PRAFO® Orthosis for Pressure Relief of the Ankle and Foot


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PRAFO® Orthosis for Pressure Relief of the Ankle and Foot

General Description:

A PRAFO® is a device that is worn on the calf and foot similar to a boot and is often used for patients that spend the majority of their time in bed.

One reason for its use is to prevent bedsores or ulcers from developing on the back of the heel. A bedsore or decubitus ulcer is caused by constant pressure on the back of the heel that can occur when lying in one position for prolonged periods of time. A PRAFO® orthosis creates air space around the back of the heel, alleviating pressure and preventing heel ulcers.

A second reason for the use of a PRAFO® orthosis is to position the foot. While lying down, a person usually has the foot pointed downward at the ankle and this is called plantar flexion. This is not a problem for short intervals, but muscle tightness develops when the foot is not ranged upward at the ankle (dorsiflexed). The result is that deformities can develop called contractures.

When a plantar flexion contracture develops, the normal range of motion is lost and the person will not be able to flex the foot upwards. If it becomes severe enough, the person will only be able to stand on the forefoot with the heel off of the ground.


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  1. With most patients, range the foot into dorsiflexion to at least a neutral position. This means to bring the foot upward so that the bottom of the foot is perpendicular to the lower leg (see figure 1). This is the normal procedure. If your healthcare provider does not want the foot to be ranged in this manner, other instructions will be provided.
  2. Place the lower leg in the device with the foot in full contact with the footplate and the calf in even contact with the calf section (see figure 2). The PRAFO® orthosis can also be applied with the knee bent, pushing the foot downward and back fully within the device.
  3. Secure the straps over the foot and then secure the top calf strap (see figures 3 and 4).
  4. Finally, make sure that the heel is fully suspended in the air and that it is not in direct contact with the device (see figure 5). If it is, the device may not have been put on properly. If you are not able to do this correctly, contact your practitioner.
  5. This device has an outrigger attached to the back of the calf section to prevent the leg from rolling to one side or the other. If instructed to use it by your healthcare provider, simply rotate it out in the direction the leg has a tendency to turn toward (see figure 6).

PRAFO® Orthosis for Pressure Relief of the Ankle and Foot - Figure 1

PRAFO® Orthosis for Pressure Relief of the Ankle and Foot - Figure 2

PRAFO® Orthosis for Pressure Relief of the Ankle and Foot - Figure 3

Care and maintenance:

The PRAFO® device’s liner can be removed and washed at a temperature below 150 degrees and dried using a cool low setting. When removing the liner, pay careful attention to how it was installed. This will make reinstallation easier.

Tips and problem solving:

If you encounter any problems with the PRAFO® orthosis or develop any pressure points or discoloration, contact your practitioner.

If you experience any problems, please contact your Orthotist.