February 11, 2013
Is there any proof that Apostherapy works and does proof even matter if people get results?
What Is AposTherapy
AposTherapy, involves the use of a convex shaped (think dome) rubber device (known as a ‘pod’) on the bottom of your shoe – a shoe you are meant to wear for one hour each day. These pods are adjustable to move the mechanical loads off the stress points in the knee of someone with osteoarthitis, thereby in theory, reducing pain.
As far as I can tell, the AposTherapy shoe uses a technology that is similar to the Power Plate phenomenon. The principles of power plates or vibration is to stimulate the body’s natural response to vibration. Vibration creates instability throughout the body and these vibrations transmit waves of energy that cause muscles to contract to stabilize the body. There is some evidence for vibration and the science of vibration plates has been used by Nasa.
The Apostherapy analysis involves walking over a computerised plate and the therapist reads the calibrations on a computer terminal. This approach seems similar to the sports shop that uses computers to measure for sport shoe insoles or orthotics. The draw back here is that, you are not getting your insoles fitted by a professional podiatrist and the insoles are usually far more expensive than the professionals charge. This does have a similar feel to the approach being used by the Apos technology. Remember that AposTherapy is a technology (a rubber dome on a shoe to be precise) and not a treatment as such. There doesn’t appear to be any actual hands on knee, physical examination performed as far as I can ascertain.
So in theory, the pod device introduces instability to the knee joint that stimulates muscles to adopt a different walking pattern. The idea of Apos does seem to be grounded in some science although the AposTherapy itself does not have any research in peer reviewed medical journals as yet but this doesn’t really bother me. AposTherapy does have plenty of anicdotal evidence (case studies) behind it which is certainly something to be considered.
What The Critics Say
Critics may ask just how long do they actually follow up and monitor their patients and this is a valid question. Critics may also say that if the ‘treatment’ was as good as they claim then the National Health Service would take it on. Ha, I say to that! There are many available treatments available for musculo-skeletal problems that have hundreds of studies in peer reviewed medical journals that have been proven to work that the NHS has not adopted.
Chiropractic is a very good example. Chiropractic has been proven to be cost effective and ‘best clinical practice’ for chronic and acute low back pain. It is even recommended for use by the department of health in their Musculoskeletal Services Framework, but it has yet to be fully utilised by the NHS and so patients continue to suffer and the NHS continue to waste money needlessly in many cases.
The other problem I see with AposTherapy is that it uses a very mechanistic approach (vs. holistic) and does nothing to address the underlying cause of knee arthritis.
* previous injury to joints (falls, car crashes, broken bones etc)
* congenital (born with) anomalies of bone
* bad posture habits
* acidic foods – alcohol, caffeine, wheat, sugar, nicotine, fizzy drinks
* manual professions
* exercise levels & body weight
How Much Does AposTherapy Cost?
A lot! I don’t like this as it has a Harley Street ring to it (yet another orthopod making a fortune on Harley Street – gosh I’m usually not so cynical) – so fine if you have osteoarthritis and are independently wealthy but for most, this will be an inaccessible therapy option.
To be quite honest, I like the underlying theory as a bit of a structural posture geek myself, and the lack of evidence other than case studies wouldn’t necessarily put me off, but the price and lack of physical examination does.
So you tell me, has it helped you? I really want to hear from some of you who have use AposTherapy shoe pods.