AposTherapy Centre London(London)

Every AposTherapy patient’s personalised treatment is based around an individually adjusted unique biomechanical system. Patients wear the personally adjusted footwear device whilst performing their daily routine tasks, achieving two widely applied rehabilitation principles with every step.

 Firstly, by adjusting the foot’s point of contact with the ground (the centre of pressure), the biomechanical system changes the forces acting on the various joints of the lower limb and low back. When calibrating the system, the AposTherapist considers which specific structures need to be supported or offloaded, in order to provide the patient with symptom relief. This decision is based upon the findings from the clinical interview, physical assessment and computerised gait-lab, as well as the pain, function and quality of life questionnaire scores.

The second rehabilitation principle is the introduction of micro-instability through perturbation during the entire gait cycle (and any other weight bearing activity). This refines the control of the central nervous system with every movement the patient performs. Again, the introduction of appropriate perturbation for the patient is done at the system\'s calibration stage. Combining correct body alignment with micro-instability represents a breakthrough in the treatment of knee pain. It is only when the patient experiences pain and symptom relief, that it becomes possible to instil optimal patterns of motion.

The unique therapeutic effects of the biomechanical system are achieved with two convex Pertupod™ discs (pods which provide perturbation), inserted under the main weight bearing areas of the foot - heel and forefoot. The AposTherapist adjusts the Pertupod™ discs in every possible direction (anterior, posterior medial and lateral), as well as adapting their height and resilience. The appropriate level of perturbation is introduced by selecting the convexity level of the Pertupod™ caps. This is determined by a number of factors including the patient’s age, overall condition, proprioceptive abilities and neuromuscular control. The goal is to challenge the patient in a manner which is barely perceptible, so that perturbation, creating micro-instability, can be controlled throughout the multiple movement repetitions performed as part of daily routine. Every biomechanical system is personally calibrated to suit the individual patient and their unique therapeutic needs. The device’s rehabilitative elements are all concentrated on the base of the device, with the most visible part of the device, the shoe, having no therapeutic role. The shoe is merely a platform which serves as an anchoring device to fasten the Pertupod™ caps to the forefoot and heel.

The calibration process must be achieved in conjunction with the patient. After personally adjusting the device in accordance with all the relevant parameters, the AposTherapist then asks the patient to walk with the device. The patient’s gait is closely examined, in order to observe any changes in movement patterns, with relation to the patient’s symptoms and clinical findings. The system\'s calibration is then refined and the patient asked to walk with the system for a second time, while his gait and symptoms are assessed once again. This process is repeated until both the patient and AposTherapist are satisfied that the ideal calibration has been achieved to produce optimal therapy outcomes. At this point the personalised treatment is defined, specifying how therapy will be performed at the patient’s convenience.