Getting the Most Out of a DAFO

In addition to wrap-around support, flexibility and ultra-fine foot definition, Cascade products excel in their ability to be tweaked to increase their desirable effects. We call these tweaks “Optimizations.” Here’s a collection of optimizations for our braces, organized by the challenge to be met. This collection is just a subset of the optimizations available. For a full listing, check the Technical Support section of our website, cascadedafo.com. If you have any questions about whether or how to use these optimizations, ask Tech Support (technicalsupport@dafo.com or 800/848-7332.) Notes– Optimizations are grouped by issue (e.g., pronation) and sequenced with most common first. Don’t optimize unless you’re certain that the standard brace is not effective enough. Our products are based on using the least amount of support to get the job done.

Pronation ST support For maintaining heel alignment of a pronator. Sustentaculum Tali support—Type 1 is built into the plastic of the brace. Type 2 consists of dense foam that fills the ST cavity. Request Mild, Moderate or Strong with order.

Varus forefoot posting Helps maintain vertical heel by stabilizing forefoot in varus position. Dense foam bottom treatment under brace, typically 1/8 – 1/4 in. high. Request with order.

Soft lateral toe containment Where correctable forefoot abduction is a problem, helps keep toes aligned yet allows toes to extend normally during gait cycle. Medium density foam toe enclosure. Request with order or add as adjustment.

Arch fill or midfoot stabilization Where arch collapse is a concern. Dense foam bottom treatment under brace, filling in space below medial longitudinal arch. Request with order or add as adjustment.

Shim pad (lateral) For nudging leg away from side of DAFO 4 to help with alignment. 3-in.-wide linear pads, 1/4-in. thick at the top edge, tapered to 0 at the bottom edge. Request with order or add as adjustment.

Supination Soft medial toe containment Where correctable forefoot adduction is a problem, helps keep toes aligned yet allows toes to extend normally during gait cycle. Medium density foam toe enclosure. Request with order or add as adjustment.

Valgus forefoot posting Helps maintain vertical heel by stabilizing forefoot in valgus position. Dense foam bottom treatment under brace that is typically 1/8 - 1/4 in. high. Request with order.

Shim pad (medial) For nudging leg away from side of DAFO 4 to help with alignment. 3-in.-wide linear pads, 1/4 in. thick at the top edge, tapered to 0 at the bottom edge. Request with order or add as adjustment.

Excess PF Heel pillow To help hold the heel down below the foam ridge. Inverted horseshoe shaped foam pads pulled into brace at fabrication. Request with order.

Heel control strap To prevent heel rise. Strap that catches the proximal posterior curve of the calcaneous, preventing heel rise. The strap goes through the Achilles area across the inside of the brace at the proximal heel and fastens at the outside of the brace with hook and loop. Request with order or add as adjustment.

Adjustable PF stop (motion limiter) Rubber-covered adjustable screw to stop PF in a range of 3–5°. For example, a lowest setting of 90° (0°) can increase to a maximum range of motion of 5° by adjusting screw upward.

Heel wedge For patients with a lack of DF range of motion who are consistently weight bearing. Dense foam bottom treatment typically used to bring brace plantarflexion to an angle in relation to the floor that will facilitate standing and walking. Request with order.

Mild PF Inside-outside strap (Bunny-style) For mild PF resistance and DF cueing, to cup lower leg inside of brace. Posterior strap for SMO designs (DAFO 4, JumpStart Bunny). Strap attaches with Velcro hook on outside of “ears”. It runs behind the leg and back outside to the other ear. A DAFO 4 will need to have a higher posterior for the strap base. Request with order.

Excess DF Check strap Posterior strap added to hinged brace style to stop motion into DF beyond the point where the strap is set. Usually made of Dacron and Velcro sewn together for strength. Fastens together with hook and loop; adjustable. Also available in heavy duty elastic version. Request with order.

Boney Foot PPT padding To pad boney areas like the navicular or base of the 5th metatarsal bones. Closed cell foam adds cushioning but does not maintain compressed shape: returns to original thickness after compression. Request with order.

Plastizote padding For boney areas like malleolar or 1st MP joint. Open cell foam compresses to fit around boney prominences. Can “bottom-out;” retains compressed shape. Request with order.

Softy liner For resting splints, sensitive skin conditions or boney surface anatomy. Dense foam liner used inside plastic outer frame. Downside is added bulk; for reduced bulk, use the polyethylene liner. Request with order.

Polyethylene liner For comfort through a soft, pliable plastic interface, more stability and less bulk. Allows thin, light, full wraparound alternative to Softy liner. Thin, soft plastic inner liner used with lower-profile plastic outer frame. Request with order.