Relationship Between Pelvic Angle, Femoral Anteversion, and Hip Muscle Strength Ratios in Bladder-bowel Dysfunction
Condition: Bladder and Bowel Dysfunction, Femoral Anteversion; Bladder and Bowel Dysfunction, Hip Strength Ratios; Bladder and Bowel Dysfunction, Pelvic Angle
MeSH terms: Intestinal Diseases; Gastrointestinal Diseases
Study type: Observational [Patient Registry]

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.
    

Intervention name(s): Scales and measurements for bladder and bowel dysfunction, pelvic angle, proximal hip strength, femoral hip anteversion
Intervention type(s): Other
Intervention description(s): 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:
Observational model: Other
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Children who are between 5-12 years old, diagnosed with bladder bowel dysfunction.