By Sally Robertson
A prompt return to usual daily activity is more likely for patients who have undergone radical prostatectomy (RP) if they start performing certain exercises soon after their operation, say researchers.
A combination of exercises focused on the pelvis and lower limbs seems to be the key to restoring fitness, flexibility, and balance in such individuals, suggest findings from a randomized controlled trial.
Performing the exercises also improves urinary incontinence and quality of life for patients, report Dong Gil Shin (Pusan National University Hospital, Busan, Korea) and colleagues.
"Elderly patients who undergo RP are susceptible to fall injuries owing to the weakness of the muscles in the lower extremities from damage to the pelvic floor muscles," explain the researchers.
"If they wish to return to their daily lives after RP, they must recover their general physical function."
In a study of 49 patients who underwent laparoscopic RP, all physical functions were more improved in those who performed a combination of resistance, flexibility, and pelvic floor exercises than they were in those who completed pelvic floor exercises only (control group).
The twice-weekly exercises lasted for a total of 60 minutes and were initiated during postoperative week 3 for 12 weeks thereafter.
At the end of the study, individuals in the combined exercise group had significantly greater improvements in functional physical fitness, flexibility, and balance ability than those in the control group.
In addition, they only had a mean urine loss of 12.2 g during a 24-hour pad test, compared with 46.2 g in the control group. The corresponding figures for continence rate were 73.1% versus 43.5%.
Furthermore, an analysis of the patients' scores for the Medical Outcomes Study 36-item Short-Form Health Survey showed that quality of life had significantly improved for those in the combined exercise group but had not for those in the control group.
The team says that, to date, no studies have focused on the reinforcement of pelvic floor and limb muscles after RP.
"We suggest that exercise intervention after RP for patients with [prostate cancer] has great merit for the recovery of general physical and mental conditions," writes the team in Urology.
"These exercise intervention effects could contribute to achieving prompt recovery of daily living," conclude Shin et al.
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