Association between motor developmental milestones, pelvic floor muscle activity, and uroflowmetry in children with...

This study aimed to determine whether children with bladder and bowel dysfunction (BBD) show deviations in motor developmental milestones and to examine the correlations between motor development timing and pelvic floor parameters. In this retrospective, cross-sectional study, 58 children aged 5-12 years diagnosed with BBD by a pediatric urologist between 2022 and 2025 were evaluated. Motor milestone ages, pelvic floor muscle activity (work/rest average, deviation, and maximum voluntary contraction), uroflowmetry, daily voiding frequency, and weekly defecation frequency were assessed. A total of 28 girls and 30 boys with a mean age of 8.9 ± 2.5 years were included. BMI percentile analysis showed that 67.2% of children had normal weight, with normal weight more common in girls (73.3%) than in boys (61.3%). The mean months for head control, unsupported sitting, crawling, unsupported standing, and unsupported walking were 3.0 ± 1.2, 7.0 ± 1.3, 8.2 ± 1.4, 12.1 ± 13.9, and 13.1 ± 2.5, respectively. The average birth month was 38 ± 1.8 weeks. The work average muscle activity was found to have a weak-to-moderate positive correlation with unsupported walking (r = 0.36, p = 0.006; p < 0.05). Voided volume was positively correlated with head control (r = 0.38, p = 0.03), unsupported sitting (r = 0.26, p = 0.044), and unsupported walking (r = 0.08, p = 0.047), with weak to moderate effect sizes. A negative correlation was found between the daily urination frequency and unsupported sitting (r =  - 0.26, p = 0.042; p < 0.05). A negative correlation was also observed between the age of unsupported walking and weekly defecation frequency (r =  - 0.27, p = 0.040; p < 0.05).

The results suggest that in children with BBD, head control, sitting, and walking milestones are positively associated with voided volume and pelvic floor muscle activity. Additionally, earlier walking and sitting were associated with lower frequencies of urination and defecation.

• As infants grow, the caudal shift in the center of gravity activates the postural role of pelvic floor muscles. • The link between pelvic floor dysfunction and motor milestones has not been explored.

• Pelvic floor muscle activity and voided volume are positively associated with head control, sitting, and walking. • Urination and defecation frequency are negatively associated with unsupported sitting and walking.