APS Therapy

For pain relief, energy enhancement & injury repair

Workshop overview Morning What is APS Therapy? History of APS APS in the UK, Personal history with APS How does it work? Action potentials & neuro-

hormonal effects Have a look Research on APS Our patients experiences & research at the MS

Centre Service/practice models

Workshop afternoon

Running a clinic Assessment, contra-indications & consent Outcome measures, research & documentation Treat each other Injury and inflammation Creating treatment plans Troubleshooting

What is APS Therapy Action Potential Simulation Safe, effective, drug free pain

relief Microcurrent electricity APS Therapy machine

APS Therapy machines

History Developed in early 1990s, south Africa First machine treated shattered elbows

successfully Prof Christian Barnard used for arthritis to keep

working 1993 1st serial machine – MD in USA 1994 FDA approval 1998 CE approval ( Europe) 1998 Gold award Geneva Medical International

Invention Marketed without training in SA & UK Moved to Holland, model of training & therapists

My story with APS

My story with APS MS Nurse Background in holistic health, diet, nutrition,

seeking PWMS have a lot of pain Neuropathic & nociceptive Medications like anti-epileptics = fatigue, weight

gain More activity = more pain Lead to cycle of deconditioning & disability Hull – case studies – research – training Bedford – clinic - pilot study – results distributorship

Painfree Potential Aim To help people relieve their pain To train healthcare practitioners Raise awareness To stimulate research For APS Therapy to take its place as a validated

treatment for pain relief, available on the NHS.

How does it work? Specific waveform

simulates Action Potentials

Action potentials

Real Action Potential

Action Potentials The change in electrical potential

associated with the passage of an impulse along the membrane of a muscle cell or nerve cell’

All the processes of the body take place by the different types of specialised cells working in harmony with each other.

‘Action potentials’ facilitate waves of electrical communication between the cells.

Action potentials

A series of biochemical reactions take place, lasting just thousandths of a second

Electrically charged molecules of sodium or potassium rush in and out of cells, as ‘gates’ in the cell membranes open and close

When they get to certain concentrations, they trigger a electrical impulse, a ‘firing’ and a depolarisation,

sending a wave of information along to the next cell, and setting up for the next wave of action potential.

Action Potentials occur in nerve cells, muscles cells and endocrine

cells ‘nerve impulses’ or as the cell ‘firing’.

In neurons, they play a central role in cell-to-cell communication.

In other types of cells, their main function is to activate intracellular processes.

In muscle cells, for example, an action potential is the first step in the chain of events leading to contraction.

Action Potentials

Action Potentials

Boosting action potentials

Communication between cells is enhanced Enhanced removal of waste products Boosts production of ATP = speeds injury repair &

body’s own healing mechanisms Cellular repair and regeneration enhanced Faster wound and injury healing Improved recovery time after exercise Pain relief Better quality of sleep Enhanced energy

Sports injury before, during, 5, & 10 minutes post APS Therapy

Electron Transport Chain

ATP storage and distribution vehicles of energy

adenosine, ribose, and three molecules of phosphate.

Energy is released when the phosphate bond is broken.

Function: convert glucose, from food, into energy. more ATP = better function and more energy

Decline in ATP production

lack of available nutrients, particularly oxygen and hydrogen, needed to create ATP.

free radicals created by chemicals in food and pollution,

poor dietary and lifestyle habits, weakened digestion leading to the inability to

break down nutrients from food, disease processes, including those that damage

the mitochondria. some people, eg athletes, place enormous

demands on the ATP in their systems.

Other Neuro-hormonal effects

Melatonin: significantly raised sedative, anxiolytic,local vasodilation & anticoagulation, limitation of tissue damage at sites of inflammation due to the effects on prostaglandins and free oxygen radicals.

 Leukine enkephalin: progressively increased Effective analgesic due to interaction with opioid receptors as well

as inhibition of substance P (the neurotransmitter responsible for pain transmission). • Limitation of tissue damage at sites of inflammation and/or hypoxia. • Increase in pulse rate and systemic blood pressure, associated with peripheral vasodilation, which results in better perfusion at the affected areas. -

Neuro-hormonal Beta-endorphins: significantly decreased Cortisol: unchanged but uninhibited

Neurohormonal Consequences of APS TherapyProf. Dr. J.M.C. Oosthuizen MBCHB; DMEDSCI  University of the Free State;Prof. Dr. E.H. de Wet MBCHB; MMED; MD

Electrotherapies One of 3 main physiotherapy modalities; manual

therapy, exercise therapy, electrotherapy. Electrical stimulation agents, including

Transcutaneous Electrical Nerve stimulation (TENS), Interferential Therapy (IFT), Functional Electrical Stimulation (FES), and Microcurrent therapy (MCT), Action Potential Simulation Therapy (APS Therapy)

Thermal modalities,  including Infra red Irradiation (IFR), Therapeutic Ultrasound and Laser Therapy, and

Non Thermal Modalities including Pulsed Ultrasound, Pulsed Electromagnetic Fields (PEMFs) and Microcurrent Therapy (MCT)

Comparison + TENS

TENSAlternating currentForeign pulseGate theory pain reliefEndorphin on ‘tapping’ mode

APS TherapyDirect currentBiological frequenciesStimulating ATP, detox, injury repair Benefits accrue and are more lasting

Research in APS An assessment of APS Therapy on 285 Patients with Chronic Pain in

2002 reported  a mean average VAPS was 6.8 before treatment and 3.3 after treatment in the over 50s, and 6.3 and 2.2 respectively in the under 50s.  Out of the 285 patients,44 (15%) ended with a ‘0’ VAPS and 199 (69%) with a score of 5 or less. (1)

A trial of APS Therapy in patients awaiting or having neurosurgery for intractable spinal pain concluded that the number of patients treated was too low to reach a statistical conclusion, but that the trend was very promising and they recommended that  patients waiting for destructive surgery should first be put on a thorough trial of APS Therapy.(2) 

In a 1999 randomized, patient blinded, placebo-controlled study, on 76 patients with chronic osteoporotic back pain, reported pretreatment baseline VAPS value average of of 57.79, and post- treatment value after the sixth treatment of 9.7 (p= 0,0001); 6 patients maintained benefits 6 months post treatment.(3)

A study in 1999 on APS Therapy compared with TENS in 99 patients with osteoarthritis of the knee did not find a significant difference between the two treatment groups given just 6 treatments over a 2 week period. The authors did note, however, that the APS group showed a significant improvement in measures of knee flexion and swelling, which persisted even 1 month after the last treatment. (4)

References 1) Papendorp DH van. (2002). Assessment of Pain

Relief on 285 patients with chronic pain. Biomedical Research 2002; 26: 249-253.

2) Du Preez, J. Neurosurgical Pain Conditions University of Pretoria 

3) Odendaal & Joubert APS Therapy- a new way of teating chronic backabacke, a pilot study South African Journal of Anaesthesiology and Analgesia.1999; 5 1

4) Berger, P. Matzner, L Study on 99 patients with osteoarthritis (OA) of the knee to investigate the effectiveness of low frequency electrical currents on mobility and pain: Action Potential Simulation therapy (APS) current compared with transcutaneous electrical nerve stimulation (TENS) and placebo.South Africa Journal of Anaesthesiology and Analgesia

Clinic APS machine Clinic – mark 1.4

• APS Therapy machine• Plastic carry case• Cords• Battery (9V, non rechargable)• Manual• Applicator• Gel• Sponge electrodes• Bathsalt• Earclips• PALS electrodes

Technical dataGENERAL

Number of outlets 4 (2 x black, 2 x red)

Operation 1 x intensity knob 1 x pulsed / continuous switch

Display 3 digit LCD which indicates milli amps.

Housing Aluminium / Plastic

   

POWER SUPPLY

Source Internal

Description 9V Alkaline or NIMH (rechargable) (use of rechargable battery is allowed, not standard included)

Type Pp3, 6LG61, 6AM6, Mn1604

   

 ELECTRICAL

Wavetype Actie Potential (AP)

Pulse load 20 μCoulomb max

Pulse energy 220 mJoule max

Signal Continuous / Pulsating

Variable outlet – Charge – Current – Frequency 0 – 46 V (no load) 0 – 3,1 mA ± 0,3mA (1kΩ) 150 Hz ± 10%

   

TECHNICAL APPROVAL

CE 0482 Certificate of medical equipment. (Notified body: Medcert Hamburg, D) MDD93/42/EEC ANNEX IX (Class IIa / Rule 9)

ISO 9001 Quality control

DIN/ISO13485 Quality medical equipment

 

Personal APS machine Mark 4

Jackie

Jackie after 4 weeks Before I started the treatment I had the ‘MS hug’ really

badly. Most of the time the pain score was 5/10, but at times it was 11/ 10! Since I started the APS Therapy I haven’t had the really bad pain at all and most of the time the pain score is around 3.5/10, too low to notice. I also had knee pain, which was about 4.5/10 on the pain scale, and 7/10 when bad. Again, since having this treatment I haven’t had the bad pain at all and the pain score has gone down to around 3/10. The fact that I no longer notice pain shows the improvement. It’s just so nice not to have to constantly think about pain.

This treatment has also had a real impact on my sleep and fatigue. I usually wake up four or five times a night with pain, but last week I only woke once. Also, I don’t have that overwhelming feeling of tiredness. Last week I did so much! I took my brother… on holiday, which involved so much walking. Normally, I would have been exhausted, but I just wasn’t. My numbness is less noticeable too.”  Jackie Clarke, Luton

Poppy

Poppy ““I’ve not felt like this since I was about 15! For

two thirds of my life, I’ve been in some kind of pain, with lack of energy, not sleeping properly, having to plan essential things that I need to do, and then struggling to get them done, and frequently cancelling appointments because I’ve not been well enough to make them. Now, it’s my fourth week, and I’ve been active every day for the past 2 weeks. For instance, 3 weeks ago, my mum came to visit, and we walked everywhere, and then I had to spend Monday in bed. 2 weeks ago, a friend came to visit, we did the same walking, but the next day I was just up and active at 6/7 am. Now I’m sleeping well at night, and nothing is such an effort any more. I want to bottle it and give it to everyone I know!”

‘Action Potential Simulation Therapy ( APS Therapy) for pain in people with MS; Report on a one year

pilot study ‘

Findings: 2013 42 people began the course 6 dropped out 1 x Migraine 1 x Vomiting 1 x Discouragement after 2 weeks 1 x Visual disturbance 2 x Ill with pre-existing medical condition

Of 38 people who completed an 8 week course of APS Therapy:

Of 61 pains that the 38 people had:

Of the 50 pains that improved;

‘Improvement’

Counted as 1 whole point on the VAS

Average improvement overall was 4.7 points

12 people reduced or discontinued medication

Could have been more, hadn’t planned

14 Neuropathic pain in feet & legs

Average VAS pre: 6.3 Average post: 2.5

‘Worst pain’ in neuropathic feet & legs

Other neurogenic & nerve pain

Joint pain & injury

Pre – mean 5.1 post mean 2.2. Actual results quite polarised

‘worst pain’ for joint pain/injury

Headaches

The remaining pains were:

2 x muscle fatigue type pain – no result 1 x post pin and plate – no result

1 x psoriasis pain – good result1 x varicose vein pain – good result

Other benefits attributed include:

Increase in energy, reduction in fatigue x 4 Reduction in swollen legs & ankles x 2 Alleviation of life-long insomnia x 2 Cessation of recurrent UTIs x 2 Improvement in circulation & discolouration Reduction of ‘fatty lump’ on hip Disappearance of swollen glands on neck Cessation of ‘fluid on skull’ sensation Reduction in dizziness & improved cognitive

function

Running a clinic

MS Therapy Centre, Bedford

Resources APS Machines, Electrodes, water electrodes Chair Surface Alcohol gel & tissues or wipes, bin Mirror can be helpful Blanket, Screens Files to store treatment plans & electrodes Space for carer / assistant / wheelchair Instruction posters For water treatment: bathsalts, somewhere to fill

bowls, ? Store bowls & towels – or get to bring in.

Patient’s journey at MSTC

Eight week course, outcomes: Cure/ no result/ Benefit, wants long term continuation, able to

reduce/ Purchase own machine MS Nurse –assesses, screens, oversees APS Therapist – timetables, trains patient/carer,

creates treatment plan, assesses, reviews & assists

Volunteers – assist clients, carry out regular review

Patient/members mainly self-manage

Difficulties along the way

Side effects? Detox effects 1 x brief exacerbation of pain ? Visual flickering reported x 1 Long term use – management problem Attributing problems Individuals

Models Clinic service, free at point of delivery Paying clinic service Rental for home use Mobile or private therapist

Benefits of APS

Less painBetter sleepMore energy

Discussion www.painfreepotential.co.uk 01908 799870 miranda@painfreepotential.co.uk Beds & Northants MS Therapy Centre www.APSTherapy.com is HQ in Holland

Thankyou very much