Significantly reduced incidence and improved survival from prostate cancer over 25 years.

BACKGROUND: Prostate cancer (PCa) was the second most frequent cancer and the fifth leading cause of cancer death among men in 2020. The aim of this study was to analyze trends in the incidence, mortality and survival of PCa in Girona, Spain, over 25 years. METHODS: Population-based study of PCa collected in the Girona Cancer Registry, 1994-2018. Age-adjusted incidence and mortality rates were calculated per 100,000 men-year. Joinpoint regression models were used for trends, calculating the annual percentage changes (APC). Observed and net survival were analyzed using Kaplan-Meier and Pohar-Perme estimations, respectively. RESULTS: A total of 9,846 cases of PCa were registered between 1994-2018. The age-adjusted incidence and mortality rates were 154.7 (95%CI: 151.7 157.8) and 38.9 (95%CI: 37.3 -40.6), respectively. An increased incidence of 6.2% was observed from 1994 to 2003 (95%CI: 4.4 -8.1), and a decrease of -2.7% (95%CI: -3.5 -;-1.9) between 2003 and 2018. Mortality APC was -2.6% (95%CI: -3.3 --2.0). Five-year observed and net survival were 72.8% (95%CI: 71.8 - 73.7) and 87.2% (95%CI: 85.9 - 88.4), respectively. Five-year net survival increased over time from 72.9% (1994-1998) to 91.3% (2014-2018). CONCLUSIONS: The analyses show a clear reduction in PCa incidence rates from 2003 on, along with an increase in overall survival when comparing the earlier period with more recent years.

Walking speed as a predictor of community mobility and quality of life after stroke.

Background: Community mobility (CM) is considered a part of community reintegration that enhances Quality of Life (QoL). Achieving an appropriate gait speed is essential in attaining an independent outdoor ambulation and satisfactory CM. Objective: The aim of this study was to identify whether gait speed is a predictor of CM and QoL in patients with stroke following a multimodal rehabilitation program (MRP). Methods: This was a baseline control trial with 6-months follow-up in an outpatient rehabilitation setting at a university hospital. Twenty-six stroke survivors completed the MRP (24 sessions, 2 days/wk, 1 hr/session). The MRP consisted of aerobic exercise, task-oriented exercises, balance exercises and stretching. Participants also performed an ambulation program at home. Outcome variables were: walking speed (10-m walking test) and QoL (physical and psychosocial domains of Euroquol and Sickness Impact Profile). Results: At the end of the intervention, comfortable and fast walking speed increased by an average of 0.16 (SD 0.21) (*p < .05) and 0.40 (SD 0.51) (**p < .001) m/s, respectively. After the intervention, all participants achieved independent outdoor ambulation with an increase of 34.14 of walking minutes/day in the community and a decrease of sitting time of 95.45 minutes/day. Regarding QoL there were increased mean scores on the physical and psychosocial dimensions of Euroquol and the Sickness Impact Profile, respectively (**p < .001). Conclusions: The results suggest that improved walking speed after the MRP is associated with CM and higher scores in QoL. These findings support the need to implement rehabilitation programs to promote increased speed.

Efectividad de un programa de rehabilitación basado en ejercicio multimodal de intensidad moderada-baja para supervivientes de ictus / Effectiveness of a multimodal low-moderate intensity exercise rehabilitation program for stroke survivors

Introducción: la cantidad de personas que sobreviven a un accidente cerebrovascular aumenta cada año. Las personas con ictus sufren déficits neurológicos y un desacondicionamiento físico que compromete la capacidad para caminar, las actividades básicas de la vida diaria y la calidad de vida relacionada con la salud (CdVRS). El objetivo de este estudio fue determinar los efectos de un programa de rehabilitación multimodal de 12 semanas de duración, basado en ejercicios de intensidad baja- moderada, en la velocidad de deambulación, la resistencia al caminar y la adherencia a la actividad física. Material y métodos: estudio observacional de medidas repetidas. La intervención consistió en 24 sesiones de 1 hora de duración dos días alternos por semana. Se reclutó un total de 31 participantes que se evaluaron al inicio, después de la intervención y a los seis meses. Resultados: veinticinco participantes completaron el programa de rehabilitación. Al final de la intervención se detectaron mejoras significativas de la velocidad de deambulación (10MWT p≤0.004*), resistencia al caminar (6MWT p≤0.000**) y adherencia (minutos de caminata/día p≤0.000**). Estos resultados se mantuvieron a los seis meses. Los participantes manifestaron una satisfacción general con el programa de rehabilitación del 94% en relación a los siguientes ítems: condición física, capacidad para caminar, equilibrio, expectativas cumplidas, satisfacción con el programa, satisfacción con la autoeficacia, estrategias aprendidas para mejorar la calidad de vida, momento adecuado para participar en el programa y lo recomendarían a terceras personas. Conclusiones: Promover la actividad física de intensidad baja-moderada puede ser una estrategia de rehabilitación interesante para los supervivientes de ictus

Introduction: The amount of people who survive a stroke is increasing annually. Persons with stroke suffer neurological deficits and a physical deconditioning that compromise walking ability, basic activities of daily living and health-related quality of life (HRQoL). The aim of the study was to determine the effects of a 12-week multimodal low-moderate intensity exercise rehabilitation program on walking speed, walking endurance and adherence to physical activity. Material and methods: An observational repeated-measures design was used. The intervention consisted of 24 sessions of 1 hour per session two alternative days a week. A total of 31 participants were recruited and were evaluated at baseline, post-intervention and at six months follow up. Results: Twenty-five participants completed the rehabilitation program. Significant improvements were found at the end of the intervention and those were maintained at six months on walking speed (10MWT *p≤0.004), walking endurance (6MWT **p≤0.000) and adherence (walking min/day **p≤0.000). Participants reported an overall satisfaction with the rehabilitation program of 94%: fitness, walking capacity, balance, accomplished expectations, satisfaction with the rehabilitation program, satisfaction with self-efficacy, learned strategies to improve QoL, adequate timing and would recommend the low-moderate intensity exercise rehabilitation program. Conclusions: Promoting low-moderate intensity physical activity may be an interesting rehabilitation strategy for stroke survivors