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A patient with PTTD came in wearing these nifty devices and swears that they are "the only thing that has helped her so far". Of course she will not wear a brace and her ortho referred her in with a script for orthoses.
They are interesting to say the least but the on inspection of the shoes the only thing that I could glean from them having no practical experience with them is that they have a rather rigid shank and sole, wedging (determined by some unknown sort of pressure may system) and the heel is slightly elevated. I can see how these alone would help a PTTD patient.
I wonder does anyone here speak Hebrew? Their website is only in Hebrew unfortunately
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"If we all worked on the assumption that what is accepted as true is really true, there would be little hope of advance." - Orville Wright
A patient with PTTD came in wearing these nifty devices and swears that they are "the only thing that has helped her so far". Of course she will not wear a brace and her ortho referred her in with a script for orthoses.
They are interesting to say the least but the on inspection of the shoes the only thing that I could glean from them having no practical experience with them is that they have a rather rigid shank and sole, wedging (determined by some unknown sort of pressure may system) and the heel is slightly elevated. I can see how these alone would help a PTTD patient.
I wonder does anyone here speak Hebrew? Their website is only in Hebrew unfortunately
It is an interesting "system" in terms of changing the location of center of pressure under the foot. The two websites did not mention how the decision is made to move the "balls" under the shoe to a different location. Now, in a PT dysfunction patient, if you moved the "balls" more medially, you would decrease the pronation moment from the ground and this could certainly help someone with PT dysfunction almost as much as wedge placed in the shoe. And only at $3000 per treatment (shoes + office visits for "adjustments").
Knee osteoarthritis can also be helped by placing a wedge in the shoe or changing the location of center of pressure under the foot. So, the shoe could be working through that mechanism as well.
It looks just like a very thin metatarsal bar. It's amazing what you can get patents for. The metatarsal bar effect could help forefoot pain as it creates a rocker bottom under the shoe and rocker bottoms can decrease forefoot pressure.
I wonder if you have to take out a liability policy for when people trip or slip while wearing these shoes that you prescribe for them?
Thank you for your insights. I also gleaned that the medial location of the "balls" would cause an that effect was similar to medial wedging by decreasing pronation moments (yes Kevin I have read your papers again!). I believe that there is a much more effective method to achieve this with a UCBL in her case.
I can also understand the simile to metatarsal bars but wonder why the heavy price tag? It seems that no one is really familiar with this shoe, maybe one of the companies reps will read this and explain further
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"If we all worked on the assumption that what is accepted as true is really true, there would be little hope of advance." - Orville Wright
The purpose of this study is to examine (retrospectively) the effect of a new biomechanical device on gait patterns of patients suffering from musculoskeletal disorders. The analysis is conducted on an existing database of the therapy center.
Quote:
Patients treated in the therapy center undergo a computerized gait test and complete several pain and function questionnaires at fixed time point. We examined the effect of the treatment on the level of pain, function and quality of life as well as on the gait patterns of these patients. Measurements were taken at baseline, after 3 months, and after 6 months.
The important point is that the product is not just simply about obtaining the shoes; a few months of periodic comprehensive clinical follow-up analysis/adjustment is required until permanent success has been reached.
In short:
People, particularly but not exclusively the elderly, tend to seek out the shoe for pain relief. More dramatically, on the APOS home web site, there had been movie clips documenting patients of all ages recovering from serious medical maladies, without the need for surgery (, most prominently the avoidance of ACL/MCL surgery.) It's been reported that a number of European athletes have been treated at the Israeli home clinic.
Quote:
Originally Posted by David Wedemeyer
I wonder if anyone has any experience with this shoe for knee OA:
A patient with PTTD came in wearing these nifty devices and swears that they are "the only thing that has helped her so far". Of course she will not wear a brace and her ortho referred her in with a script for orthoses.
They are interesting to say the least but the on inspection of the shoes the only thing that I could glean from them having no practical experience with them is that they have a rather rigid shank and sole, wedging (determined by some unknown sort of pressure may system) and the heel is slightly elevated. I can see how these alone would help a PTTD patient.
I wonder does anyone here speak Hebrew? Their website is only in Hebrew unfortunately
Just the latest update on the APOS system - BUPA are, apprently, funding the treatment with them....despite not funding anything else to do with shoes and orthoses...you can see from the website www.apostreatment.co.uk that they are now 'in association with BUPA' .....I wonder how much money they are making out of this???!!!!
48. THE EFFECT OF A NOVEL DEVICE AND TREATMENT METHODOLOGY ON KNEE OSTEOARTHRITIS : A DOUBLE BLIND, RANDOMIZED, PROSPECTIVE STUDY
Y. Bar Ziv; Y. Beer; Y. Ran; S. Benedict; and N. Halperin
Dept. of Orthopedics, Assaf Harofeh Medical Center, Zerifin, Israel
Background: During the past decades many treatments and devices were developed in attempt to unload the diseased articular surface in knee Osteoarthritis (OA). A novel biomechanical device and treatment methodology (The APOS System) was introduced in order to unload the diseased articular surface during activity (dynamic wedging), strengthen dynamic stabilizers and train neuromuscular control by means of controlled biomechanical perturbations. The purpose of this study is to examine the effectiveness of APOS System in reducing pain and improving function in knee OA patients.
Method: A double blind, randomized, prospective study was performed with 61 knee OA patients, aged 49–83 (66 ±8.1) years and graded 1–4 (3 ±1) according to Kellgren & Lawrence. Patients were randomized into research (active) and control (placebo) groups. All patients under-went 8 weeks of treatment. Patients were examined at baseline and supervised 4 times during the study. Patients in the research group used the biomechanical device that consists of 2 biomechanical elements located under the strategic weight bearing spots of each of the patient’s feet and a mounting and positioning mechanism embedded in designated shoes. The treatment methodology that was applied to the research group included dynamic wedging of the diseased articular surface. Patients in the control group used a placebo device without the biomechanical elements. Patients were assessed at baseline, after 4 weeks and after 8 weeks at the end of the study using Knee Society Score, WOMAC, SF-36, ALF and VAS. The assessment was performed without the examiner knowing the group affiliation of the patient.
Results: The two groups were statistically similar (p>0.05) at baseline with respect to age, Kellgren&Lawrence classification and all assessed parameters including subscales. Significant difference between groups over time was observed for Knee Score (p<0.001), Knee Society Function Score (p<0.001), WOMAC (p<0.001), SF-36 (p<0.001), ALF (p<0.001) and VAS (p<0.001). Significant improvement was observed in the research group throughout all assessed parameters (measured improvement for Knee Score, Knee Society Function Score, WOMAC, SF-36, ALF and VAS were a multiplication of 1.8, 1.4, 3, 1.4, 1.35 and 2 in the applicable scale respectively). A slight deterioration was observed in the control group throughout all assessed parameters at final assessment.
Conclusion: The findings demonstrate that APOS System is effective and significantly improves function and reduces pain among knee OA patients.
Correspondence should be addressed to: Orah Naor, IOA Secretary and Co-ordinator (email: ioanaor@netvision.net.il)
Now i'm a bit peeved, Bupa would hardly sniff at paying for Orthtoics, are advising My!! patients, in spite of the fact that I have already seen them and examined them, and advised them, to go somewhere to get APOS. What advantage does this have?? and why has BUPA decided to climb into bed with them, when they clearly will cost an arm and a leg, and will restrict the individual to One! pair of shoes, unless they buy another.
Are we missing something here?? APOS is promising to change your life.
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oh, I wish I was out on My Harley
The purpose of this study is to:
Analyze the short-term effects of external center of pressure manipulation of the foot in idiopathic hip osteoarthritis patients during gait on:
Gait parameters (spatiotemporal, kinematic, and kinetic)
Muscle activation patterns of the lower limbs and back
Analyze the long-term effects (during the period of one year) of external center of pressure manipulation of the foot in idiopathic hip osteoarthritis patients during gait on:
Gait parameters (spatiotemporal, kinematic, and kinetic)
Motor learning and muscle activation patterns
Energy consumption
Pain, physical function, and quality of life
The hypotheses of the study, in reference to the aforementioned study objectives are:
Changes in foot center of pressure will have an immediate effect on gait parameters and muscle activation patterns of the lower limbs and back.
Long-term manipulation of foot center of pressure, as a result of a year-long rehabilitation program using the AposTherapy Biomechanical System, will result in improvement in gait parameters, changes in muscle activation patterns as a result of new motor learning, improvement in energy consumption, decrease in pain, improvement in physical function, and improvement in quality of life.
Adaptive changes of foot pressure in hallux valgus patients.
Wen J, Ding Q, Yu Z, Sun W, Wang Q, Wei K. Gait Posture. 2012 May 1.
Quote:
BACKGROUND:
Hallux valgus (HV) is one of the most common deformities in podiatric and orthopedic practice. Plantar pressure technology has been widely used in studying the pressure distribution in HV patients for better assessment to plan interventions. However, previous studies produced an array of controversial findings and most of them only focused on the forefoot.
METHODS:
We examined the dynamic changes of foot pressure of the whole foot with a large-sample investigation (229 patients and 35 controls). Foot pain, which has been largely neglected previously, was used to group the participants.
RESULTS:
Compared to healthy controls, patients had significantly higher loading of the first and second metatarsals, where the transverse arch usually collapses, and significantly less loading of the hallux. Moreover, forces in most regions reached their maximum late, indicating a slow build-up of loading. Patients shortened the loading duration on their forefoot, loaded more on the medial foot starting from early foot contact, and delayed the medial-to-lateral load transition. Notably, nearly all these changes were more pronounced in patients with pain.
CONCLUSIONS:
Biomechanical changes in HV patients are not only caused by physical deformity but also by modified neural control strategies, possibly to alleviate discomfort and to accommodate the foot deformity. Our results suggest that dynamic evaluation of the whole foot and consideration of foot pain are necessary for the functional assessment of foot pressure in HV patients. The foot balance changes have important clinical implications.
Thank you there are some very interesting comments made that we would like to address. Please follow the below link to view all of our published scientific and clinical data, within some of the most highly regarded Clinical Journals in the world. These studies provide extensive evidence regarding the efficacy of the treatment.
AposTherapy is an active personalized intervention whereby the calibration of the foot-worn system reduces moments acting upon the affected area of the knee to reduce pain. By reducing the pain, and stimulating the neuromuscular system in a purely functional environment, as treatment progresses benefits will be felt in normal everyday footwear.
The APOS system
Hybrid Mode
