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Effect of Connective Tissue Manipulation on Clinical Symptoms and Pelvic Floor Muscles in Children With Lower Urinary
Melis Ünal1, Elif Develi2, Halil Tuğtepe3
1Division of Pediatric Urology, Uropelvic Solutions Pelvic Floor Rehabilitation Center, Istanbul, Turkey.
Insights
Combining connective tissue manipulation (CTM) with pelvic floor muscle (PFM) exercises significantly improved uroflowmetry and reduced incontinence symptoms in children with lower urinary tract disorders.
Area of Science:
- Pediatric Urology
- Rehabilitation Medicine
Background:
- Lower urinary tract disorders (LUTDs) in children present challenges in management.
- Current treatments often focus on behavioral or pharmacological interventions.
Purpose of the Study:
- To evaluate the efficacy of a combined approach using connective tissue manipulation (CTM) and pelvic floor muscle (PFM) exercises for pediatric LUTDs.
- To assess the impact on symptoms, uroflowmetry, and PFM function.
Main Methods:
- Forty children with LUTDs were randomized into a PFM exercise group or a CTM+PFM exercise group (CTG).
- Interventions were administered thrice weekly for 8 weeks.
- Evaluations included electromyography-uroflowmetry, bladder ultrasonography, bladder diary, PFM activation assessment, and symptom scoring.
Main Results:
- The CTG group showed significant improvements in mean flow rate (Q-Ave), maximum voiding volume, and reduced incontinence frequency compared to the PFM group.
- Enhanced PFM contraction activation (work average) and lower Dysfunctional Voiding and Incontinence Scoring System scores were observed in the CTG.
- Statistical significance was noted for key parameters (P < .05).
Conclusions:
- Connective tissue manipulation combined with PFM exercises offers superior benefits for specific uroflow, bladder diary, and symptom severity parameters in pediatric LUTDs.
- This noninvasive manual therapy approach, CTM+PFM exercises, presents a novel and accessible treatment option for children with lower urinary tract disorders.
Objective:
The aim of the study was to examine the impact of a combined approach involving connective tissue manipulation (CTM) and pelvic floor muscle (PFM) exercises on symptoms, uroflowmetry parameters, and PFM activation in children with lower urinary tract disorders.
Methods:
Forty children with lower urinary tract disorder were randomized into 2 groups: (1) PFM group and (2) CTM+PFM exercise group (CTG). The treatment was performed 3 times a week for 8 weeks. Children were evaluated with electromyography-uroflowmetry, bladder ultrasonography, bladder diary, electromyography-PFM activation, and the Dysfunctional Voiding and Incontinence Scoring System at baseline and 8 weeks after interventions.
Results:
A comparison of the 2 groups revealed that the CTG group demonstrated greater improvement in mean flow rate (Q-Ave), maximum voiding volume, incontinence frequency, PFM contraction activation (work average), and Dysfunctional Voiding and Incontinence Scoring System scores (P < .05).
Conclusion:
Connective tissue manipulation applied in addition to pelvic floor muscle exercises was more effective on certain uroflow and bladder diary parameters, symptom severity score, and certain PFM activation parameters. Connective tissue manipulation applied together with PFM exercises may be a novel approach in children with lower urinary tract disorders, a noninvasive and accessible manual therapy method.
