Exercise training (ET) in adult and elderly patients receiving anti-lymphoma treatments is feasible and may improve the provision of care.

Lymphoma treatments can produce adverse effects leading to a reduced quality-of-life (QoL). Besides, in patients ≥65years, it can promote an accelerated geriatric decay. We conducted a prospective study on supervised Exercise-Training (ET), in consecutive, patients aged 18-80years, during anti-lymphoma treatments.16/30 (53%), median-age = 65.5y, participated to the ET sessions, this was the Interventional Group (IG); 14/30 (47%), median-age = 63y, were the Reference Group (RG). Both groups participated to the fitness and the QoL assessments, at baseline (T0), 3-months (T1) and 6-months (T2) after the start of chemotherapy. The adherence to the ET program was 50% (95% CI:36-64%). The IG showed substantial improvements compared to the CG in cardiorespiratory fitness (Cooper test) at both T1 and T2 and in all the functional domain of the QoL questionnaire (QLQ-C30) at T2. This study showed ET, during chemotherapy, is feasible and safe, even in patients ≥65 years. Furthermore, it may improve the provision of care.

Conservative treatment for Insertional Achilles Tendinopathy: platelet-rich plasma and focused shock waves. A retrospective study.

BACKGROUND: Insertional Achilles tendinopathy (IAT) represents a serious challenge for both physiatrists and surgeons. Here we analyse the results obtained by two conservative treatments [platelet-rich plasma (PRP) injections and focused extracorporeal shock-wave therapy (ESWT)] in physically active patients with IAT. METHODS: During two consecutive periods, 45 consecutive patients with IAT were treated with 3 sessions of ESWT (2400 impulses at 0.17-0.25 mJ/mm2 per session) (24 cases between September 2011 and July 2013) or with 2 autologous PRP injections over two weeks (21 cases between September 2013 and July 2015). All patients were evaluated at 0, 2-, 4-, 6-month follow-up after therapy. The outcome measures were VISA-A, VAS, Patient Satisfaction. RESULTS: Intra-group analysis showed a significant improvement of VISA-A and VAS scores in both groups at all time-points. No differences between groups were observed for VAS and VISA-A scores at all time-points, excepted for VISA-A at 4-months in favour of ESWT group (P=0.049). Patient satisfaction increased progressively (>70% at 6 months) and with no differences between two groups. CONCLUSION: Both ESWT and PRP therapy are effective and safe. Our study confirms the success of these conservative treatments in Achilles tendinopathy, even in the insertional one. LEVEL OF EVIDENCE: IIIa.

Urinary incontinence and neuropathy after radical prostatectomy: diagnosis and treatment.

INTRODUCTION AND OBJECTIVE: The urinary incontinence after radical prostatectomy is secondary to neuropathy with various degrees from neurapraxia to neurotmesis. We propose to apply therapeutic and rehabilitative models appropriate to the diagnosis and to evaluate the results. MATERIALS AND METHODS: We examined 79 homogeneous patients with urinary incontinence after radical prostatectomy. After having defined the diagnosis by a urodynamic examination, the study of pudendal nerve somatosensory-evoked potentials (SEPs) and perineal electromyography (EMG), patients were divided into four groups (A; B; C; D) and submitted to different clinical drug protocols and rehabilitation. After 3 months, patients were reevaluated. RESULTS: Twenty-eight patients with idiopathic overactive bladder (Group A) have been treated with anticholinergics: two unchanged (7%); 14 improved (50%); and 12 recovered (43%). Sixteen patients with overactive bladder and sphincter incompetence (Group B) have practiced physiokinesis therapy (FKT) of pelvic floor and anticholinergic therapy: one unchanged (6%); eight improved (50%); and seven recovered (44%). Fourteen patients with perineal incompetence to continence (Group C) have been treated with FES, FKT of pelvic floor, and Biofeedback: three patients were unchanged (21%); five improved (36%); and six recovered (43%). Twenty-one patients with sphincter denervation (Group D) performed FES, FKT of pelvic floor, and Biofeedback: 16 unchanged (76%); five improved (24%); and zero recovered (0%). Of these 16 patients, six non-responders have placed a transobturator tape (TOT) sling and four an artificial sphincter. CONCLUSIONS: A therapy adherent to the diagnosis increases success rate.