A review of the literature pertaining to KAFOs and HKAFOs for ambulation

Stefania Fatone*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations


The purpose of this review is to evaluate the scientific literature regarding the clinical use of knee-ankle-foot orthoses (KAFOs) and hip-knee-ankle-foot orthoses (HKAFOs) for ambulation to establish what is known and what requires further research to optimize the application of these orthoses. A search of the literature was carried out using a number of computerized databases. Based on their abstracts, publications were included and ranked when they were written in English and evaluated some aspect of ambulation with [H]KAFOs (KAFO and HKAFO). A total of 240 articles were identified that met the inclusion and exclusion criteria; however, there were only two systematic reviews and two randomized control trials located. A selection of recent cross-sectional studies and non-systematic reviews were also considered. The results of this review indicate that, while a reasonable amount of literature has been written regarding [H]KAFOs, the level of evidence regarding the use of [H]KAFOs for ambulation is generally low. There was some evidence (grade C recommendation) that use of HKAFOs diminishes with time in both adults and children with paraplegia and that when orthoses are used they are used mostly for therapeutic purposes. There was also some evidence that regardless of orthotic device used walking speed is slow and energy cost high in people with paraplegia. The main limitation of most studies of [H]KAFOs for ambulation was small sample size and inadequate study design.

Original languageEnglish (US)
JournalJournal of Prosthetics and Orthotics
Issue number7 PROCEEDINGS
StatePublished - Jun 1 2006


  • Ambulation
  • Hip-knee-ankle-foot orthosis
  • Knee-ankle-foot orthosis
  • Orthotic devices
  • Reciprocating gait orthosis

ASJC Scopus subject areas

  • Biomedical Engineering
  • Orthopedics and Sports Medicine
  • Rehabilitation


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