Ankle-foot orthoses (AFOs) are a common tool in the CMT toolkit. If you have foot drop, weak ankles, or a tendency to trip or roll, chances are someone has fitted you for braces at some point. Yet, research on whether AFOs actually improve walking in CMT has been surprisingly thin, showing small effects, or none at all.
In a new study, Dutch researchers found that AFOs can measurably improve how people with CMT walk, but it depends on how the braces are chosen and fitted.
The team evaluated 48 adults with CMT using detailed assessments of muscle strength, walking speed, and energy expenditure. They also conducted a 3D analysis and met with participants to discuss their personal goals.
After the evaluation, participants received a customized brace tailored to their specific needs. Some study participants were new to braces, while others were already wearing a standard AFO. At five months, the team re-evaluated participants and noted their findings.
Better-fitting braces key to walking improvements
For the group as a whole, the customized braces delivered gains across the board:
- Walking speed rose about 8%
- Energy expenditure dropped about 4%, meaning walking took less effort
- Perceived walking ability improved, with participants reporting they’re feeling more stable and confident on uneven ground
People who had never worn braces improved the most broadly. They walked about 9% faster, used roughly 10% less energy, and improved on nearly every perceived walking measure. People who were already wearing a standard AFO also improved. This group posted a bigger jump in walking speed (around 11%), but their walking efficiency didn’t change significantly, and fewer of their perception measures shifted.
Most participants met at least one personal goal, such as walking farther, standing longer, or moving with less pain.
Why the fit may make the difference
The researchers believe the customized braces achieved these positive results because they were more supportive and better matched to each person’s specific needs, rather than pulled from a standard size range.
Because many people with CMT have weakness not just lifting the foot, but pushing off and controlling the ankle during each step, a flexible, off-the-shelf brace may not provide enough support. According to researchers, the custom braces resisted ankle movement more, helping people roll through each step more smoothly, take longer strides, and walk faster with less effort. They concluded that improved ankle mechanics even in people who already had braces suggests their previous AFOs simply weren’t optimized for what their legs needed.
The study found no change in fatigue or overall physical functioning.
Don’t settle for AFOs that are “just okay”
A brace that once suited you might no longer be ideal. Since CMT can change over time, a brace that fit well years ago might not align with your legs now. The study indicates that individuals with more precisely fitted braces experienced significant improvements.
If your AFOs feel “just okay” or are outright uncomfortable, it may be time to get re-evaluated. Other reasons to get evaluated: It’s been a long time since your last one, you’re tripping or tiring more, or you’ve never had a detailed gait assessment (where they watch and measure how you walk).
Take notes on what you want to improve before you go. Do you want to walk faster? Be more stable? Have more confidence on uneven terrain? Also note where your current brace falls short — when you feel unstable or catch your toe, and where it rubs or pinches. Be honest about comfort, because a brace only helps if you’ll wear it. The more specific you are about what’s not working, the better your orthotist can customize the fit or design.
You don’t have to figure this out alone. Our Bracing and Orthotics hub explains the process in more detail. CMTA Centers of Excellence directory can connect you with clinicians who know CMT, and our private Facebook group is full of people swapping tips on finding braces that work for them.
Your braces should help you go farther with less effort and feel steadier doing it, not just get you out the door. This study shows that it may be worth making sure they do.
The information provided here is for informational purposes only and does not constitute medical advice. The CMTA does not endorse any specific products or treatments for CMT. Please consult your doctor before making any healthcare decisions.
