AFO (Ankle-Foot Orthosis) Management -Optimizing Functional Gait Biomechanics & Outcomes – Vibhor Agrawal



AFO (Ankle-Foot Orthosis) Management -Optimizing Functional Gait Biomechanics & Outcomes – Vibhor Agrawal


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AFO (Ankle-Foot Orthosis) Management -Optimizing Functional Gait Biomechanics & Outcomes by Vibhor Agrawal,
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Vibhor Agrawal
4 Hours 45 Minutes
Audio and Video
Aug 18, 2017


Over the past several years, ankle foot orthoses (AFOs) have evolved in form, function, and complexity. They are no longer simple plastic devices that are beneficial only during the swing phase of gait. The newer designs incorporate the biomechanical principles of closed-kinetic chain to enhance joint and muscle function for improved gait and mobility.

Recent scientific evidence has demonstrated the advantages of AFOs for improving functional outcomes in patients with stroke, cerebral palsy, multiple sclerosis, and more. As therapists are constantly looking for ways to maximize patient function and increase revenue, it is critical to keep up with the recent developments in the field for optimizing outcomes. 

This course will provide effective strategies for clinical management of AFOs. You will delve into the biomechanics of closed-chain gait, and to understand its effect on joint motion and muscle function. You will learn how to integrate gait biomechanics with muscle function and AFO design to enhance outcomes in adult and pediatric patients. Explore the different types of AFOs and become well-versed on the most recent evidence covering intervention strategies and clinical management of AFOs.

Discuss the appropriate outcome measures to detect clinically meaningful differences in patients following an intervention. Learn the tips for billing and documentation to maximize returns. The information obtained in this course can be easily implemented in the clinic immediately for enhanced outcomes.




  • Current gait terminology
  • Open-chain vs. closed-chain muscle function
  • Four foot rockers
  • Ankle joint and muscle function during gait
  • Gravitational and ground reaction forces at the foot, ankle, and knee

Review of the most current scientific literature of the following pathologies:

  • Stroke
  • Sensory perception loss
  • Cerebral palsy
  • Charcot-Marie-Tooth disease
  • Other neuromuscular conditions


  • Review of the existing outcome measures
    • 6MWT
    • 10 meter walk test
    • Functional Independence Measure
  • Scandinavian Stroke Scale
  • Minimal detectable change with AFO
  • Minimal clinically important difference in these measures


  • Review of the different types of AFOs
    • Solid-ankle AFOs
    • Articulated AFOs
  • Biomechanical influences of AFOs on a patient’s gait
  • The impact of AFOs on joint and muscle function
  • Indications and contraindications of each type of AFO
  • Differentiating between over-the-shelf and customfabricated AFOs


  • CP
  • MS
  • Selecting the appropriate AFO


  • Patient evaluation
  • Taking appropriate measurements
  • Ensuring a good fit
  • Do’s and Don’ts of AFO fitting
  • Signs and Symptoms of incorrect fit
  • Providing instructions at delivery
  • When to refer the patient to a specialist
  • Follow-up
    • Biomechanical evaluation at subsequent visits
    • Knowing when to change the AFO treatment plan


  • CPT codes for billing for time and expertise
  • L-codes for reimbursement for the AFO
  • Documentation requirements
  • Maximizing revenue with AFOs


Vibhor Agrawal, PhD Related seminars and products: 1

VIBHOR AGRAWAL, PhD, is a professor of Physical Therapy at the University of Miami, where he teaches courses on gait and biomechanics. He has an extensive research background in gait and movement biomechanics, with more than 50 published papers and abstracts in national and international peer-reviewed journals. He regularly presents at conferences and reviews for leading rehabilitation journals. He is an associate editor for the journal Prosthetics Orthotics International, an executive member of the International Society for Prosthetics and Orthotics and on the Board of Directors for the Orthotics & Prosthetics Activities Foundation.

As an entrepreneur, and founder of Enability LLC, Dr. Agrawal has dedicated himself to enabling individuals with disabilities through knowledge, service, and research. He also provides consulting services to corporate organizations in the design and development of assistive devices, clinical research, and education.

Speaker Disclosures:

Financial: Vibhor Agrawal is a professor at the University of Miami. He receives a speaking honorarium from PESI, Inc.

Non-financial: Vibhor Agrawal is on the Board of Directors for the Orthotics & Prosthetics Activities Foundation.

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