Relationship Between Pelvic Angle, Femoral Anteversion, and Hip Muscle Strength Ratios in Children With Bladder-bowel Dysfunction
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Femoral anteversion angle measurement
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 5 Years 至 12 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •To be between the ages of 5-12
- •To be diagnosed with bladder- bowel dysfunction
排除标准
- •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
结局指标
主要结局
Femoral anteversion angle measurement
时间窗: Baseline
Hip anteversion was measured using the Craig test with the subject in the prone position and the knee flexed to 90°. The examiner passively rotates the hip, palpating the trochanter major, until the most prominent part of the trochanter reaches its most lateral position. The angle between the true vertical and the shaft of the tibia was measured to the nearest degree, using a Accurate Compass smartphone inclinometer.
Pelvic angle measurement
时间窗: Baseline
The inferior prominence of the anterior superior iliac spine (ASIS) and the most prominent aspect of the posterior superior iliac spine (PSIS) were identified with palpation, and pelvic angle was measured as the angle formed between the horizontal plane and a line from ASIS and PSIS landmarks using an inclinometer (Performance Attainment Associates, St Paul, MN). A positive value reflected an anterior pelvic tilt (ASIS sitting lower than the PSIS).
Hip agonist-antagonist muscle ratios
时间窗: Baseline
In the isometric muscle strength measurement procedure, each test position was evaluated with 2 repetitions of submaximal force for familiarization and 3 evaluations were taken with maximal force. Each test lasted 5 seconds, with 30-second breaks between trials. A 1-minute break was given between different measurements. MicroFET(Draper, UT) hand dynamometer was used for muscle strength measurement. The order of strength testing was randomized. The dynamometer is fixed to the leg with the help of a strap. Force values are measured in kilograms and normalized to body mass using the following formula:(kg power/kg body mass)x100. The intrarater reliability study will be completed before participants' measurements begin to be taken. Hip abductor, adductor, flexor, extensor, internal rotation, external rotation muscle strength is measured. Hip adductor/abductor, medial/lateral rotator, and flexor/extensor strength ratios muscle strength ratios will be evaluated.
次要结局
- Ultrasonography - Post Voiding Residual Measurement, Bladder thickness(Baseline)
- Femoral internal and external rotation angle(Baseline)
- Pelvic Floor Muscle Activation Measurement:(Baseline)
- Pelvic Floor Muscle Strength Assessment:(Baseline)
- Dysfunctional Voiding and Incontinence Scoring System(Baseline)
- EMG-uroflowmetry(Baseline)
研究者
Halil Tugtepe
Professor, Dr. (MD)
Tugtepe Pediatric Urology Clinic