The DAFO Guide to Brace Selection

We created The DAFO Guide to Brace Selection as a useful tool to match patient needs to available brace styles.

Download the DAFO Guide

How to Use this Guide:

  1. 1. Find your patient group
  2. 2. Match the level of involvement
  3. 3. Choose a suggested brace style

Low Tone Pronation

  • Foot collapses and medial arch flattens
  • Heel everts
  • Forefoot abducts
  • Low muscle tone allows for easy correction

Mild

  • Visible medial arch
  • Mild heel eversion and forefoot abduction
  • Can correct when prompted
  • Can be manually corrected with no resistance

Moderate

  • Reduced medial arch
  • Moderate heel eversion and forefoot abduction
  • Can improve when prompted
  • Can be manually corrected with mild resistance

Strong

  • Absent medial arch
  • Strong heel eversion and forefoot abduction
  • Cannot improve when prompted
  • Can be manually corrected with moderate resistance

High Tone Pronation or Supination

  • Pronation:
    • Foot collapses and medial arch flattens
    • Heel everts and forefoot abducts
  • Supination:
    • Foot bears weight on lateral side, high medial arch
    • Heel inverts and forefoot adducts

Mild

  • Visible medial arch
  • Mild heel eversion and forefoot abduction
  • Can correct when prompted
  • Can be manually corrected with mild resistance

Moderate

  • Reduced medial arch
  • Moderate heel eversion and forefoot abduction
  • Can improve when prompted
  • Can be manually corrected with moderate resistance
JumpStart Bunny
JumpStart Bunny
Wrap-around strap
DAFO 4
DAFO 4
Wrap-around strap

Strong

  • Absent medial arch
  • Strong heel eversion and forefoot abduction
  • Cannot correct when prompted
  • Can be manually corrected with strong resistance or cannot be corrected
DAFO Tami2
DAFO Tami2
Free ankle
DAFO 3.5
DAFO 3.5
Very flexible strut

Swing Phase Inconsistency

  • The foot tends to be toe down and slightly inverted as the leg is advancing through the air
  • Ankle position is weak and not reliable

Mild

  • Lands heel first
  • No obvious compensations of the knee and hip
  • Occurs almost never (less than 80% of the time)
  • Can control when prompted
JumpStart Bunny
JumpStart Bunny
Wrap-around strap
DAFO 4
DAFO 4
Wrap-around strap

Moderate

  • Lands foot-flat, accompanied by pronation/supination
  • Some compensations of the knee and hip
  • Occurs almost always (80% of the time)
  • Can improve when prompted
DAFO Tami2
DAFO Tami2
Free ankle
DAFO 3.5
DAFO 3.5
Very flexible strut

Strong

  • Lands forefoot-first, accompanied by pronation/supination
  • Marked compensations of the knee and hip
  • Occurs consistently (100% of the time)
  • Cannot control when prompted
DAFO 3.5
DAFO 3.5
Semi-rigid strut
DAFO FlexiSport
DAFO FlexiSport
Moderately flexible strut

Excess Plantarflexion/Toe Walking

  • Bears weight primarily on forefoot
  • Toes point downward and heel does not touch ground when walking
  • Excess muscle tone, range of motion, or habit results in toe walking

Mild

  • Ankle plantarflexion: 0°
  • Occurs occasionally (less than 50% of the time)
  • Can correct when prompted
  • Can be manually corrected with mild resistance
JumpStart Bunny
JumpStart Bunny
Posterior strap
DAFO 4
DAFO 4
Posterior strap

Moderate

  • Ankle plantarflexion: 0–2°
  • Occurs frequently (50% of the time)
  • Can improve when prompted
  • Can be manually corrected with moderate resistance
DAFO 3.5
DAFO 3.5
Moderately flexible strut
DAFO FlexiSport
DAFO FlexiSport
Moderately flexible strut

Strong

  • Ankle plantarflexion: 2° or more
  • Occurs constantly (100% of the time)
  • Cannot correct when prompted
  • Can be manually corrected with strong resistance or cannot be corrected

Knee Hyperextension

  • Knee locks backwards into extension
  • Excess muscle tone or weakness create knee hyperextension

Mild

  • Gentle knee extension: 0–2°
  • Occurs occasionally (less than 50% of the time)
  • Can correct when prompted
  • Can be manually corrected with mild resistance
JumpStart Bunny
JumpStart Bunny
Posterior strap
DAFO 4
DAFO 4
Posterior strap

Moderate

  • Marked knee extension: 2–5°
  • Occurs frequently (50% of the time)
  • Can improve when prompted
  • Can be manually corrected with moderate resistance
DAFO Tami2
DAFO Tami2
Free ankle
DAFO 3.5
DAFO 3.5
Moderately flexible strut
DAFO FlexiSport
DAFO FlexiSport
Moderately flexible strut

Strong

  • Significant knee extensions: 5° or more
  • Occurs constantly (100% of the time)
  • Cannot correct when prompted
  • Can be manually corrected with strong resistance

Excess Dorsiflexion/Crouching

  • Knees, and sometimes hips, remain flexed when standing or walking
  • Posture may be due to weakness or low muscle tone

Mild

  • Gentle excess dorsiflexion and knee flexion: 5–10°
  • Occurs occasionally (less than 50% of the time)
  • Can correct when prompted
  • Can be manually corrected with mild resistance
JumpStart Bunny
JumpStart Bunny
Wrap-around strap
DAFO 4
DAFO 4
Wrap-around strap

Moderate

  • Marked excess dorsiflexion and knee flexion: 10–15°
  • Occurs frequently (50% of the time)
  • Can improve when prompted
  • Can be manually corrected with moderate resistance
DAFO 3.5
DAFO 3.5
Semi-rigid strut
DAFO Flexisport
DAFO Flexisport
Semi-rigid strut

Strong

  • Significant excess dorsiflexion and knee flexion: 15° or more
  • Occurs constantly (100% of the time)
  • Cannot correct when prompted
  • Can be manually corrected with strong resistance or cannot be corrected

Positioning or Limited Ambulation

  • Foot and ankle positions are uncomfortable and limit function
  • Poor positions created by excess and unbalanced muscle tension

Mild

  • Accompanied by mild pronation/supination
  • Frequent assisted ambulation
  • Can be manually corrected with moderate resistance
JumpStart Bunny
JumpStart Bunny
Posterior strap
DAFO 4 Softy
DAFO 4 Softy
Posterior strap

Moderate

  • Accompanied by moderate pronation/supination
  • Occasional assisted ambulation
  • Can be manually improved
DAFO 3.5 Softy
DAFO 3.5 Softy
Moderately flexible strut

Strong

  • Accompanied by strong pronation/supination
  • Assisted transfers only; or non-weight-bearing
  • Cannot be manually corrected