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Bracing. Wearing an ankle-foot orthosis (AFO) can help stretch and lengthen muscles and tendons. An AFO is a plastic brace that extends up the back of the lower leg and holds the foot at a 90 angle. Typically, bracing is performed for a longer period of time than casting (months rather than weeks).
Treatment Plan: A toe walking SMO is a variation of a supramalleolar orthosis with no cut-out for the Achilles tendon and a short extension of the posterior trim line to serve as a kinesthetic reminder during gait to induce proper biomechanics.
Supramalleolar orthosis is prescribed for them to improve their walking and to help increase their tone. Babies and toddlers with Downs Syndrome, Cerebral Palsy, gross motor delay and such conditions which result in hypotonia often need to wear the SMO brace.
SMOs are most often worn by kids who pronate. This is also called walking flat footed. The braces guide feet into proper alignment while also helping your child feel more confident and stable.
Supramalleolar orthosis is prescribed for them to improve their walking and to help increase their tone. Babies and toddlers with Downs Syndrome, Cerebral Palsy, gross motor delay and such conditions which result in hypotonia often need to wear the SMO brace.

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Wearing Schedule Day 1: Only use the SMOs for one hour. Day 2: Use the SMOs for two hours, one hour in the morning and one hour in the afternoon. Day 3: Use the SMOs for four hours, two hours in the morning and two hours in the afternoon.
Physical therapy to stretch the Achilles tendon and calf muscles, splints or leg braces to promote a normal gait, or a series of casts to progressively relocate the toes toward the shin may all be effective treatments if its discovered that a physical condition is the cause of the patients ITW.
Supramalleolar orthosis is prescribed for them to improve their walking and to help increase their tone. Babies and toddlers with Downs Syndrome, Cerebral Palsy, gross motor delay and such conditions which result in hypotonia often need to wear the SMO brace.
If your child has a hard time walking due to loose ankle joints, an SMO may help give them enough external support to make walking easier and more efficient. If your child spends most of their time in a wheelchair, an AFO may help position their feet comfortably on the footrest.
Supramalleolar orthoses (SMO) are a form of ankle-foot orthosis (AFO) for children, which is a medical device to help guide the gait development of a child. Unlike the AFO, SMOs support extends just above the ankle bones (malleoli) and is less visible when worn in shoes.

justification letter from doctor