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.
How to Use this Guide:
- 1. Find your patient group
- 2. Match the level of involvement
- 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
Wrap-around strap
DAFO 4
Wrap-around strapStrong
- 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
Free ankle
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
Wrap-around strap
DAFO 4
Wrap-around strapModerate
- 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 3.5
Very flexible strutStrong
- 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
Semi-rigid strut
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
Moderate
- Ankle plantarflexion: 0–2°
- Occurs frequently (more than 50% of the time)
- Can improve when prompted
- Can be manually corrected with moderate resistance
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 hyperextension: 0–2°
- Occurs occasionally (less than 50% of the time)
- Can correct when prompted
- Can be manually corrected with mild resistance
Moderate
- Marked knee hyperextension: 2–5°
- Occurs frequently (more than 50% of the time)
- Can improve when prompted
- Can be manually corrected with moderate resistance
Strong
- Significant knee hyperextension: 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
Wrap-around strap
DAFO 4
Wrap-around strapModerate
- Marked excess dorsiflexion and knee flexion: 10–15°
- Occurs frequently (more than 50% of the time)
- Can improve when prompted
- Can be manually corrected with moderate resistance
DAFO 3.5
Semi-rigid strut
DAFO FlexiSport
Semi-rigid strutStrong
- 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
Moderate
- Accompanied by moderate pronation/supination
- Occasional assisted ambulation
- Can be manually improved
DAFO 3.5 Softy
Moderately flexible strutStrong
- Accompanied by strong pronation/supination
- Assisted transfers only; or non-weight-bearing
- Cannot be manually corrected
