Effectiveness of Pelvic Floor Muscle Training Alone and in Combination With Biofeedback, Electrical Stimulation, or Both Compared to Control for Urinary Incontinence in Men Following Prostatectomy: Systematic Review and Meta-Analysis.

Background: The efficacy of pelvic floor muscle training (PFMT) alone and in combination with biofeedback (BFB), electrical stimulation (ES), or both for urinary incontinence in men following prostatectomy is inconclusive. Purpose: The purpose of this study was to determine whether PFMT works well alone or in combination with BFB, ES, or both in comparison with a control. Data Sources: The databases Ovid Medline, EMBASE, CENTRAL, Scopus, and Web of Science, and the specialized register of the Citroen Incontinence Review Group were searched from study inception to August 2017. Abstract proceedings from urological meetings, including the European Association of Urology and the American Urological Association, were also searched. Study Selection: Randomized controlled trials that compared PFMT alone and PFMT with ES, BFB, or both and no treatment, placebo, or sham were included in the review. Data Extraction, Synthesis, and Quality: Two independent reviewers completed data extraction and quality appraisal. The Grading of Recommendations, Assessment, Development, and Evaluation tool was used for quality appraisal. Meta-analysis was done with software used for preparing and maintaining Cochrane reviews. Limitations: Methodological flaws in the included studies limited internal validity. Conclusions: PFMT alone, PFMT plus BFB and ES, and PFMT plus ES were more effective than the control for urinary incontinence following prostatectomy. The effect of PFMT plus BFB on postprostatectomy incontinence remains uncertain.

Measurement of diabetic wounds with optical coherence tomography-based air-jet indentation system and a material testing system.

OBJECTIVE: Material testing system is a conventional but destructive method for measuring the biomechanical properties of wound tissues in basic research. The recently developed optical coherence tomography-based air-jet indentation system is a non-destructive method for measuring these properties of soft tissues in a non-contact manner. The aim of the study was to examine the correlation between the biomechanical properties of wound tissues measured by the two systems. METHOD: Young male Sprague-Dawley rats with streptozotocin-induced diabetic were wounded by a 6 mm biopsy punch on their hind limbs. The biomechanical properties of wound tissues were assessed with the two systems on post-wounding days 3, 7, 10, 14, and 21. Wound sections were stained with picro-sirius red for analysis on the collagen fibres. Data obtained on the different days were charted to obtain the change in biomechanical properties across the time points, and then pooled to examine the correlation between measurements made by the two devices. Qualitative analysis to determine any correlation between indentation stiffness measured by the air-jet indentation system and the orientation of collagen fibres. RESULTS: The indentation stiffness is significantly negatively correlated to the maximum load, maximum tensile stress, and Young's modulus by the material testing system (all p<0.05). The orientation of collagen changes with the indentation stiffness over time. CONCLUSION: Our findings support the use of optical coherence tomography-based air-jet indentation system to evaluate the biomechanical properties of wounds in a non-contact manner. It is a potential clinical device to examine the biomechanical properties of chronic wounds in vivo in a repeatable manner.

Transcutaneous electrical nerve stimulation for neuropathic pain.

This study examined the clinical effectiveness of high-frequency transcutaneous electrical nerve stimulation for reducing hypersensitivity of the hand. Nineteen patients suffering from hand hypersensitivity were randomly assigned into either a treatment or a placebo group. A visual analogue scale and the Downey Hand Centre Hand Sensitivity Test were used to measure the tactile tolerance of the hand. Grip strength was assessed by a grip dynamometer. Daily applications of electrical stimulation were provided for 2 weeks. Significantly lower pain scores were found in the treatment group than in the placebo group by Day 7 and Day 11. The ranking of ten dowel textures of the Downey Hand Centre Hand Sensitivity Test in the treatment group was significantly higher than in the placebo group by Day 7 and Day 11. However, no significant inter-group difference was found in grip strength.

The motor dysfunction of patients with knee osteoarthritis in a Chinese population.

OBJECTIVE: To determine the extent of motor dysfunction in people with knee osteoarthritis (OA), as compared with similarly aged subjects without knee OA, in a Chinese population. METHODS: Seventy-six subjects participated in this study. Isometric peak torque of the knee muscles, range of knee motion at rest and during walking, gait velocity, cadence, and stride length were compared. RESULTS: The isometric peak torque of both the quadriceps and the hamstrings of the affected leg of patients with knee OA were weaker than those of the controls (most P < 0.05). The gait velocity was 23.4% slower (P = 0.001), the cadence 33.3% less (P < 0.001), and the stride length 13.4% shorter (P = 0.010) in the patients with OA. The range of knee motion in the patients was reduced by 11.2% at rest (P = 0.003) and by 14.7% during walking (P = 0.001). CONCLUSION: Patients with knee OA exhibited statistically significant deficiencies in the physical performance tested, as compared with similarly aged subjects without knee OA (by 9.6% to 33.3%), in a Chinese population. The indication that this study group seems less severely limited than those reported in Western literature warrants further investigation.

Transcutaneous electrical nerve stimulation: nonparallel antinociceptive effects on chronic clinical pain and acute experimental pain.

OBJECTIVE: To investigate to what extent a single 60-minute session of transcutaneous electrical nerve stimulation (TENS) would modify chronic clinical pain, acute experimental pain, and the flexion reflex evoked in chronic low back pain patients. STUDY DESIGN: Thirty young subjects with chronic low back pain were randomly allocated to two groups, receiving either TENS or placebo stimulation to the lumbosacral region for 60 minutes. The flexion reflex was elicited by an electrical stimulation applied to the subject's right sole and recorded electromyographically from the biceps femoris and the tibialis anterior muscles. MAIN OUTCOME MEASURES: Subjective sensation of low back pain and the electrically induced pain were measured by two separate visual analog scales, termed VAS(LBP) and VAS(FR), respectively. Data obtained before, during, and 60 minutes after TENS and placebo stimulations were analyzed using repeated measures ANOVA. RESULTS: The VAS(LBP) score was significantly reduced to 63.1% of the prestimulation value after TENS (p<.001), but the reduction was negligible after placebo stimulation (to 96.7%, p = .786). In contrast, no significant change was found in the VASFR score (p = .666) and the flexion reflex area (p = .062) during and after stimulation within each group and between the two groups (p = .133 for VASFR and p = .215 for flexion reflex area). CONCLUSIONS: The same TENS protocol had different degrees of antinociceptive influence on chronic and acute pain in chronic low back pain patients.