Comparison of thoracic expansion, trunk endurance, and lumbopelvic flexibility in children with and without lower urinary tract dysfunction

Abstract

Purpose: The aim of this study was to examine thoracic expansion, trunk endurance, and lumbopelvic flexibility in children with Lower Urinary Tract Dysfunction (LUTD) compared to healthy group. Methods: The study included a total of 36 children: 18 children aged 7-15 years diagnosed with LUTD with Dysfunctional Voiding Incontinence Scoring System (DVISS) >8.5, and 18 healthy children matched for gender, age, body mass index, and percentile. Thoracic expansion was assessed using circumference measurement; core endurance using the “Dynamic Sit-up Test and Static Lateral Plank Test”; and lumbopelvic flexibility using the “Sit-and-Reach Test”, “Passive Straight Leg Raise Test”, “Modified Schober Test”, and “Prone Quadriceps Femoris Flexibility Test”. Results: Thoracic expansion was lower in the LUTD group (p=0.003). While lateral plank time was shorter in the LUTD group (p=0.031), no difference was found between the groups in terms of the dynamic sit-up test (p>0.05). Lumbopelvic flexibility values for the "Sit-and-Reach Test” (p=0.033), “Passive Straight Leg Raise Test” (dominant p=0.016; non-dominant p=0.008), “Modified Schober Test” (p=0.023), and “Prone Quadriceps Femoris Flexibility Test” (p=0.006) were found to be lower in the LUTD group. Conclusion: While there is no difference in anterior dynamic endurance in children with LUTD compared to their healthy peers, it can be said that thoracic expansion and lumbopelvic flexibility are limited, and lateral trunk endurance capacity are weaker. Rehabilitation programs should address not only the pelvic floor but also the thoracic and lumbopelvic structures through a holistic approach. Further assessment and intervention studies should be planned.

Keywords

• Lower urinary tract symptoms
• Child
• Abdominal muscles
• Flexibility
• Case-control studies.

Alt üriner sistem disfonksiyonu olan ve olmayan çocuklarda torakal ekspansiyon, gövde enduransı ve lumbopelvik esnekliğin karşılaştırılması

Abstract

Amaç: Bu çalışmanın amacı alt üriner sistem disfonksiyonu (AÜSD) olan çocuklarda sağlıklı gruba kıyasla torakal ekspansiyonun, gövde enduransının ve lumbopelvik esnekliğin incelenmesiydi. Yöntem: Çalışmaya 7-15 yaş aralığında, AÜSD tanısı almış ve İşeme Bozukluğu Semptom Skoru (İBSS) >8,5 olan 18 çocuk ile cinsiyet, yaş, vücut kitle indeksi ve persentil açısından uyumlu 18 sağlıklı çocuk olmak üzere toplam 36 çocuk dahil edildi. Çocukların torakal ekspansiyon kapasitesi çevre ölçümü ile; gövde enduransı “Dinamik Mekik Testi” ve “Statik Lateral Plank Testi” ile ve lumbopelvik esnekliği “Otur-Uzan Testi”, “Pasif Düz Bacak Kaldırma Testi”, “Modifiye Schober Testi” ve “Yüzüstü Quadriceps Femoris Esneklik Testi” ile değerlendirildi. Bulgular: AÜSD grubunun torakal ekspansiyon kapasitesi değeri daha düşüktü (p=0,003). Gövde enduransı açısından lateral plank süresi AÜSD grubunda daha az olmakla birlikte (p=0,031), dinamik mekik testi açısından gruplar arasında fark olmadığı saptandı (p>0,05). AÜSD grubunun “Otur-Uzan Testi” (p=0,033), “Pasif Düz Bacak Kaldırma Testi” (dominant p=0,016; dominant olmayan p=0,008), “Modifiye Schober Testi” (p=0,023) ve “Yüzüstü Quadriceps Femoris Esneklik Testi”ne (p=0,006) ait lumbopelvik esneklik değerleri sağlıklı gruba göre daha düşük bulundu. Sonuç: AÜSD olan çocuklarda sağlıklı akranlarına kıyasla anterior dinamik enduransta bir farklılık olmadığı, torakal ekspansiyonun ve lumbopelvik esnekliğin kısıtlı olduğu ve lateral gövde endurans kapasitesinin daha düşük olduğu söylenebilir. AÜSD olan çocuklarda rehabilitasyon programları pelvik tabanın ötesinde bütüncül bir yaklaşım ile torakal ve lumbopelvik yapıları da ele almalıdır. Konuya ilişkin ileri değerlendirme ve müdahale çalışmaları planlanmalıdır.

Keywords

• Alt üriner sistem semptomları
• Çocuk
• karın kasları
• Esneklik
• Vaka kontrol çalışmaları.

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