What addition can be made to an AFO to decrease excessive pronation?

The addition of an extrinsic medial wedge to an ankle-foot orthosis (AFO) is an effective method to decrease excessive pronation. This type of wedge is specifically designed to provide additional support to the medial side of the foot, which helps in redistributing weight and aligning the foot more favorably. By creating this supportive surface, it encourages the foot to more effectively resist the inward rolling motion associated with pronation, promoting a more neutral alignment.

The extrinsic medial wedge is particularly useful because it allows for adjustment in the orthotic design without modifying the shoe or footbed structure. Its placement helps facilitate a more stable support during gait, potentially reducing the risk of further issues related to pronation, such as strain on the ligaments and muscles of the lower extremity.

In contrast, other options like a medial heel wedge or soft footbed may not provide sufficient correction for excessive pronation, as they may only address foot positioning rather than the underlying dynamics of the gait. A posterior heel cup primarily stabilizes the heel rather than directly influencing the medial aspect of the foot where pronation occurs. Thus, the extrinsic medial wedge provides a targeted solution for managing excessive pronation in patients using an AFO.