Effect of physical exercise combined with shockwave therapy on erectile dysfunction in diabetic patients.

Introduction: The aim of the study was to evaluate whether physical exercise (PE) in addition to extracorporeal shockwave therapy (ESWT) is more effective in improving erectile function as compared to ESWT and PE alone in diabetic patients with erectile dysfunction (ED). Material and methods: Forty-five patients with type 2 diabetes mellitus (DM) and ED were divided into three equal groups: group 1 (ESWT group) received treatment with ESWT twice weekly for 6 weeks, comprising 3000 shockwaves at an energy density of 0.25 mJ/mm2 and an emission frequency of 6 Hz; group 2 (PE group) received treatment with physical exercise three times per week for 12 weeks; and group 3 (combined group) was treated using physical exercise in the form of the program followed by the PE group, plus ESWT in the form of the same parameter and protocol as that of the ESWT group. Treatment outcomes were measured by International Index of Erectile Function-5 (IIEF-5) score variations recorded at 4 and 12 weeks after the end of treatment with respect to the baseline. Results: The mean IIEF-5 scores significantly improved in all groups at the 4-week follow-up without intergroup differences. At the 12-week follow-up, the mean IIEF-5 improvement and durability were significantly higher among patients in combined groups. Conclusions: The combined approach of ESWT and PE provides significant advantages in erectile dysfunction improvement and durability as compared to ESWT or PE alone in diabetic patients with ED.

Effects of a core stability exercise program on balance and coordination in children with cerebellar ataxic cerebral palsy.

OBJECTIVE: To evaluate the effects of a core stability exercise program on balance, coordination, and severity of ataxia in children with cerebellar ataxic cerebral palsy (CP). METHODS: Forty children with cerebellar ataxic CP (mean age: 6.75±1.35 years) were randomly assigned to a control group and an intervention group for 2 months of follow-up. The control group received a standard physical therapy program three times weekly (1 h per session), while the intervention group received a core stability program for 30 min, in addition to the selected physical therapy program. Both groups were evaluated pre-treatment and post-treatment using the Scale for the Assessment and Rating of Ataxia, the Balance Error Scoring Systems scale, Bruininks-Oseretsky tests of motor proficiency, and HUMAC balance system scores. RESULTS: We found statistically significant reductions in the severity of ataxia, as well as improved balance and coordination in both groups, with stronger effects observed in the intervention group (P<0.05). CONCLUSION: The core stability program can improve balance and coordination in children with cerebellar ataxic CP when incorporated with a standard physical therapy program.