The Effect of Physiotherapy on Erectile Dysfunction Secondary to Prostatic Adenectomy: A Randomized Control Trial Study.

PURPOSE: The objective of this randomized controlled trial was to investigate the impact of manual therapy (friction massage) and pelvic floor muscle (PFM) training on erectile dysfunction (ED), pelvic floor muscle thickness, and blood flow in the penile arteries and veins in men who have undergone prostatic adenectomy (PA). MATERIALS AND METHODS: This study employed a randomized, double-blinded, controlled trial design. Forty patients participated and were divided into two groups: intervention and control (n=20 per group). The intervention group received 10 sessions of pelvic floor muscle training and manual therapy, while the control group solely underwent pelvic floor muscle training. The recovery rate was measured using the International Index of Erectile Function 15 (IIEF-15) questionnaire and Erection Hardness Score (EHS). Sonographic factors were assessed using simple and Doppler ultrasound. RESULTS: The intervention group exhibited significantly higher erectile function scores (F(1,37)=158.04, P<0.001, η2P=0.810) and a higher average total (IIEF-15) score (20.52) (F(1,37)=136.76, P<0.001, η2P=0.787) compared to the control group in the post-test assessment. Comparison between the two groups revealed an increase in ultrasonic parameters such as the thickness of the ischiocavernosus and bulbospongiosus muscles, maximum systolic velocity, and minimum diastolic velocity of the cavernosal artery in the intervention group. However, the maximum blood flow velocity in the posterior vein decreased. CONCLUSION: PFM training and friction massage play a significant role in managing ED following PA, positioning them as the primary treatment approach for men experiencing ED post-prostatectomy.

Cross-cultural adaptation and validation of the Persian version of the painDETECT questionnaire.

OBJECTIVE: The purpose of this study was to translate and cross-culturally adapt the painDETECT questionnaire into the Persian language and assess the clinometric properties of the translated version (P-PDQ). METHODS: This is a single-center prospective observational study. After forward and backward translations, consensus was achieved by the expert panel on the pre-final version. Semantic equivalence of this version was assessed and necessary modifications were made accordingly to achieve the final version (P-PDQ). One hundred and fifty chronic pain patients were sub-classified into neuropathic pain (NeP (n = 82)) or non-NeP (n = 68) groups by two pain specialists. P-PDQ was then administered to 50 patients twice with an interval of 5-7 days to assess relative reliability. Chronbach's α and intraclass correlation coefficient (ICC) were calculated to evaluate internal consistency and test-retest reliability of the P-PDQ, respectively. Criterion validity was assessed as the correlation of the P-PDQ and the validated Persian version of the self-report Leeds Assessment of Neuropathic Symptoms and Signs (P-sLANSS). RESULTS: Chronbach's α and ICC of the P-PDQ were 0.76 and 0.97, respectively. The P-PDQ scores were significantly correlated with those of P-sLANSS (ρ = 0.87, p < .01). The mean overall score of P-PDQ was significantly higher in the NeP group (p < .01) which reflects discriminant validity. Sensitivity, specificity, positive and negative predicting values and Youden index were 74.70%, 98.51%, 78.04%, 98.48%, and 0.73, respectively at the cutoff value ≤17. CONCLUSION: The P-PDQ is a reliable and valid tool to distinguish neuropathic component in chronic pain cases.

The Isokinetic and Electromyographic Assessment of Knee Muscles Strength in the Short- and Long-Term Type 2 Diabetes.

BACKGROUND: Type 2 diabetes (T2DM) patients are subject to muscle weakness. OBJECTIVES: The aim of the study was an assessment of electromyographic (EMG) activity of knee muscles during isometric maximal voluntary contraction in the different disease durations of T2DM. METHODS: Eighteen patients with less than 10 years and twelve patients with more than 10 years of T2DM were compared with nineteen matched healthy control subjects. EMG of flexor and extensor muscles of knee concurrently with isometric maximal peak torque of knee flexion and extension at 75 degrees of knee flexion were recorded in three groups. RESULTS: Isometric maximal peak torque of extension and root mean squared (RMS) of vastus lateralis and medial hamstring in the healthy control was significantly higher than both patient groups. Whenever the maximal isometric peak flexion torque was not significantly different between groups, the mean power frequency (MPF) of flexor muscles especially medial hamstrings were higher in the short-term T2DM than healthy control groups. The two factors, gender and age, had significant effect on maximal peak torque and RMS of knee muscles. CONCLUSIONS: EMG could show the effect of T2DM, gender and age on knee muscles activity. It seems that the medial hamstring was the most sensitive muscle of knee compartment to show the effect of T2DM and difference of short and long-term T2DM in EMG study.