Prostate Rehabilitation Exercise Program (PREP) Founder
Heath Prentice has designed the Prostate Exercise Rehabilitation Program to help men with prostate cancer prevent and recover from many symptoms of prostate cancer treatments. Heath is an Accredited Exercise Physiologist (AEP) and completed an undergraduate degree in Science, Exercise and Health Science at the University of Western Australia. Once completing his undergraduate degree Heath then chose to undertake a Graduate Diploma in Exercise Rehabilitation at the University of Western Australia to become an AEP.
Upon graduating Heath began working at PROST! Mens’s Health Exercise for Prostate Cancer, where he has been the head Exercise Physiologist since 2012. Working in the face to face delivery of exercise for men with prostate cancer has given Heath a profound understanding of the side effects of all prostate cancer treatments and the best exercises to help combat side effects such as incontinence, erectile dysfunction, fatigue and loss of muscle mass.
Through PROST! Heath has developed detailed knowledge of pelvic floor muscles and how to most effectively train them. Heath is also a certified Pilates instructor and has discovered that combining principles of Pilates with strength based exercises can help men successfully engage the correct muscles and recover from prostate cancer side effects.
Having worked with dozens of men with prostate cancer over the years Heath would now like to share his knowledge and help as many men recover from prostate cancer as possible. He has seen the benefits of pelvic floor specific and generalized strength training firsthand and his vision is for every man with prostate cancer to engage in regular exercise that has been created specifically for them.
More Information on the benefits of PREP
The Prostate Rehabilitation Exercise Program (PREP) has been created for males who have been diagnosed with Prostate Cancer. PREP prescribes exercises that are specifically targeted to assist with the rehabilitation of common side effects of prostate cancer treatments, particularly urinary incontinence and erectile dysfunction.
Research studies into the effects of pelvic floor training have shown that specific pelvic floor exercises are an effective rehabilitation strategy to reduce incontinence (insert reference). Studies have also suggested that pelvic floor training assists with erectile dysfunction and a randomized control study revealed that specific pelvic floor muscle exercises were significant in improving erectile function (Dorey et al. 2005). There is also evidence which shows that performing pelvic floor exercises before surgery can decrease the severity of incontinence and erectile dysfunction post-operatively.
There are other common side effects from many prostate cancer treatments (including hormone therapies, surgery etc.) such as loss of bone density, weight gain, osteoporosis, decreased muscle mass and fatigue. All of these side effects can all be reduced and/or prevented by performing regular cardiovascular and resistance based exercise, which is a strong focus of the PREP. Aside from the specific side effects from prostate cancer treatments, engaging in regular exercise helps improve general quality of life and mental health.
Exercises contained in this pack are specifically designed to be performed at home with minimal equipment. The PREP pack contains all the equipment required to complete the exercises, which are outlined later on. There are 20 weeks worth of exercise sessions and the type of treatment, either surgical or non-surgical, influences the configuration of these weekly sessions.
If undergoing surgical treatment:
The first 8 weeks are designed to be completed prior to surgery, allowing time for the pelvic floor muscles to strengthen and this has been shown to help improve post-surgical outcomes (research). If surgery is scheduled for sooner then 8 weeks simply start at week 1 and complete the sessions until the week of surgery.
Following surgery a six week break from the exercise sessions is required, it is highly recommended to have physiotherapy treatment in this time period and ensure that the surgeon has cleared you prior to returning to the exercise program.
The last 12 weeks of the program are followed sequentially and with no need for any breaks in-between weeks. These sessions aim to start restoring pelvic floor strength and progress to incorporating functional strengthening exercises for the pelvic floor and main muscle groups.
If undergoing non-surgical intervention:
Follow the weekly guides sequentially and there is no need for the six week break after week 8. However, depending on the non-surgical intervention (e.g. hormone therapy, radiotherapy etc.) there may be a need for an occasional weeks break subject to how the body reacts after each treatment. As previously mentioned the exercise sessions have been designed for all treatment modalities and there will be benefits from performing the 20 week program regardless of the treatment.
The PREP is also intended for males that have previously undergone treatment but are still having incontinence and erectile dysfunction issues months or years after initial treatment. Specific pelvic floor exercises as found in the weekly exercise sessions help to improve bladder and bowel control, therefore decreasing incontinence. Strengthening the pelvic floor muscles have also shown to improve sensation during intercourse.
Each week of the 20 week program has 3 exercise sessions. These are designed to take approximately 45 minutes and contain two different styles of exercise sessions:
1. Pelvic floor specific exercises with pelvic floor integrated resistance exercises
· Starts with isolated pelvic floor exercises to increase awareness and activation of the pelvic floor muscles
· Exercises are then slowly transitioned into performing upper and lower body strengthening exercises while still engaging the pelvic floor muscles, which is highly important for completing normal daily tasks
· These are the first and third sessions of every week
2. Extended pelvic floor specific exercises
· The session begins with isolated pelvic floor exercises and progresses to functional pelvic floor exercises
· There is no resistance component, which allows muscles to fully recover and a complete focus on pelvic floor strengthening
· This is the second exercise session of each week
The PREP comes with a fitball and resistance bands, which are used throughout the exercise sessions to make exercises more challenging and bring variety to the sessions. In addition to the 3 pelvic floor and resistance exercise sessions, the program also encourages at least two walks per week. These should be on different days to the exercise sessions and work towards walking non-stop for approximately 30 minutes.
Pelvic floor muscles are not easily activated and other abdominal muscles will often automatically switch on while attempting to perform an isolated pelvic floor contraction. This manual teaches techniques to ensure the pelvic floor is being exercised and is the only structured exercise program that serves to specifically train the pelvic floor muscles. Not only do the exercises focus on static pelvic floor holds to build initial pelvic floor strength but also progress to dynamically train the pelvic floor to assist with activities of daily living.
Pelvic Floor Anatomy:
The pelvic floor is situated at the bottom of the pelvis and is made up of three muscle layers. These muscles are stretched out like a hammock and support the bladder, prostate gland and rectum. The pelvic floor muscles have numerous functions including:
Sexual function and stimulation
Plays a key role in core stability