as studies have shown that they help improve gait and toe clearance in patients with hemiplegia.

If you're having difficulty walking and notice you catch your toes on the floor, particularly on one side of your body, see a healthcare provider immediately.

Types of Ankle Foot Orthoses

Your healthcare provider can help assess your gait (often people with foot drop exhibit a high steppage gait pattern) and choose the best AFO for your specific condition.

If your foot drop is temporary, a non-custom, off-the-shelf AFO may be sufficient. If it appears your condition is permanent, a custom-molded ankle-foot orthosis may be warranted. Technologies have advanced to where custom orthotics can be created via three-dimensional (3D) printing.

Some differences among the options:

  • A solid AFO that offers no ankle movement can be large and clunky but may be necessary to stabilize your ankle and foot while walking.
  • A hinged (articulated) model allows some ankle flexion.
  • A smaller, more mobile AFO can include a posterior leaf spring. This type of AFO has a rigid front toe plate with a flexible posterior footplate that bends and stores energy when you step. As you raise your foot off the ground, the spring adds a little boost to your step, quickly raising your foot and toes off the ground.

An ankle-foot orthosis is not the same as a walking boot, which is used not for medical conditions, but to protect the foot and ankle after injury or surgery.

A Word From Verywell

An improperly fitted ankle-foot orthosis may rub your foot and ankle, leading to redness and possibly bleeding. Check your foot daily for any signs of skin irritation, as this could lead to infection. If you notice problems, discontinue use of your ankle-foot orthosis and see your healthcare provider right away. You may need to have your AFO adjusted.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Pourhosseingholi E, Farahmand B, Bagheri A, Kamali M, Saeb M. Efficacy of different techniques of AFO construction for hemiplegia patients: a systematic review. Med J Islam Repub Iran. 2019;33:50. doi:10.34171/mjiri.33.50

  2. National Institute of Neurological Disorders and Stroke. Foot drop information page.

  3. Van der linden ML, Andreopoulou G, Scopes J, Hooper JE, Mercer TH. Ankle kinematics and temporal gait characteristics over the duration of a 6-minute walk test in people with multiple sclerosis who experience foot drop. Rehabil Res Pract. 2018;2018:1260852. doi:10.1155/2018/1260852

  4. Prosser LA, Curatalo LA, Alter KE, Damiano DL. Acceptability and potential effectiveness of a foot drop stimulator in children and adolescents with cerebral palsy. Dev Med Child Neurol. 2012;54(11):1044-1049. doi:10.1111/j.1469-8749.2012.04401.x

  5. McCabe FJ, McCabe JP. An unusual presentation of right-sided sciatica with foot drop. Case Rep Orthop. 2016;2016:9024368. doi:10.1155/2016/9024368

  6. Carolus AE, Becker M, Cuny J, Smektala R, Schmieder K, Brenke C. The interdisciplinary management of foot drop. Dtsch Arztebl Int. 2019;116(20):347-354. doi:10.3238/arztebl.2019.0347

  7. Pongpipatpaiboon K, Mukaino M, Matsuda F, et al. The impact of ankle-foot orthoses on toe clearance strategy in hemiparetic gait: a cross-sectional study. J Neuroeng Rehabil. 2018;15(1):41. doi:10.1186/s12984-018-0382-y

  8. Chang JS, Lee HY, Kim MK. Effects of the ankle angle of an ankle foot orthosis on foot pressure during the gait in healthy adults. J Phys Ther Sci. 2015;27(4):1033-1035. doi:10.1589/jpts.27.1033

  9. Wojciechowski E, Chang AY, Balassone D, et al. Feasibility of designing, manufacturing and delivering 3D printed ankle-foot orthoses: a systematic review. J Foot Ankle Res. 2019;12(1):11. doi:10.1186/s13047-019-0321-6

  10. O’Connor J, McCaughan D, McDaid C, et al. Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis. Southampton, UK: NIHR Journals Library.

By Laura Inverarity, DO
 Laura Inverarity, PT, DO, is a current board-certified anesthesiologist and former physical therapist.