Effectiveness of Biofeedback Training in Children with Neurogenic Bladder and Bowel Disorder with Spina Bifida

To the best of our knowledge, no study has been found in which biofeedback training combined with breathing was applied on children with neurogenic bladder. Additionally, to the best of our knowledge, no study has been found in which biofeedback exercises were applied to children with spina bifida. Therefore, in this study, researchers aim to compare the bladder functions, pelvic floor and abdominal muscle activations and quality of life of children with spina bifida who do not have access to any alternative treatment, receive only urotherapy training and biofeedback training combined with breathing.The aim of this study is to examine and compare the bladder and bowel functions, activation of pelvic floor and abdominal muscle groups, and quality of life of children diagnosed with spina bifida who did not receive any treatment due to bladder-intestinal dysfunction, received only urotherapy training, and received biofeedback training combined with breathing.

Evaluation Methods Gross Motor Function Classification System (GMFCS): The basic scale used to classify mobility is the classification called Gross Motor Function Classification System (GMFCS). According to this classification, patients are divided into 5 groups, from level 1, who can walk without any problems, to level 5, who is wheelchair-bound.

General Headings of Each Level:

Level i: walks without restriction. Level ii: walks with restrictions. Level iii: walks using hand-held mobility devices. Level iv: self-motion is limited. Can use motorized mobility device. Level v: transported in a manually propelled wheelchair. Bladder and bowel diary: It is a form recorded by the child or his/her parents in a 48-hour period, in which the child daily schedule records the amount of fluid he/she takes in and excretes, the frequency of urination, the frequency of urinary incontinence, the activity in which the incontinence occurs, the stool he/she makes throughout the day, and the quality of the stool.

Voiding Disorders Symptom Score (VBSS): Voiding Disturbances Symptom Score (VBSS), which was developed by Akbal et al. and whose validity and reliability have been proven, includes 14 questions. The first 13 questions examine the child urinary and defecation habits, daytime and/or nighttime urinary incontinence, and urination functions; The 14th question is intended to evaluate the child general quality of life. In the evaluation of IBSS 1,2 and the 3rd question will receive a minimum of 0 and a maximum of 9 points; Min 0, max 5 points from the 4th question; Min 0, max 2 points from Questions 5, 8, 9, 11, 12 and 13; A minimum of 0 and a maximum of 33 points can be obtained from the scale, with a minimum of 0 and a maximum of 3 points from the 6th Question and a minimum of 0 and a maximum of 1 from the 7th and 10th Questions. Although the Cronbach Alpha value of the scale is 0.50, the Cronbach Alpha value for this study was determined as 0.711.