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Anyone seen the full page advertisement in The Times today for the 'unique' devices calibrated by specially trained physiotherapists called AposTherapy devices for the treatment of knee pain? Promoting the hard sell like some other miracle devices, has anyone had any experience of these?
Possibly, but I don't see BUPA paying for the fish or even prescriptive orthotics..... Looks similar to the kind if advertisingby a well known osteopath and his miraculous heel pain orthotics. Anyone from the industry know who is behind these?
About this time last year I was in my final year at uni. Some guys from apostherapy came and gave a lecture in the evening. The next day one of the guys was working in the gait lab trying to calibrate the devices. It took him all day and in the end gave up.
Thanks for that Admin. Hadn't seen the earlier posts. Gosh, between Dennis's foot typing, Rhubarbs Miracle Cure-alls and now this APOS System, I have to ask, what has podiatry been playing at for the last two decades. Three thousand quid for a pair of these bouncy shoes - endorsed by our friends at BUPA - sixty thousand satisfied customers over, what four years......that's a lot of money. Here we are arguing over who should cut toenails and these guys are selling, let's say, interesting products at an incredible rate. Mhmm. Even if they are crap, they are still taking a lot of business away frompodiatry. And if they aren't up to mark, how would a disgruntled customer feel about parting with say five hundred pounds to a podiatrist once they don't work?
Had a little incident recently involving a physio who had seen one of my patients recently - and without asking what they were prescribed for or contacting me, proceeded to advise my patient that the orthotics I had supplied the previous year (for FnHL) were "wholly inappropriate and a complete waste of money because they didin't support the arch and placed a lot of pressure on the inside of the heel". Right. So better have some of the prefabricated orthotics his practice supplies. One wonders if this aggresive and unprofessional approach by some physios and osteopaths and chiropractors in the biomech and orthotics fields is but a small sample or representative of something more widespread....
Had a little incident recently involving a physio who had seen one of my patients recently - and without asking what they were prescribed for or contacting me, proceeded to advise my patient that the orthotics I had supplied the previous year (for FnHL) were "wholly inappropriate and a complete waste of money because they didin't support the arch and placed a lot of pressure on the inside of the heel". Right. So better have some of the prefabricated orthotics his practice supplies. One wonders if this aggresive and unprofessional approach by some physios and osteopaths and chiropractors in the biomech and orthotics fields is but a small sample or representative of something more widespread....
The physiotherapist that made such a fuss during the Q & A session with Simon Bartold, Joe Hamill and myself at the Biomechanics Summer School in Manchester six months ago probably falls into this category. He is supposedly friends with Blaise Dubois.
If a physiotherapist, physical therapist, another podiatrist or a medical doctor had said that to one of my patients, I would first call him to tell him/her I didn't think this was appropriate behavior. If the behavior persisted however, I would contact an attorney who would send him a letter regarding the slander he is spreading throughout the medical community and the legal consequences of continuing his slander. That, I'm sure, would stop this type of nonsense immediately.
__________________
Sincerely,
Kevin
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Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
I have no issue with clinicians of other disciplines supplying devices, providing they do so ethically and with good foundation - same with colleagues in podiatry, but you have to question the methodology and business approach of the hard sell. Makes for very sceptical patients....
Had a couple of patients in Singapore who was using the apos therapy and had worse problems after two falls within a week span due to the istability they provide.
The patients found it impossible to climb stairs with the apos shoes. They have two circular discs in the sole which forms the weight bearing surface. They are rounded and have they ability to be adjusted. The theory behing this is to change the forces on the knees and by doing so claims to heal OA. Even if that were the case, the patients I saw who wore them were of greater risk of falls than anything else.
Had a couple of patients in Singapore who was using the apos therapy and had worse problems after two falls within a week span due to the istability they provide.
The patients found it impossible to climb stairs with the apos shoes. They have two circular discs in the sole which forms the weight bearing surface. They are rounded and have they ability to be adjusted. The theory behing this is to change the forces on the knees and by doing so claims to heal OA. Even if that were the case, the patients I saw who wore them were of greater risk of falls than anything else.
Off-topic - but I like the foot-strat in your avatar.
The outcome of a novel biomechanical therapy for patients suffering from anterior knee pain.
Haim A, Segal G, Elbaz A, Mor A, Agar G, Bar-Ziv Y, Beer Y, Morag G, Debi R, Atoun E. Knee. 2012 Dec 26.
Quote:
BACKGROUND:
This study was devised to examine the effect of a novel biomechanical therapy for patients suffering from anterior knee pain (AKP).
METHODS:
A retrospective analysis of 48 patients suffering from AKP was performed. Patients underwent a gait evaluation, using an electronic walkway mat, and completed the SF-36 health survey and the WOMAC questionnaire at baseline and after 3 and 6months of therapy. A special biomechanical device was individually calibrated for each patient. AposTherapy is a functional, non-invasive rehabilitation therapy consisting of a biomechanical foot-worn device that is used during activities of daily living. Repeated measures analyses were performed to compare gait parameters and self-evaluation questionnaires between baseline, 3months and 6months.
RESULTS:
Walking velocity significantly increased by 5.7cm/s, cadence increased by 1.6 steps/minute, and stride length increased by 3.4cm in relation to pretreatment testing (p<0.001 for all). End-point evaluation revealed additional improvement of these parameters; however these did not significantly differ from that of mid-treatment. Pain decreased by 36.6% and 49.2% following 13 and 26 weeks of treatment, respectively (P<0.01) and function improved by 25.2% and 41.7% following 13 and 26 weeks of treatment, respectively (P=0.01).
CONCLUSIONS:
The males show significantly greater coronal dimensions of the trochlea than women which are likely to contribute to the higher prevalence of prosthetic overhang in women with some standard implants.
CLINICAL RELEVANCE:
Based on the current study's results it may be concluded that this therapy might have a positive effect for patients with AKP.
Long-Term Effects of AposTherapy in Patients with Osteoarthritis of the Knee: A Two-Year Followup
Yaron Bar-Ziv, Eytan M. Debbi, Yuval Ran, Shaike Benedict, Nahum Halperin, and Yiftah Beer Arthritis; Volume 2013 (2013)
Quote:
Several biomechanics treatments for knee osteoarthritis (OA) have emerged with the goal of reducing pain and improving function. Through this, researchers have hoped to achieve a transition from the pathological gait patterns to coordinated motor responses. The purpose of the study was to determine the long-term effects of a therapy using a biomechanical device in patients with knee OA. Patients with knee OA were enrolled to active and control groups. The biomechanical device used in therapy (AposTherapy) was individually calibrated to each patient in the active group. Patients in the control group received standard treatment. Outcomes were the Western Ontario and McMaster Osteoarthritis Index (WOMAC), Aggregated Locomotor Function (ALF), Short Form 36 (SF-36), and Knee Society Score assessments. The active and control groups were similar at the baseline (group difference in all scores. The active group showed a larger improvement over time between groups in all three WOMAC categories (21.7, and 18.1 for pain, stiffness, and function; all), SF-36 Physical Scale (), Knee Society Knee Score (), and Knee Society Function Score (). At the two-year endpoint, the active group showed significantly better results (all). The groups showed a difference of 4.9, 5.6, and 4.7 for the WOMAC pain, stiffness, and function scores, respectively, 10.8 s in ALF score, 30.5 in SF-36 Physical Scale, 16.9 in SF-36 Mental Scale, 17.8 in Knee Society Knee Score, and 25.2 in Knee Society Function Score. The biomechanical therapy examined was shown to significantly reduce pain and improve function and quality of life of patients with knee OA over the long term.
Sorry for late response guys, coming to this thread late.
Mark I have to agree with your summation of the physio and chiro worlds, I practice in sydney and our practice consults in two other states. We often get our pts ringing up sometimes weeks after we prescribe a device saying that their physio or chiro has said the devices we prescribed are rubbish as they put too much pressure at the heel and not enough arch support.
Our practice manager has on a couple of occasions rang some of these clinicians and asked what the hell they were playing at saying this!
When we ascertained there credentials it turned out both of these particular physios had no additional lower limb biomechanics training. Unbelievable!! The funny thing is of these cases we get, we ask the pt 'but has your condition/ pain improved and they always respond yes!!
So to your question is it a relatively small sample or does this go across the board I'm thinking its a bigger issue than we think, as I also had similar responses when working with the NHS!!
Some sports re-hab guys who I was seeing as a patient told me that insoles are only good for old people who cannot manage strengthening exercises. I had not told them I was a pod student at that point...
PURPOSE:
The purpose of the current study was to assess the effects of a new foot-worn device on the gait, physical function and pain in patients suffering from knee osteoarthritis (OA) who had a low-impact injury to the medial meniscus causing a degenerative meniscal tear.
METHODS:
A retrospective analysis of 34 patients with knee OA and a degenerative medial meniscal tear was performed. Patients underwent a gait evaluation, using an electronic walkway mat, and completed the SF-36 health survey and the WOMAC questionnaire at baseline and after 3 and 12 months of therapy. AposTherapy is a functional, biomechanical, non-invasive rehabilitation therapy consisting of a foot-worn device that is individually calibrated to each patient and is used during activities of daily living. Repeated-measures analyses were performed to compare gait parameters and self-evaluation questionnaires between baseline, and 3 and 12 months.
RESULTS:
Significant improvements were found in gait velocity, step length and single-limb support of the involved knee following 12 weeks of therapy (all p < 0.01), alongside an improvement in limb symmetry. These results were maintained at the 12-month follow-up examination. Significant improvements were also found in all three domains of the WOMAC index (pain, stiffness and physical function) and in the SF-36 Physical Health Scale and the SF-36 Mental Health Scale (all p < 0.01).
CONCLUSIONS:
Patients with knee OA and a degenerative medial meniscal tear using a biomechanical foot-worn device for a year showed improvement in gait, physical function and pain. Based on the findings of this study, it can be postulated that this biomechanical device might have a positive effect on this population.
AposTherapy Biomechanical Devices
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