SAFO: The versatile drop foot orthosis

Since its founding in 1989, Dorset Orthopaedic has established itself as one of the UK’s leading prosthetic and orthotic providers.

The company operates five clinics across the country, catering to clients with a diverse range of needs.

SAFO (Silicone Ankle Foot Orthosis) is one of Dorset Orthopaedic’s most popular products.

The award-winning drop foot solution has helped countless stroke survivors lead full, active lives.

Dorset Orthopaedic orthotist Kim Pickering explains how drop foot affects stroke survivors.

“Drop foot is basically a weakness in the dorsi flexors – the muscles that bring the foot up. It can often be combined with weaknesses in the inverters or evertors, too.

“Drop foot is linked to multiple conditions, such as MS, Charcot Marie Tooth, spinal cord injuries and, of course, stroke.”

The condition is fairly common, with around 20 per cent of all stroke survivors unable to properly lift their foot when walking, often dragging it along the ground.

Drop foot can have a huge impact on day-to-day life. Activities like exercise, socialising and work are severely affected.

Kim, who is based at the Ringwood clinic, explains:

“The condition varies in severity, from very mild to severe.

“In severe cases, it impacts on everything there’re doing so they rely on their SAFO quite considerably.”

SAFO is a pure silicone orthosis which is strengthened along the front of the leg and down the top of the foot.

This prevents the foot from dropping down as the leg swings forwards or backwards.

SAFO is custom-made for each client.

The orthosis was traditionally made using a plaster cast. But Dorset Orthopaedic is now moving into 3D scanning to make fitting and duplicating a SAFO more convenient for the technician and the client.

Appearance is important for clients wanting to incorporate a SAFO into their lives.

The original SAFO Classic was designed with discretion in mind. The silicone material and natural colour make it almost indistinguishable from skin.

However, many clients like to get creative, opting for designs that reflect their personality.

“We have lots of different skin tones that we can colour-match to the client if they’re looking for a cosmetic look,” Kim says.

“As lot of our technicians are artists, we can do tattoo designs, football club crests – all kinds of things in different colour combinations.”

In recent years, SAFO has evolved to appeal to clients’ diverse lifestyle preferences beyond just the aesthetic.

The SAFO Sport, for example, offers additional support for high-impact activities.

“Some of our more able patients were running in their SAFOs. So we designed the SAFO Sport, which has reinforcement going down the front,” Kim says.

“It works like a bow that compresses when the foot lands on the floor and then extends as they take off.

“It’s just a little bit more of a dynamic splint and a little bit tougher than our standard SAFO.”

The SAFO has proven hugely popular among the stroke community, with many reporting that they ‘couldn’t live without it,’ Kim says.

The comfortable fit means patients can wear the SAFO for longer amounts of time than with other solutions.

“Some patients come to us after not having used their splints because they’re so uncomfortable. Lots of people really struggle with walking until they start using a SAFO.”

The SAFO is just one of countless drop foot solutions out there, with Dorset Orthopaedic offering a wide range of AFOs made using different materials and supports.

The company also offers functional electrical stimulation (FES) devices, which stimulate the nerve to lift the foot.

The best way for clients to find what works is to visit a clinic and try the products for themselves.

David Coggle

“We have different surfaces, slopes and cambers for them to walk on to really see whether a SAFO is going to work for them.

“I always encourage anyone that comes in to try all the samples on and see what they think.”

A SAFO from Dorset Orthopaedic has helped David Coggle get back on his feet.

David Coggle survived a massive basal ganglia bleed in December 2021, finally making it back home in May following intensive rehab.

David’s wife Jennifer explains:

 “We felt that investing in SAFO would be a good idea, because David wanted to get back to doing the activities he used to as best he could. So we went over to Dorset Orthopaedic to be measured up.

“In the past few weeks, the only way he’s been able to get around is with the SAFO. If we hadn’t had it, he would have been back in a wheelchair.

“Just this morning, he’s been curling at a local bowling club in his SAFO.”

This is an excerpt from our Special Report – Innovations in Stroke