Product Features and Benefits

• Truly custom functional brace
• Anatomically designed from the patient cast
• Enhanced comfort from orthopedic grade leathers allow for air exchange
• Heat thermo-moldable shell allows for easy spot adjustments
• Circumferential control provides stability with a lower height
• Disperses weight-bearing forces eliminating pressure points
• Lightweight and low profile, increases proprioceptive feedback for better balance and steadier gait
• Custom anterior tibial shell locks distal tibia, limiting sagittal plane excursion
• Range of motion control
• Protects surgical repair
• Superior reimbursement
• Industry best 5 day in-house fabrication turnaround time
• Semi-flexible design allows for bilateral use
• Allows normal function of healthy tissues to prevent atrophy
• Enhanced patient compliance

Clinical Indications

There are over 300 clinical diagnosis associated with the Stepwell Custom AFO including:

• Distal Tarsal Tunnel
• Posterior Tibial Tendon Dysfunction
• Arthritic ankle/midfoot
• Post-fusion of the foot and ankle
• Chronic instability of the rearfoot and midfoot
• Late effects of foot and ankle trauma
• Pes Cavus/Pes Planus deformities
• Diabetic/Charcot deformities
• Peroneal/Achilles tendonopathies
• Nerve entrapments of the foot and ankle

The Stepwell Custom AFO vs. Other Bracing Options

The flexible nature of the Stepwell Custom AFO allows the physician to approach patients who need a solution for more dynamic activities, who still have muscle function and variance in their posture. Rigid braces are for static postures, patients with little muscle function and that no correction is possible in their biomechanics.

The Stepwell Custom AFO is designed to address the patients’ specific diagnoses. The AFO is designed much like a surgeon would design a surgery, only locking the diseased portion of the foot while allowing normal function of the other joints. A rigid brace is unable to perform these tasks, as it attempts to immobilize ALL of the joints of the foot and ankle.

Stepwell Custom AFO (Ankle-Foot-Orthotic) Instructions

This is a general list of things to do and questions you may have about your Stepwell Custom AFO. At all times we are available to speak with your clinician about your specific needs. You should always follow the specific instructions provided to you from your healthcare professional.

Initially, the Stepwell Custom AFO should be worn for short periods of time. In this educational packet we have provided you with a suggested break-in schedule that your healthcare professional may modify depending on your clinical presentation and goals of your AFO therapy.

The AFO is designed in component sections and the use of each component is based on your occupational, home and recreational pursuits. Your clinician will determine the proper amount of time in each component/combination, determined by the stage of your medical condition.

The visual analog pain scale sheets provided in this packet, with check off sections, should be completed daily between your follow-up appointments. This log will be a useful tool for both you and your healthcare professional to discuss impressions you have regarding your therapy. In time, you will learn which component combinations are best suited to your functional activity demands.

If you notice any areas of irritation, such as red spots, blisters, or swelling, you should stop the use of the AFO and call your healthcare professional for further instruction.

It is recommended to always wear a sock the same height as your AFO to act as an interface between your skin and your AFO. Socks that have a seam should be turned inside out to avoid seam irritation, fit snugly, and not bunch to avoid creating an area of irritation.

The home scoring sheets provided to you will help form a dialog with your healthcare professional. You may discover that certain activities in your life may require the use of both AFO components during or after your activity to control and manage your functional demands. Your healthcare professional will be able to guide you on the length of time that is necessary for you to wear your device, as well as specific activities related to your medical diagnosis. Your healthcare provider will determine, based on your specific medical diagnosis, an appropriate follow-up appointment schedule. You should bring your AFO and daily patient logs with you to each appointment.

Realistic Expectations
The success of your AFO treatment depends greatly on you and your expectations. If you maintain your AFO in good condition, you can expect it to last for many years. As you age or face new physical demands, the needs of your foot and ankle may change. Follow-up visits with your healthcare professional may help control new foot and ankle problems before symptoms develop. Your foot and ankle problem took time to develop, so do not expect your symptoms to go away overnight. However, if you wear your AFO as instructed, your symptoms can lessen over time and healing can occur. Also, keep in mind that your AFO can help you move more comfortably, but that the structure of your foot and ankle has been unchanged. Also remember that your AFO will only work if you wear them, with clinical symptoms subsiding over time.

Follow-up Visits
Once you are wearing your AFO as directed, regular check-ups can help you maintain the health of your foot and ankle condition. As with contact lenses, your AFO prescription may change over time and your healthcare professional may recommend a new AFO. Children, athletes, and people with health concerns affecting the foot and ankle may require special care. Your healthcare professional will recommend a follow-up schedule to meet your individual needs. By controlling your foot and ankle movement, your AFO can make it easier to get on with your life and the activities that you enjoy. Help yourself keep this symptom-free pace by wearing your AFO as symptoms may exhibit themselves, and consulting with your healthcare professional on a regular basis.

Care of Your Stepwell Custom AFO
The Stepwell Custom AFO is made from structural leather, plastics and various foams, and they will not withstand submersion in water. If the AFO does become wet, simply let the device air-dry and do not attempt to speed up the drying process. Walking around the inside of your home is okay without shoes on, but when out in the community, footwear should be worn at all times to prevent premature wear of your AFO, as well as your safety.

If your AFO does not provide functional improvement for your medical condition within approximately 60 days, you must inform your healthcare provider and bring your AFO in for a follow-up appointment. If your AFO is providing necessary functional improvement to your specific medical condition, but showing wear, you should contact your clinician. Many times a simple refurbishment of an AFO component is all that is needed to extend the useful lifetime of your device.

Sock Selection
Socks should be worn at all times with your Stepwell Custom AFO. Comfortable socks should;

1. Fit smoothly against your foot, above your AFO and be snug. An athletic sock may be needed depending on the height of your device.
2. It is best if the socks are seamless, but if seams are present, please turn your socks inside out to prevent seam irritation.
3. Socks should not wrinkle easily since this can create a pressure point inside the AFO and cause an injury or discomfort.

Shoe Selection

1. Look for a shoe (discussion with your clinician is best) with a tongue that opens all the way, this is called an open-vamp shoe. This allows you to put the AFO into the shoe easily.
2. The AFO will function the best with a shoe that is new, has a large toe box and a stiff heel counter.
3. Changing to different shoes may affect the function of your AFO, as shoes can be constructed differently. Additionally, excessively worn shoes will not allow the AFO to function properly and can adversely influence the fit.
4. A shoe with a removable foot liner allows for more depth, if needed, to accommodate for the added volume of the foot with the AFO.
5. If possible, have your feet measured while standing on them, as the shoes you currently own may already be too short or too narrow to begin with, regardless of the addition of the AFO.
6. The lightest weight shoe will work the best, and usually a shoe with a stiff heel counter is ideal.
7. Remember, footwear is an integral part of the proper use of an AFO and can directly impact the functional success and symptom improvement for your medical condition.
8. Some popular shoe brands that work well with the Stepwell Custom AFO are: Brooks, Pedors, Orthofeet, Aetrex, and Drew.
9. It is best to wear the AFO when selecting shoes to ensure a proper fit. If you are using the AFO on only one foot, then you may find it necessary to only remove the shoe liner from that shoe, while keeping the shoe liner in the non-AFO side so you are “balanced” in height.

Your Healthcare Professional Knows Best

• Keep your AFO dry
• Tighten the AFO to maintain a comfortable snugness, and as swelling subsides, some AFOs may need to be tightened at Walkwell.
• Change and launder your socks on a regular basis

WARNING: ALERT!
If you notice any of the following, call your healthcare professional immediately:

• The AFO is “broken” (some creasing around the ankle is normal, acting as an “internal hinge”)
• You notice swelling above or below the AFO
• Your toes become discolored (red or white)
• Numbness occurs in your foot, ankle or toes
• You develop constant pain
• You develop a sore in your skin, a blister, or red irritation