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Sexual dysfunction, including erectile dysfunction and penile shortening, is a frequent consequence of radical pelvic surgeries such as prostatectomy, cystoprostatectomy, and rectal cancer surgery. These complications primarily result from nerve injury and hypoxia‐induced corporal fibrosis. As survivorship care gains prominence in oncology, preserving sexual function and penile anatomy has become a critical objective. Penile traction therapy (PTT) is a non‐invasive intervention that applies controlled mechanical stretch to the penis. Through mechanotransduction, PTT may stimulate tissue remodeling, preserve length, and reduce fibrosis. Initially developed for Peyronie's disease, PTT is now being explored for penile rehabilitation following pelvic surgery. Preliminary clinical studies, including randomized controlled trials, suggest that early initiation of PTT may help maintain or even improve penile length and erectile function (EF). Treatment is generally well tolerated, with high adherence and minimal side effects. The advent of second‐generation devices, offering enhanced ergonomics and reduced daily usage times, has further improved feasibility and patient compliance. This review outlines the pathophysiological basis of post‐surgical penile changes, the mechanism of action of PTT, and the emerging evidence base for its use in the post‐oncological setting. Although PTT use remains off‐label in this context, it represents a promising component of multimodal penile rehabilitation strategies. Its broader adoption is currently limited by barriers such as device cost, lack of insurance coverage, and the absence of standardized protocols. Structured follow‐up, patient education, and multicenter long‐term studies are essential to validate efficacy, establish best practices, and optimize accessibility for patients recovering from radical pelvic surgery.

The turnover of integrin receptors is critical for cell migration and adhesion dynamics. Here we find that force development at integrins regulates adaptor protein recruitment and endocytosis. Using mobile RGD (Arg-Gly-Asp) ligands on supported lipid membranes (RGD membranes) and rigid RGD ligands on glass (RGD-glass), we find that matrix force-dependent integrin signals block endocytosis. Dab2, an adaptor protein of clathrin-mediated endocytosis, is not recruited to activated integrin-beta3 clusters on RGD-glass; however, it is recruited to integrin-mediated adhesions on RGD membranes. Further, when force generation is inhibited on RGD-glass, Dab2 binds to integrin-beta3 clusters. Dab2 binding to integrin-beta3 excludes other adhesion-related adaptor proteins, such as talin. The clathrin-mediated endocytic machinery combines with Dab2 to facilitate the endocytosis of RGD-integrin-beta3 clusters. From these observations, we propose that loss of traction force on ligand-bound integrin-beta3 causes recruitment of Dab2/clathrin, resulting in endocytosis of integrins. Force is known to recruit adaptor proteins to the intracellular tails of integrin extracellular matrix receptors. Here the authors show that matrix force-dependent β3 integrin signals block endocytosis by preventing the recruitment of the clathrin adaptor Dab2.

In resource‐limited settings, selecting the appropriate treatment for femoral fractures is crucial as it affects both patient recovery and the efficient use of medical resources. This review explores the treatment options for adult and elderly patients with surgical contraindications suffering from femoral fractures, with a particular emphasis on the trade‐offs between surgical intervention and traction therapy. Through a systematic literature search of major databases such as PubMed, Web of Science, and the Cochrane Library, we identified 39 studies that met the inclusion criteria, focusing on complications, treatment effectiveness, functional recovery, and cost analysis. We found that although intramedullary nailing may offer better clinical outcomes, traction therapy often becomes the treatment of choice in resource‐poor environments due to limited surgical resources. The professional judgment of physicians (OR 10.81; 95% CI 8.28–14.11), patient preferences (OR 1.33; 95% CI 0.80–2.21), and hospital surgical capacity (OR 1.87; 95% CI 0.56–6.28) are key factors influencing treatment choice. For elderly patients, the choice of treatment requires a balance between the risks of surgery and the potential complications of non‐surgical treatment (OR 0.78; 95% CI 0.10–5.90). Ultimately, the decision‐making process is complex and requires a comprehensive consideration of available resources, cost‐effectiveness, patient health status, physician experience, patient preferences, and expected clinical outcomes. In resource‐constrained areas, this process is particularly challenging and necessitates a careful consideration of the risks and benefits of both surgical and non‐surgical treatment options. This review examines the trade‐offs between surgical intervention and traction therapy for adult and elderly patients with femoral fractures and surgical contraindications, particularly in resource‐limited settings. While intramedullary nailing may offer better clinical outcomes, traction therapy is often preferred due to limited surgical resources. Physician judgment, patient preferences, and hospital surgical capacity significantly influence treatment choices. For elderly patients, treatment selection requires balancing the risks of surgery with the potential complications of non‐surgical treatments.

Cervical traction therapy is commonly used for cervical spondylosis; however, complications, such as subdural hematomas can occur. Possible mechanisms include cerebrospinal fluid (CSF) leakage and bridging vein damage. A 51-year-old Japanese woman developed a persistent headache after 2 weeks of cervical traction therapy. Magnetic resonance imaging revealed bilateral subdural hematomas. Bed rest, oral analgesics, and daily infusion therapy failed to improve symptoms, but 2 epidural blood patches led to recovery. Although no direct CSF leakage was found, a spinal epidural lesion may have contributed. Cervical traction therapy may cause subdural hematomas via intracranial hypotension. Clinicians should consider this risk and conduct thorough diagnostic evaluations in affected patients.

Low back pain (LBP) is one of the most costly diseases in the developed world. This study aimed to investigate the effects of underwater traction therapy on chronic low back pain. The primary objective was to prove that underwater traction therapy has favorable effects on LBP. Our secondary objective was to evaluate whether it also leads to improvement in the quality of life. This is a prospective, multicenter, follow-up study. A total of 176 patients with more than 3 months of low back pain enrolled from outpatient clinics were randomized into three groups: underwater weight bath traction therapy and non-steroidal anti-inflammatory drugs (NSAIDs); weight bath; and only NSAIDs. The following parameters were measured before, right after, and 9 weeks after the 3-week therapy: levels of low back pain in rest and during activity were tested using the visual analogue scale (VAS), the Oswestry Low Back Disability Questionnaire, and the EuroQol-5D-5L Questionnaire.The VAS levels improved significantly (p < 0.05) in both underwater weight bath traction therapy groups by the end of the treatment, whereas the improvement in the third group was not statistically significant. Furthermore, the improvements measured in the groups receiving traction therapy were persistent during the follow-up period. There were no significant changes in the Oswestry Index or the EuroQol-5D-5L without VAS parameters in any of the groups.Based on our results, for patients suffering from LBP pain who underwent underwater weight bath traction therapy, there were favorable impacts on the pain levels at rest or during activity. Clinical trial registration ID: NCT03488498, April 5, 2018

Background and Objectives: We aimed to develop a cranial suture traction therapy program, a non-surgical therapeutic method for facial asymmetry correction. Materials and Methods: Six experts, including rehabilitation medicine specialists, oriental medical doctors, dentistry specialists, five experts, including Master’s or doctoral degree holders in skin care and cosmetology with more than 10 years of experience in the field, 4 experts including educators in the field of skin care, a total of 15 people participated in the validation of the development of the cranial suture traction therapy program in stages 1 to 3. Open questions were used in the primary survey. In the second survey, the results of the first survey were summarized and the degree of agreement regarding the questions in each category was presented. In the third survey, the degree of agreement for each item in the questionnaire was analyzed statistically. Results: Most of the questions attained a certain level of consensus by the experts (average of ≥ 4.0). The difference between the mean values was the highest for the third survey at 0.33 and was the lowest between the second and third surveys at 0.47. The results regarding the perceived degree of importance for each point of the evaluation in both the second and third stages of the cranial suture traction therapy program were verified using the content validity ratio. The ratio for the 13 evaluation points was within the range of 0.40−1.00; thus, the Delphi program for cranial suture traction therapy verified that the content was valid. Conclusions: As most questions attained a certain level of consensus by the experts, it can be concluded that these questions are suitable, relevant, and important. The commercialization of the cranial suture traction treatment program will contribute to the correction and prevention of facial dislocations or asymmetry, and the developed treatment will be referred to as cranial suture traction therapy (CSTT).

Background The main clinical manifestations of hemophilia are muscle and joint bleeding. Recurrent bleeding leads to a degenerative process known as hemophilic arthropathy. The development of inhibitors (antibodies against FVIII/FIX concentrates) is the main complication in the treatment of hemophilia. The objective was to assess the safety and efficacy of manual therapy treatment in a patient with hemophilia and inhibitor. Case presentation A 26-year-old patient with hemophilia B and inhibitor received physiotherapy treatment based on manual therapy for 3 months, with a frequency of 2 sessions per week. The joint status was evaluated using the Hemophilia Joint Health Score ; pain was assessed with the Visual Analog Scale ; and the range of movement was evaluated using a universal goniometer. The patient developed no joint bleeding in the knees or ankles as a result of the physiotherapy treatment. Following treatment, improvements were noted in the range of movement of knees and ankles, the perception of pain in both knees, and ankle functionality. Conclusions Until now, manual therapy using joint traction was contraindicated in patients with hemophilia and inhibitor, as it was feared to cause possible joint bleeding. This is the first case study to address the safety and efficacy of manual therapy in a patient with hemophilia and an inhibitor. The results of this study may help to establish which manual therapy treatments are indicated in patients with hemophilic arthropathy and inhibitors. Thus, a physiotherapy program based on manual therapy may be safe in patients with hemophilia and inhibitor and such therapy may improve joint condition, pain, and joint range of motion in patients with hemophilia and inhibitor. Randomized clinical trials are needed to confirm the results of this case study.

This chapter discusses the purpose, principle of operation, specifications, and applications of traction unit. The traction unit is a device to provide treatment by relieving pressures on structures that may be causing pain of skeletal or muscular origin, specifically in the cervical, thoracic, lumbar, hip, wrist, and shoulder regions of the body. Manual traction involves the therapist using his or her hands on the patient's body, with the body weight of the therapist providing the tractive force. In motorized traction, the traction is exerted by a motorized pulley. The various modes of traction therapy are static traction therapy, intermittent traction therapy and cyclic traction. The purpose of traction is to regain normal length and alignment of the involved bone, lessen or eliminate muscle spasms, relieve pressure on nerves especially spinal nerves, and prevent or reduce skeletal deformities or muscle contractures.

Treating men with Peyronie's disease remains a challenging problem facing clinicians working across urology and sexual medicine fields. Patients can often be left disappointed by current treatment paradigms, and an overall lack of suitable molecular targets has limited the options for novel, effective medical therapy. Managing men with Peyronie's disease often involves careful counselling alongside multifaceted and possible combination treatments to help improve symptoms whilst ameliorating potential side effects of therapy. We review the latest medical literature and evidence in the contemporary management of Peyronie's disease.

Peyronie’s disease is a condition that causes abnormal healing of the tunica albuginea, causing penile curvature. It is difficult to treat and its management is continuing to evolve. Proposed non-surgical treatments have included oral, topical, intralesional, extracorporeal shockwave, and traction therapy. The study of Peyronie’s disease is made difficult by heterogeneity in the timing of presentation, severity and characteristics of deformity, and associated complaints. Moreover, meta-analyses of studies are difficult due to inconsistencies across study endpoints and the duration of treatments. This article reviews the current clinical evidence and guideline recommendations, with a focus on an improvement in penile curvature.