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The APOS system

Discussion in 'Biomechanics, Sports and Foot orthoses' started by David Wedemeyer, Sep 7, 2008.

  1. David Wedemeyer

    David Wedemeyer Well-Known Member

    Members do not see these Ads. Sign Up.
    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 :bash:

  2. efuller

    efuller MVP

    Hi David,

    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?


    Eric Fuller
  3. David Wedemeyer

    David Wedemeyer Well-Known Member

    Hi Eric,

    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 :cool:

  4. NewsBot

    NewsBot The Admin that posts the news.

    This clinical trial on the APOS system was just completed:

    The Effect of a New Biomechanical Device
  5. RandomBrowser

    RandomBrowser Welcome New Poster

    Information, in English, about the APOS shoe system can be found at:


    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.

    Last edited by a moderator: Mar 19, 2009
  6. nicpod1

    nicpod1 Active Member

    Hi Folks,

    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???!!!!
  7. Ian Drakard

    Ian Drakard Active Member

    So BUPA will pay out for overpriced treatment from physios, despite inflation of orthotic prices being a reason they gave me for not covering podiatry :craig:
  8. Griff

    Griff Moderator

    The APOS system of 'Gait Redesign'

    Does anyone have any knowledge or experience of this service that some Bupa Physiotherapists are offering in the UK?


  9. markleigh

    markleigh Active Member

    Re: The APOS system of 'Gait Redesign'

    I found this:

    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)
  10. Griff

    Griff Moderator

    Thanks for the thread merge Admin - I must've missed the original thread the first time round

  11. Iain Johnston

    Iain Johnston Active Member

    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.
  12. Iain Johnston

    Iain Johnston Active Member

    Re: The APOS system of 'Gait Redesign'


    According to BUPA they have two locations, Reading ans Solihul.
  13. Griff

    Griff Moderator

    This may be of interest


    Attached Files:

    • APOS.pdf
      File size:
      1,008.4 KB
  14. NewsBot

    NewsBot The Admin that posts the news.

    This clinical trial has just been registered:
    Effects of Foot Center of Pressure Manipulation on Hip Osteoarthritis Patients During Gait
  15. NewsBot

    NewsBot The Admin that posts the news.

    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.
  16. AposTherapyUK

    AposTherapyUK Welcome New Poster

    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.
    Last edited by a moderator: Oct 5, 2015

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