Children with voiding dysfunction present deficits in motor performance
Sabrina Orlandi Barbieri1, Rita Pavione Rodrigues Pereira2, Fernando Copetti3
1Programa de Pós Graduação em Ciências do Movimento e Reabilitação da Universidade Federal de Santa Maria, Santa Maria, RS, Brazil.
Insights
Children with Lower Urinary Tract Dysfunction (LUTD) show significant deficits in gross motor skills and lower limb strength. Early motor assessments are crucial for comprehensive care and improved outcomes in these children.
Area of Science:
- Pediatric Urology
- Developmental Pediatrics
- Motor Control
Background:
- Lower Urinary Tract Dysfunction (LUTD) is common in children, often linked to motor cortex maturation delays and sensory-motor integration issues.
- This may lead to deficits in gross motor skill acquisition, an area requiring further research.
- This study investigates the relationship between LUTD and gross motor performance in school-aged children.
Purpose of the Study:
- To compare gross motor performance between children with and without LUTD.
- To identify predictors of gross motor performance in children, including LUTD diagnosis, lower limb strength, BMI, age, and sex.
- To compare lower limb strength, BMI, age, and sex between the two groups.
Main Methods:
- A cross-sectional observational study involving 77 school-aged children (5-11 years).
- Participants were divided into a Lower Urinary Tract Dysfunction group (n=34) and a control group (n=43).
- Gross motor skills were assessed using the Test of Gross Motor Development-Third Edition, and lower limb strength was measured via a horizontal jump test.
Main Results:
- Children with LUTD demonstrated significantly lower Gross Motor Index scores and reduced lower limb strength compared to controls.
- Lower Urinary Tract Dysfunction diagnosis and lower limb strength were identified as strong predictors of gross motor performance.
- Age and sex also contributed significantly to the prediction model for gross motor performance.
Conclusions:
- Children diagnosed with Lower Urinary Tract Dysfunction exhibit notable deficits in gross motor skills and lower limb strength.
- Integrating motor assessments into LUTD evaluation protocols is essential for a comprehensive, functional approach.
- Interdisciplinary collaboration is recommended to enhance both urinary and motor outcomes in children with LUTD.
Background:
Lower Urinary Tract Dysfunction (LUTD) is a prevalent condition in childhood. Children with enuresis often exhibit delayed maturation of the motor cortex and disruptions in sensory-motor integration, suggesting possible deficits in the acquisition of gross motor skills. However, this association remains underexplored in literature. This cross-sectional observational study had two primary objectives: (1) to compare the gross motor performance of school-aged children with and without lower LUTD; and (2) to examine whether LUTD diagnosis, lower limb strength, body mass index (BMI), age, and sex were associated with gross motor performance in these children. The secondary objective was to compare lower limb strength, BMI, age, and sex between children with and without LUTD.
Methods:
A total of 77 neurotypical schoolchildren aged 5-11 years were recruited from local schools and stratified into two groups: The LUTD group (LUTD-G; n = 34), identified through the Dysfunctional Voiding Scoring System, and a control group (Control-G; n = 43) composed of asymptomatic children. Gross motor skills were assessed using the Test of Gross Motor Development-Third Edition yielding a Gross Motor Index (GMI), and lower limb strength was evaluated via horizontal jump test. Sociodemographic characteristics, BMI, physical activity levels, and urinary habits were also assessed.
Results:
The sample was predominantly female (63.64 %), white (57.14 %) and within the normal BMI range (55.84 %). The two groups were comparable in sociodemographic characteristics, physical activity levels, and urinary habits. However, children in the LUTD-G showed significantly lower GMI scores (p < 0.001) and lower limb strength (p = 0.024) than the Control-G. Regression analysis identified LUTD (β = -0.62, p < 0.001) and lower limb strength (β = 0.41, p < 0.001) as the stronger predictors of gross motor performance, with age (β = -0.31, p = 0.002) and sex (β = 0.20, p = 0.036) also contributing to the model.
Conclusion:
Children with LUTD exhibited marked deficits in gross motor performance and lower limb strength, reinforcing the need for interdisciplinary collaboration among healthcare professionals. These findings highlight the importance of integrating motor assessments into LUTD evaluation protocols and support a comprehensive, functional approach to improve both urinary and motor outcomes in affected children.
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