Relationship Between Pelvic Angle, Femoral Anteversion, and Hip Muscle Strength Ratios in Bladder-bowel Dysfunction

NCT ID: NCT05182671

Last Updated: 2024-02-12

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 50 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2022-01-15
• Study Completion Date: 2024-02-09

Brief Summary

Bladder and bowel dysfunction is a combination of lower urinary tract and bowel dysfunction seen in children over 5 years of age without identifiable or discernible neurological abnormalities. The proper functioning of the bladder, bowel, nerves, pelvic floor muscles and related anatomical structures provides the bowel and lower urinary tract function. Dysfunction of any structure of the pelvic floor can potentially cause to bladder and bowel dysfunction. The ability of the pelvic floor muscles to perform the correct contraction and relaxation function is also closely related to the position of the pelvis, muscle strength of the hip muscles, and femoral anteversion. Disruption of one of the links forming the chain causes a change in the mobility and stability of all mechanically related structures and may affect the optimal force that the pelvic floor muscles can produce.

As far as investigators know, there is no study in the literature examining the relationship between BBD and pelvic angle, femoral anteversion angle, femoral internal/external rotation angle ratio and hip muscle strength ratios in children with bladder-bowel dysfunction. Considering the close relationship between pelvis position, hip muscle strength, and femoral anteversion with the pelvic floor, investigators think that this relationship should be evaluated in children with BBD and will contribute to the literature.

Detailed Description

Bladder and bowel dysfunction (BBD) is a combination of lower urinary tract (LUT) and bowel dysfunction seen in children over 5 years of age without identifiable or discernible neurological abnormalities. Constipation and fecal incontinence are common bowel dysfunctions. Common lower urinary tract dysfunction (LUTD) symptoms of BBD include dysuria, urgency, urinary frequency, difficulty in initiating urine, daytime incontinence, enuresis, straining, delayed voiding, and urinary retention. Urological conditions such as overactive bladder, underactive bladder and dysfunctional voiding can also be part of BBD.

The proper functioning of the bladder, bowel, nerves, pelvic floor muscles and related anatomical structures provides the bowel and LUT function. The pelvic floor is a structure located at the base of the pelvis, consisting of smooth and striated muscle sphincters, endopelvic fascia, connective tissue and ligaments, mucosal and vascular tissues, levator ani and more superficial perineal muscles. It actively supports the pelvic organs (bladder, bowel, uterus) and provides continence. Dysfunction of any structure of the pelvic floor can potentially cause to bladder and bowel dysfunction.

The ability of the pelvic floor muscles to perform the correct contraction and relaxation function is also closely related to the position of the pelvis, muscle strength of the hip muscles, and femoral anteversion. The pelvis and lower extremity consist of interconnected closed chain structures. The movement of any link in the chain depends on the movement of the other links. For this reason, disruption of one of the links forming the chain causes a change in the mobility and stability of all mechanically related structures and may affect the optimal force that the pelvic floor muscles can produce.

As far as investigators know, there is no study in the literature examining the relationship between BBD and pelvic angle, femoral anteversion angle, femoral internal/external rotation angle ratio and hip muscle strength ratios in children with bladder-bowel dysfunction. Considering the close relationship between pelvis position, hip muscle strength, and femoral anteversion with the pelvic floor, investigators think that this relationship should be evaluated in children with BBD and will contribute to the literature.

Conditions

Bladder and Bowel Dysfunction, Femoral Anteversion; Bladder and Bowel Dysfunction, Hip Strength Ratios; Bladder and Bowel Dysfunction, Pelvic Angle

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

Children diagnosed with bowel and bladder dysfunction

Children who are between the ages of 5-12 and diagnosed with bladder- bowel dysfunction by pediatric urologist.

Scales and measurements for bladder and bowel dysfunction, pelvic angle, proximal hip strength, femoral hip anteversion

Intervention Type: OTHER

Assessments Children whose physical examination has been completed and diagnosed with BBD will be evaluated with following assessments.

Demographic Data Form Questionnaire Forms Dysfunctional Voiding and Incontinence Scoring System Bladder Diary Bowel Diary EMG-uroflowmetry Ultrasonography

Post Voiding Residual Measurement:

Bladder wall thickness

Pelvic Floor Muscle Activation Measurement:

Pelvic Floor Muscle Strength Assessment:

Hip agonist-antagonist muscle ratios Pelvic angle measurement Femoral anteversiyon angle measurement

Femoral internal and external rotation angle:

Interventions

Scales and measurements for bladder and bowel dysfunction, pelvic angle, proximal hip strength, femoral hip anteversion

Assessments Children whose physical examination has been completed and diagnosed with BBD will be evaluated with following assessments.

Demographic Data Form Questionnaire Forms Dysfunctional Voiding and Incontinence Scoring System Bladder Diary Bowel Diary EMG-uroflowmetry Ultrasonography

Post Voiding Residual Measurement:

Bladder wall thickness

Pelvic Floor Muscle Activation Measurement:

Pelvic Floor Muscle Strength Assessment:

Hip agonist-antagonist muscle ratios Pelvic angle measurement Femoral anteversiyon angle measurement

Femoral internal and external rotation angle:

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• To be between the ages of 5-12
• To be diagnosed with bladder- bowel dysfunction

Exclusion Criteria

• To be younger than 5 years old
• To have an orthopedic disease that would prevent the evaluation
• To have anatomical changes in the urinary system
• To have having a neurological disorder
• To have cognitive impairment and mental retardation
• To have an orthopedic surgery that can change pelvis and lower extremity biomechanics

• Minimum Eligible Age: 5 Years
• Maximum Eligible Age: 12 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Bahçeşehir University

OTHER

Sponsor Role: collaborator

Halil Tugtepe

OTHER

Sponsor Role: lead

Responsible Party

Halil Tugtepe

Professor, Dr. (MD)

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Aygül Köseoğlu, PT, MSc

Role: PRINCIPAL_INVESTIGATOR

Tuğtepe Pediatric Urology Clinic

Halil Tuğtepe, MD, Prof Dr,

Role: STUDY_CHAIR

Tuğtepe Pediatric Urology Clinic

Pelin Pişirici, PT, PhD

Role: STUDY_DIRECTOR

Bahçeşehir University Faculty of Health Sciences

Tuğçe Atalay, PT

Role: STUDY_CHAIR

Tuğtepe Pediatric Urology Clinic

Ece Zeynep Saatçi, PT

Role: STUDY_CHAIR

Tuğtepe Pediatric Urology Clinic

Melis Ünal, PT

Role: STUDY_CHAIR

Tuğtepe Pediatric Urology Clinic

Locations

Private Tugtepe Pediatric Urology Clinic

Istanbul, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

TUGTEPEPUC

Identifier Type: -

Identifier Source: org_study_id