A systematic review of supervised comprehensive functional physiotherapy after radical prostatectomy

Area of Science:

• Urology
• Physical Therapy
• Rehabilitation Medicine

Background:

• Radical prostatectomy (RP) can lead to decreased physical and emotional functioning and reduced Health-Related Quality of Life (HRQoL).
• Current standard conservative treatment, pelvic floor muscle training (PFMT), may not fully address the multidimensional physiological changes post-RP.
• More comprehensive physiotherapy interventions are needed for patient-centered recovery.

Purpose of the Study:

• To evaluate if Comprehensive Functional Physical Therapy (CFPT), focusing on lower limb and lumbo-pelvic exercises, improves physical capacities and functions, including urinary continence (UI).
• To assess the impact of CFPT on emotional functions and HRQoL in patients post-RP.
• To compare the effectiveness of CFPT against PFMT alone.

Main Methods:

• Systematic review conducted following PRISMA guidelines.
• Literature search across PubMed, PEDro, Web of Science, and Cochrane Library up to January 2022.
• Eligibility criteria determined using the PICO approach; study quality assessed for evidence levels.

Main Results:

• Eight clinical trials met the inclusion criteria.
• All studies reported significant positive outcomes for urinary continence (UI) with CFPT (P<0.05).
• CFPT demonstrated significant improvements in physical capacities, physical and emotional functioning, and HRQoL (P<0.05).

Conclusions:

• Comprehensive Functional Physical Therapy (CFPT) is a safe and effective non-invasive intervention for post-RP recovery.
• CFPT shows superior outcomes in UI recovery, physical capacities, functioning, and HRQoL compared to PFMT alone.
• Further standardized, multidisciplinary-guided clinical trials are recommended to confirm these findings.