BACKGROUND: In a previous article, we have underlined the emerging level of evidence for the effectiveness of a more comprehensive functional physical therapy than solely pelvic floor muscles training (PFMT) for men after radical prostatectomy (RP). More and more authors suggest that physiotherapy programs should not focus only on the side effect of continence, but more generally on the interaction of continence disorders with all other side effects related to patient\'s physical and emotional functioning.
OBJECTIVE: The aims of this narrative review are to highlight rehabilitation approaches unrelated to analytical PFMT that would seem relevant to consider in the future for post-RP men.
METHODS: Our narrative review sought to map the body of literature relevant to the primary objective (non-PFMT), supplementing the data from our previous review with additional recent articles that were not eligible due to not meeting the inclusion criteria for a systematic review.
RESULTS: After full text screening, 13 interventional studies have been selected. Intervention strategies were based on five major type of exercises: flexibility, synergism & co-activation, coordination & movement control, strength & endurance, aerobic & games therapy. Most of the studies of this narrative review focused on synergies, co-activations and movement control techniques that emphasized the deep abdominal muscles and PFMs reflexive activation. The wide variety of countries represented in the 13 studies with consistent results point to the potential effectiveness and replicability across various socio-cultural, ethnical, or religious contexts.
CONCLUSIONS: We found 13 studies from 9 different countries that provide a more complete rehabilitation approach than PFMT alone in men post-RP. Intervention strategies were built around five main types of exercises, with the majority of them emphasizing synergies, co-activations, and movement control techniques. In light of these data, we hope that future research will enable us to offer the most relevant and patient-centered physiotherapy treatment.

OBJECTIVE: Exercise-induced hyperglycemia is recognized in type 1 diabetes (T1D) clinical guidelines, but its association with high-intensity intermittent exercise (HIIE) in acute studies is inconsistent. In this meta-analysis, we examined the available evidence of blood glucose responses to HIIE in adults with T1D. The secondary, aim was to examine predictors of blood glucose responses to HIIE. We hypothesized that there would be no consistent effect on blood glucose from HIIE, unless examined in the context of participant prandial status.
METHODS: We conducted a literature search using key words related to T1D and HIIE. Studies were required to include at least 6 participants with T1D with a mean age >18 years, involve an HIIE intervention, and contain pre- and postexercise measures of blood glucose. Analyses of extracted data were performed using a general inverse variance statistical method with a random effects model and a weighted multiple regression.
RESULTS: Nineteen interventions from 15 reports were included in the analysis. A mean overall blood glucose decrease of -1.3 mmol/L (95% confidence interval [CI], -2.3 to -0.2 mmol/L) was found during exercise, albeit with high heterogeneity (I2=84%). When performed after an overnight fast, exercise increased blood glucose by +1.7 mmol/L (95% CI, 0.4 to 3.0 mmol/L), whereas postprandial exercise decreased blood glucose by -2.1 mmol/L (95% CI, -2.8 to -1.4 mmol/L), with a statistically significant difference between groups (p<0.0001). No associations with fitness (p=0.4), sex (p=0.4), age (p=0.9), exercise duration (p=0.9), or interval duration (p=0.2) were found.
CONCLUSIONS: The effect of HIIE on blood glucose is inconsistent, but partially explained by prandial status.

BACKGROUND: Being physically active on a regular basis has a favourable impact on diabetes-related complications. With the exception of evidence advising individuals with an active diabetic foot ulceration (DFU) to avoid weight-bearing activity, no physical activity (PA) recommendations are currently provided for this population.
OBJECTIVE: The aim of this scoping review was to examine and map the existing research evidence of PA participation for individuals with an active DFU.
METHODS: A scoping review using the Arksey and O\'Malley framework was conducted in electronic databases and grey literature from inception to June 2020 to identify publications that investigated individuals with type 1 or type 2 diabetes and an active DFU at enrolment in relation to a PA intervention. Reported outcomes had to inform on effects of PA on any health or wound parameters.
RESULTS: Nineteen articles from 17 distinct studies met inclusion criteria. Fourteen of the included studies were published in the last 10 years. Types of exercises and materials used, duration of studies, offloading considerations and provision of wound care varied greatly between studies. Included studies are heterogenous in methodological designs and aims, and reporting was often lacking important components of wound care and PA interventions. A discussion based on descriptive statistics and narrative analysis is provided.
CONCLUSIONS: It is not possible from this scoping review to determine what would be the ideal components of a PA program for this specific population. Conclusions are limited by the quality and design of the included studies. No articles evaluated quality of life, mortality or cardiorespiratory capacity, nor were adverse effects routinely reported.

Purpose: We systematically reviewed the effectiveness of interventions to increase physical activity in older adults (aged ≥ 60 y), admitted for inpatient rehabilitation, without increasing the amount of therapy. Method: Five electronic databases were systematically searched to identify English-language articles reporting controlled trials of interventions to increase the physical activity (through participation or behavioural change) of older adults receiving inpatient rehabilitation. Trials were excluded if an intervention increased the intensity of usual care, either during the week or on the weekend. Two reviewers independently completed trial selection, quality assessment, and data extraction. Data were synthesized descriptively, and effect sizes with 95% CIs were calculated. Results: Of the 316 articles identified, 3 were included. Two were activity-based, and 1 was a behavioural change intervention. Physical activity was significantly improved in the behavioural change intervention trial that occurred during therapy (d = 0.27; 95% CI: 0.02, 0.52) and non-therapy time (d = 0.43; 95% CI: 0.19, 0.68). Participants in all trials were sedentary for the vast majority of the day. Conclusions: Older adults in inpatient rehabilitation have a high level of inactivity. Evidence is lacking that interventions increase physical activity in older adults admitted to inpatient rehabilitation without increasing the amount of time in therapy. Evidence from one trial indicates that behaviour-based strategies are effective for increasing physical activity levels in the inpatient rehabilitation setting.
Objectif : analyse systématique de l’efficacité des interventions pour accroître l’activité physique chez les personnes âgées (de 60 ans et plus) hospitalisées en réadaptation, sans accroître la durée de la thérapie. Méthodologie : les chercheurs ont fait une fouille systématique dans cinq bases de données électroniques pour trouver des articles en anglais sur des études contrôlées d’interventions visant à accroître l’activité physique (par la participation ou le changement de comportement) de personnes âgées hospitalisées en réadaptation. Ils ont exclu les études dont l’intervention accroissait l’intensité des soins habituels pendant la semaine ou la fin de semaine. Deux analystes ont procédé à la sélection indépendante des études, à l’évaluation de la qualité et à l’extraction des données. Les chercheurs ont effectué la synthèse descriptive et calculé l’ampleur de l’effet à l’aide de l’intervalle de confiance à 95 %. Résultats : trois études ont été retenues sur les 316 articles extraits. Deux reposaient sur l’activité et une était une intervention pour changer le comportement. L’activité physique s’améliorait considérablement dans l’étude sur l’intervention visant à changer le comportement pendant la durée de la thérapie (d = 0,27; IC à 95 % : 0,02, 0,52) et sans thérapie (d = 0,43; IC à 95 % : 0,19, 0,68). Dans toutes les études, les participants étaient sédentaires pendant la plus grande partie de la journée. Conclusion : les personnes âgées hospitalisées en réadaptation présentent des taux élevés d’inactivité. Les données probantes sont insuffisantes pour déterminer si les interventions accroissent l’activité physique chez les personnes âgées hospitalisées en réadaptation sans accroître la durée de la thérapie. Selon les données probantes d’une étude, des stratégies axées sur le comportement sont efficaces pour accroître le taux d’activité physique lors d’une hospitalisation en réadaptation.

With the world\'s population aging at a rapid rate, the prevalence of Alzheimer\'s disease (AD) has significantly increased. These statistics are alarming given recent evidence that a third of dementia cases may be preventable. The role of lifestyle factors, such as diet and exercise, can directly alter the risk of disease development. However, an understanding of the effectiveness of dietary patterns and exercise strategies to reduce AD risk or improve brain function is not fully understood. The aim of this review is to discuss the effects of diet and exercise on AD risk. Key components of the Western and Mediterranean diets are discussed in relation to AD progression, as well as how physical activity promotes brain health. Components of the Western diet (saturated fatty acids and simple carbohydrates) are detrimental to the brain, impair cognition, and increase AD pathologies. While components of the Mediterranean diet (polyunsaturated fatty acids, polyphenols, and antioxidants) are considered to be neuroprotective. Exercise can significantly reduce the risk of AD; however, specific exercise recommendations for older adults are limited and optimal intensity, duration, and type remains unknown. This review highlights important modifiable risk factors for AD and points out potential avenues for future research. Novelty Diet and exercise are modifiable factors that can improve brain health and reduce the risk of AD. Polyunsaturated fatty acids, polyphenols, and antioxidants are neuroprotective. Exercise reduces neuroinflammation, improves brain insulin sensitivity, and increases brain derived neurotrophic factor.

The purpose of this systematic review was to synthesize and evaluate current literature examining the effects of exercise on postprandial fat oxidation, as well as to provide future direction. A quantitative review was performed using meta-analytic methods. A moderator analysis was performed to investigate potential variables that could influence the effect of exercise on postprandial fat oxidation. Fifty-six effects from 26 studies were retrieved. There was a moderate effect of exercise on postprandial fat oxidation (Cohen\'s d = 0.58 (95% CI, 0.39 to 0.78)). Moderator analysis revealed that sex, age, weight status, training status, exercise type, exercise intensity, timing of exercise, and composition of the meal challenge significantly affected the impact of prior exercise on postprandial fat oxidation. The moderator analysis also indicated that most previous studies have investigated the impact of prior moderate-intensity endurance exercise on postprandial fat oxidation in young, healthy, lean men. Suggested priorities for future research in this area include (i) an examination of sex differences in and/or female-specific aspects of postprandial metabolism; (ii) a comprehensive evaluation of exercise modalities, intensities, and durations; and (iii) a wider variety of test meal compositions, especially those with higher fat content. Novelty A systematic review of the impact of exercise on postprandial fat oxidation was performed using meta-analytic methods. Analysis revealed a moderate effect of exercise on postprandial fat oxidation. The presented data support a need for future studies to investigate sex differences and to include comprehensive evaluations of exercise modalities, intensities, and duration.

BACKGROUND: Chronic dyspnoea that remains unexplained after resting pulmonary function and cardiovascular testing is a common problem in clinical practice. The aim of this study was to determine the utility of cardiopulmonary exercise testing (CPET) in the diagnosis of unexplained dyspnoea.
METHODS: This retrospective single-centre study included consecutive patients with dyspnoea who had normal resting cardiopulmonary examinations (including chest X-ray, electrocardiography, pulmonary function tests [PFTs], and cardiac ultrasound). CPET was performed using a cycle ergometer with analysis of blood gases. The results were interpreted as being most likely due to one of the six pathophysiological mechanisms shown below. Consensus required agreement between at least three of the authors.
RESULTS: Of the 194 patients included (median age 53 years, sex-ratio (M:F) 0.83, mean body mass index 27.3±5.36kg/m2), 32% of the test profiles were compatible with deconditioning, 20% with inappropriate hyperventilation (without gas exchange abnormalities), 18% with disorders of gas exchange, 13% with sub-maximal CPET, 9% with cardiovascular anomalies, and 8% with normal CPET. Of the patients with gas exchange abnormalities, the most common causes were bronchiectasis (6), emphysema (6), recent pneumonia (2), and diffuse interstitial pneumonitis (2). Ten of the patients with cardiovascular abnormalities had chronotropic insufficiencies, 5 had excessive tension responses, and 3 had disorders of rhythm or repolarisation.
CONCLUSIONS: CPET may greatly facilitate the diagnosis of unexplained dyspnoea. More than 50% of the dyspnoea cases examined here were due to deconditioning or hyperventilation syndrome and would benefit from a simple pulmonary rehabilitation program.

OBJECTIVE: The aim of this systematic review and meta-analysis was to determine the effects of whole-body vibration training on metabolic abnormalities, mobility, balance and aerobic capacity in older adult patients with type 2 diabetes mellitus.
METHODS: We searched PubMed, Cochrane Library, PEDro, LILACS and SciELO (from the earliest date available to March 2018) for controlled trials that evaluated the effects of whole-body vibration on the health-related outcomes of patients with type 2 diabetes. Two reviewers independently selected the studies and performed statistical analyses of the studies. Weighted mean differences, standard mean differences and 95% confidence intervals (CIs) were calculated.
RESULTS: In total, 7 studies, involving 279 patients who had type 2 diabetes, that compared whole-body vibration with other exercises and/or controls were included. Individual studies suggested that whole-body vibration was associated with improvements in pain levels, blood flow in the legs, glycated hemoglobin levels and fasting blood glucose levels. Whole-body vibration improved mobility weighted mean differences (-.24 seg; 95% CI -2.0, -0.5; n=96); balance standard mean differences (2.34; 95% CI 1.16, 3.5; n=57); and aerobic capacity standard mean differences (0.7; 95% CI 0.2, 1.3; n=59).
CONCLUSIONS: Whole-body vibration could be a useful strategy in the management of the symptoms and disabilities associated with type 2 diabetes; however, it is necessary to perform further studies to reinforce the reported findings.

OBJECTIVE: The sedentary lifestyle is defined by a lack of regular mobilizing activities in the activities of daily life. The purpose of this work was to gather data related to the potential link between urinary incontinence and sedentary lifestyle in women.
METHODS: A literature review (Pubmed/MEDLINE databases) based on keywords: women; urinary incontinence; sedentary; sedentary behavior; sedentary lifestyle; physical activity; exercise; sport, over the period 2008-2018 was carried out.
RESULTS: Five cross-sectional observational studies were analyzed. Overall, the data supported a link between sedentary behavior and urinary incontinence in women. Several potential confounding factors (age, body mass index, comorbidities, lower socio-familial support) have been identified in the literature. Pathophysiological mechanisms remain poorly established, potentially including metabolic factors, postural factors and muscle dysfunctions. Few articles respected the strict definition of sedentary lifestyle, and no prospective study investigating the causal link between meddle or long-term sedentary was highlighted.
CONCLUSIONS: The limited data available in the literature suggests that sedentary lifestyle is a risk factor for female urinary incontinence. Many confounding factors have been identified, justifying further studies evaluating more specifically the causal link between sedentary lifestyle and urinary incontinence in women.

BACKGROUND: Beneficial effects of physical exercise have been previously demonstrated in patients with chronic obstructive pulmonary disease. The aim of this systematic review was to summarize the evidence supporting physical exercise to improve on lung function, exercise capacity and quality of life in cystic fibrosis patients.
METHODS: Medline database was used to search clinical studies from 2000 to 2015. We also analyzed the bibliographic section of the included studies, in order to identify additional references.
RESULTS: A total of 17 studies were identified. A great disparity was found in the results of the different studies. No systematic benefit was found on lung function, exercise capacity or quality of life. No relationship between the type of program and the benefits achieved was observed.
CONCLUSIONS: Evidence that physical exercise benefits lung function, exercise capacity and quality of life in cystic fibrosis patient is inconsistent and evidence does not support a particular standardized program for all patients.