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HKAFO

An HKAFO (Hip-Knee-Ankle-Foot Orthosis) is a full-leg brace designed to support and stabilize the lower limbs and hips for individuals with significant muscle weakness or paralysis, enabling improved standing and walking ability.

What Is an HKAFO?

An HKAFO is a full-leg orthotic device designed to provide support, stability, and alignment from the foot all the way up to the hip. It is commonly prescribed for individuals who have paralysis, muscle weakness, or neurological disorders that impact the ability to stand or walk independently.

Who Uses an HKAFO?

This brace is typically used by individuals with:

  • Spinal cord injuries
  • Spina bifida
  • Cerebral palsy
  • Polio or post-polio syndrome
  • Muscular dystrophy
  • Severe muscle or nerve damage affecting lower limbs

Parts of an HKAFO

  • Footplate or shoe insert: Provides base support
  • Ankle-foot orthosis (AFO): Stabilizes the ankle and foot
  • Knee joint and uprights: Keeps the knee locked or controlled during motion
  • Thigh cuff: Wraps around the upper leg for support
  • Hip joint and pelvic band: Controls hip movement and links both legs, sometimes with a pelvic girdle
  • Straps and buckles: Help secure the brace in place

Purpose and Benefits

  • Promotes upright posture
  • Assists with ambulation (walking)
  • Reduces the risk of joint contractures or deformities
  • Provides stability for transfers (e.g., wheelchair to bed)
  • Improves alignment of lower limbs
  • May delay or prevent the need for surgery in some cases

Limitations

  • Bulky and heavy: Can be difficult to put on or wear for long periods
  • Energy-consuming: Walking with an HKAFO takes significant effort
  • May require assistive devices (like crutches or walkers) to walk safely
  • Limited mobility compared to powered orthoses or prostheses
  • Not suitable for everyone—depends on upper body strength and endurance

Training and Rehabilitation

  • Users often go through physical therapy to learn how to:
    • Stand, balance, and shift weight properly
    • Walk with assistive devices
    • Develop strength and endurance
  • Therapy focuses on gait training, core strengthening, and compensatory strategies

Custom vs. Prefabricated

  • Custom HKAFOs are tailored to an individual's body and specific needs.
  • Prefabricated options may be used temporarily or for general support but are less precise in fit.

Alternatives and Adjuncts

  • KAFO (Knee-Ankle-Foot Orthosis): When hip support isn't needed
  • RGO (Reciprocating Gait Orthosis): A special type of HKAFO that uses a cable system to help with a more natural walking motion
  • Powered exoskeletons: Used in some rehab settings, but still limited in everyday use