anterior trim AFO's

anterior trim AFO's

BleakleyS

List members, I was hoping you could offer some advice.
I work with stroke pt's in a acute rehab setting ( often I week post)
Many of our folk need bracing for ankle and knee stability and we have been
using a lot of full control anterior trim afo's set in neutral. My question
is this: when we receive the afo it is set to true neutral (0 degrees),
however, when the shoe heel height is added, the tibia is advanced and we end
up with a brace set in apparent dorsiflexion ( in weight bearing) My problem
is that many of my pt's are not benifiting from the knee stability because
they are getting a flexion moment at the knee at initial contact instead of
the desired extension one? Also in static stance, the AFO causes the knee to
flex in order for the foot to be in full contact with the floor.
I was wondering if anyone else is having similar problems and how best to
address them.
Thanks in advance for your time
Scott Bleakley, MSPT