What is AposTherapy® and How Can it Help Support My CCG or Trust?
AposTherapy® (Apos – All Phases Of Step) is a treatment plan that has been developed in Israel, and is positioned for patients with chronic knee, hip and low back pathologies who have already tried conservative treatments but still experience significant symptoms which impact negatively on activities of daily living. It works by simultaneously addressing the biomechanics and neuromuscular control with the aim of reducing pain and restoring optimal movement. It has been available in the UK for 9 years and is covered by several leading insurers with over 60,000 people internationally having been treated. The treatment plan consists of in-depth assessment, continual measurement of outcomes such as gait and PROM’s and the expert calibration and provision of a biomechanical foot-worn device by specially trained physiotherapists.
Patients conveniently only wear the device for short periods of time (between 1 and 2 hours) during their normal daily activities in order to establish neuromuscular learning over time. The treatment has been thoroughly researched with over 50 published papers including independent prospective studies and further research in progress. Importantly, 87% of patients experienced clinically significant pain relief, 88% reported improvements in their mobility, and 92% would recommend the treatment to Friends and Family.
“Real World” outcomes from our current NHS Projects are showing good clinical outcomes for a population that would otherwise be candidates for total joint replacements. Thereby providing an effective, non-invasive alternative for the patient whilst reducing the requirement of more invasive treatments such as TKR/THR surgery.
Cost benefits for the NHS with the inclusion of AposTherapy® into the MSK pathway
The cost of the AposTherapy® programme is significantly lower that of a total knee replacement, which includes a full assessment and gait analysis, 12 months of focused support to re-educate the muscles to ensure optimal movement and then ongoing maintenance programmes in following years.
With outcomes indicating a significant reduction in pain, improvement in mobility and a reduction in progression to total knee replacement this does indicate significant value for money. Treating patients with AposTherapy® instead of TKR is cash releasing and could significantly reduce direct cash spent compared with conducting knee replacements for the same population.
Example: A provider installs AposTherapy® into the MSK pathway and as such triage’s screen for suitability patients based on known clinical indicators and in-line with relevant local Service Restriction Policies. The service then assesses these patients, and if suitable commences them in the therapy as prescribed. It is accepted that a low percentage will not succeed with AposTherapy® and therefore we share the risk around that decay rate. Due to great clinical outcomes and this risk-share mechanism, the CCG can expect a reduction of referrals into Secondary care for joint replacement surgery, therefore providing a significant cost saving.
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