Examination of Trunk and Lower Extremity Biomechanics in Children With LUTD.
Condition: Lower Urinary Tract Symptoms; Posture Disorders in Children; Muscle Weakness Condition; Urinary Incontinence in Children; Lower Extremity Problem
MeSH terms: Muscle Weakness; Urinary Incontinence; Lower Urinary Tract Symptoms
Study type: Observational [Patient Registry]

Summary: 
      This study aimed to examine trunk and lower extremity biomechanics among children with lower
      urinary tract dysfunction (LUTD). It was targeted to pioneer including biomechanical changes
      into treatment if detected in the trunk and lower extremities of children. Voluntary
      participants meeting inclusion criteria were divided into two groups: the LUTD group (n=43)
      and the healthy group (n=43). No treatment was applied to participants and the same
      evaluation methods were used in both groups. Trunk muscle strength, muscle endurance,
      posture, flexibility, and pelvic floor muscle activity of participants was evaluated with
      stabilizer pressurized biofeedback unit, sit-ups and modified push-ups test; trunk flexors
      endurance test and Modified Biering Sorensen Test; Posture Screen Mobile And Foot Posture
      Index; sit-reach-test and Beighton Score; and NeuroTrac-Myoplus4Pro, respectively. In
      addition, the quality of life of participants was evaluated with Pediatric Quality of Life
      Inventory (PedsQL).
    

Detailed description: 
      A detailed evaluation is of great importance in the correct diagnosis and treatment of
      patients with LUTD. In order for a holistic evaluation to show the right path, history taking
      and physical examination are the most important steps of the evaluation. In addition, it is
      recommended by ICCS to observe and question the conditions that may cause urgency, holding
      maneuvers and behavioral structure of the patient. In current clinical practice, changes in
      posture and balance have been noticed during physiotherapy assessments in children and
      adolescents with incontinence. In addition, we think that it is possible to disrupt the trunk
      and lower extremity alignments, which are frequently performed by children with incontinence.
      These changes may be an important part of the physical and developmental disturbances in
      children with incontinence. The pelvis and lower extremity consist of interconnected closed
      chain structures. The movement of any link in the chain depends on the movement and positions
      of the other links. Therefore, disruption of the alignment of one of the links forming and
      affecting the chain may cause a change in the mobility and stability of all mechanically
      related structures, and may also affect the optimal force and activation that the pelvic
      floor muscles can produce. Our study hypothesizes that the movement of any link in the closed
      chain of the body and the disruption of one of the links forming this chain cause a change in
      the mobility, stability and balance of all structures that are mechanically connected, this
      change will closely affect the activation of the pelvic floor muscles, as well as the
      children in this group. It was stated that the trunk and lower extremity alignment might have
      been impaired due to the holding maneuvers that he frequently performed.

      Our study, it was aimed to examine the trunk and lower extremity biomechanics in children
      with LUTD. In addition, if biomechanical changes are detected in the trunk and lower
      extremities of children and adolescents with incontinence, our study will lead to the
      necessity of including these changes in the treatment.
    

Intervention name(s): The same evaluation methods were used for both groups.
Intervention type(s): Other
Intervention description(s): No treatment applied to participants and same evaluation methods used in both groups. Trunk muscle strength, muscle endurance, posture, flexibility and pelvic floor muscle activity of participants was evaluated with stabilizer pressurized biofeedback unit, sit-ups and modified push-ups test; trunk flexors endurance test and Modified Biering Sorensen Test; Posture Screen Mobile And Foot Posture Index; sit-reach-test and Beighton Score; and NeuroTrac-Myoplus4Pro,
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Participants aged 5-18 years who were newly diagnosed with lower urinary tract dysfunction
        and healthy participants in the same age group.