The effect of ankle-foot orthoses on balance: A clinical perspective

Balance is established and maintained by a complex integration of motor and sensory systems. When these systems are impaired, balance can be altered and function will be disrupted. The ankle-foot orthosis (AFO) represents an intervention that may improve balance and functional deficits. However, there is limited evidence related to the effect of AFOs on balance to guide clinical decision making. To determine how AFOs can best address the issues of imbalance and functional compromise, it is important for clinicians to consider the following factors: patient expectations and task relevance, effects on the body's center of mass, fatigue, area of contact as it pertains to the base of support, proprioception, and balance preservation outside of normalized ambulation. A better understanding of these factors will help to identify realistic treatment objectives and optimize outcomes associated with the provision of AFOs.