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Does trunk muscle training with an oscillating rod improve urinary incontinence after radical prostatectomy? A prospective randomized controlled trial [with consumer summary]
Heydenreich M, Puta C, Gabriel HH, Dietze A, Wright P, Zermann DH
Clinical Rehabilitation 2020 Mar;34(3):320-333
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the effect of a new therapeutic approach, using an oscillating rod to strength the pelvic floor and deep abdominal musculature and to speed up recovery of continence after radical prostatectomy. DESIGN: Prospective randomized controlled clinical trial. SETTING: Inpatient uro-oncology rehabilitation clinic. SUBJECTS: Ninety-three (intervention group (IG)) and ninety-one patients (control group (CG)) with urinary incontinence after prostatectomy were examined. INTERVENTION: All patients were randomly allocated to either standard pelvic floor muscle exercises and oscillating rod therapy (IG) or standard pelvic floor muscle exercises and relaxation therapy (CG). MAIN OUTCOME MEASURES: Urinary incontinence (1- and 24-hour pad test) was assessed, and health-related quality of life (HRQL; Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire) was measured for all patients before and after three weeks of treatment. RESULTS: One hundred and eighty-four patients (mean (SD) age 64.1 (6.94) years) completed the study. The IG showed a significant reduction in urinary incontinence (1-hour pad test: p = 0.008, 24-hour pad test: p = 0.012) and a significant improvement of HRQL (p = 0.017) compared with CG. Continence was significantly improved in both groups (1-hour pad test 22.6 to 8.5 g (IG) versus 23.0 to 18.1 g (CG)/24-hour pad test 242.9 to 126.7 g (IG) versus 237.6 to 180.9 g (CG)). CONCLUSION: The study demonstrated that a combination of conventional continence exercises and the new oscillation rod training increased abdominal and pelvic floor musculature and speeded up recovery of continence after radical prostatectomy.

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