Clinical trial NCT05182671: Relationship Between Pelvic Angle, Femoral Anteversion, and Hip Muscle Strength Ratios in Bladder-bowel Dysfunction
Official title: Relationship Between Pelvic Angle, Femoral Anteversion, and Hip Muscle Strength Ratios in Children With Bladder-bowel Dysfunction
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Bladder and Bowel Dysfunction, Femoral Anteversion
Bladder and Bowel Dysfunction, Hip Strength Ratios
Bladder and Bowel Dysfunction, Pelvic Angle
Lead sponsor: Tugtepe Pediatric Urology Clinic
Sponsor class: OTHER
Collaborators: name: Bahçeşehir University
First posted: 2022-01-10
Enrollment: 50
Sex: ALL
Minimum age (years): 5
Maximum age (years): 12
Standard ages: CHILD
Accepts healthy volunteers: no
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.

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.

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

Primary outcomes:
measure: Femoral anteversion angle measurement
timeFrame: Baseline
measure: Pelvic angle measurement
timeFrame: Baseline
measure: Hip agonist-antagonist muscle ratios
timeFrame: Baseline
Secondary outcomes:
measure: Dysfunctional Voiding and Incontinence Scoring System
timeFrame: Baseline
measure: EMG-uroflowmetry
timeFrame: Baseline
measure: Ultrasonography - Post Voiding Residual Measurement, Bladder thickness
timeFrame: Baseline
measure: Pelvic Floor Muscle Activation Measurement:
timeFrame: Baseline
measure: Pelvic Floor Muscle Strength Assessment:
timeFrame: Baseline
measure: Femoral internal and external rotation angle
timeFrame: Baseline
Other outcomes:
Locations:
city: Istanbul
country: Turkey
facility: Private Tugtepe Pediatric Urology Clinic
Study officials:
affiliation: Tuğtepe Pediatric Urology Clinic
name: Aygül Köseoğlu, PT, MSc
role: PRINCIPAL_INVESTIGATOR
affiliation: Tuğtepe Pediatric Urology Clinic
name: Halil Tuğtepe, MD, Prof Dr,
role: STUDY_CHAIR
affiliation: Bahçeşehir University Faculty of Health Sciences
name: Pelin Pişirici, PT, PhD
role: STUDY_DIRECTOR
affiliation: Tuğtepe Pediatric Urology Clinic
name: Tuğçe Atalay, PT
role: STUDY_CHAIR
affiliation: Tuğtepe Pediatric Urology Clinic
name: Ece Zeynep Saatçi, PT
role: STUDY_CHAIR
affiliation: Tuğtepe Pediatric Urology Clinic
name: Melis Ünal, PT
role: STUDY_CHAIR
References: