Can I walk safely in a PRAFO?
This is a question that we are often asked. The short answer is yes, you can walk in a PRAFO (Pressure Relief Ankle Foot Orthosis). The PRAFO is an orthotic device family that is designed to provide complete relief from pressure or shear at the vulnerable heel area whether the user is in bed or walking around. Pressure ulcers represent a big problem for the NHS and protection from pressure and shear is key to prevention, or when things go wrong, to accelerate healing.
However, each PRAFO in the range offers much more than pressure relief though and this is essential to facilitate continuity of care. Continuity of care is an important part of the rehabilitation process and that is why our PRAFOs are designed so that the user can walk in them. If a product allows pressure protection but does not support the next step in the rehabilitation process then a different product would be required which necessitates further cost and inefficiency.
The range of PRAFOs offers full support to the foot and ankle, adjustability and features that are optimised for walking. This allows a wearer to get up and move around with complete trust in the device’s protection for pressure relief, or depending on their condition, heightened support during activities.
By integrating a PRAFO orthosis into the daily routine the user will benefit from improved mobility and confidence while maintaining adequate protection from pressure-related issues.
The short video below shows the typical fitting process for a PRAFO ankle foot orthosis
Types of PRAFO
There are several designs of the PRAFO with different levels of adjustment, to suit adults, paediatric users and infants and there are also some specialised versions. The family share some similarities in terms of benefits and features.
For example, the following adult versions allow various levels of adjustment that can be used to accommodate deformity or optimise walking ability.
Three of the products in the PRAFO range
650SKG - adjustment of dorsiflexion/plantarflexion (foot and ankle angle) using orthotic bending irons. This was the original version still favoured by many clinicians
652SKG - allows adjustment of dorsiflexion/plantarflexion with a screwdriver (The so called ‘APU’)
653SKG - allows both dorsiflexion/plantarflexion and valgus/varus adjustment (The so called ‘Dual Action’)
655SKG - allows simple adjustment in all three possible planes of motion (The ‘Tri-planar’ orthosis)
The 752SKT Bariatric product shares the features of the range with a larger structure and heavy duty components
654SKG - Dynamic Dorsiflexion Assist provides a stretch to combat contractures and inversion/eversion control. This is a very important version when for example, post-stroke, the patient is at risk of developing a ‘foot drop’. If this is allowed to develop then mobilisation can be delayed which is a serious blow to progress in rehabilitation.
The 752SKT is a bariatric version of the PRAFO that features adjustable dorsiflexion/plantarflexion. This unique product is equipped as standard with a synthetic "sheepskin" liner for enhanced tissue protection with the large user in mind.
Why you can walk in a PRAFO
As we indicated at the start of this article a user of a PRAFO is able to walk safely wearing the product which is not the case with all "pressure relief" products. The PRAFO range all feature a metal upright structure that, depending on the weight of the user could be an aluminium alloy or steel component. This is important as it allows the product to best manage the natural loads that arise when walking. This structure is unique to the trademarked PRAFO range and allows the walking base to be firmly attached to the structure. Some competitor designs may appear to offer similar features but they will only provide a plastic upright structure that will flex during walking and the walking base would typically be attached using velcro.
The Pad and Strap liner option enhances the control of the foot and ankle
With some versions of the PRAFO, an alternate liner system is available. The Pad and Strap kit can replace the standard Kodel liner and can allow a secure connection to the user's foot and ankle. This can provide a superior connection between the brace and the user when the intention is to extend the degree of mobility to be achieved. It can also be used when bulky wound dressings make it difficult to use the Kodel liner.
When using this type of orthosis, it's important to talk to your orthotist, physical therapist or another knowledgeable clinician to make sure it's appropriate for your needs. They can also provide instructions on how to properly wear and adjust the device. With proper use, a PRAFO can significantly reduce the risk of pressure ulcers, assist healing if necessary and improve mobility while maintaining functionality during daily activities.
We are always available to guide you to the best product for your needs. You may also find our quick device chooser to be helpful.