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Updated: Feb 11, 2026
Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Lumbopelvic stabilization-based physiotherapy and rehabilitation and urotherapy for lower urinary tract dysfunction
Demet Öztürk1, Aynur Ayşe Karaduman1, Türkan Akbayrak2
1Lokman Hekim University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey.
Insights
Urotherapy effectively treated lower urinary tract dysfunction (LUTD) in children with Duchenne Muscular Dystrophy. Adding lumbopelvic stabilization exercises improved mobility and strength but not urinary symptoms.
Area of Science:
- Pediatric Rehabilitation
- Neuromuscular Disorders
- Urology
Background:
- Children with Duchenne Muscular Dystrophy (DMD) often experience lower urinary tract dysfunction (LUTD).
- Effective management strategies are crucial for improving quality of life in these children.
Purpose of the Study:
- To investigate the effectiveness of supervised lumbopelvic stabilization exercises combined with urotherapy for children with DMD and LUTD.
- To compare the outcomes of urotherapy alone versus urotherapy plus lumbopelvic stabilization.
Main Methods:
- A randomized controlled trial involving 32 ambulatory children (aged 5-12 years) with DMD and LUTD (Dysfunctional Voiding and Incontinence Symptom Scale score ≥ 8.5).
- Participants were randomized to receive either urotherapy alone (control group) or urotherapy plus eight weeks of supervised lumbopelvic stabilization exercises (treatment group).
- Outcomes included lower urinary tract symptoms (assessed via DVISS, bladder/enuresis diaries), bowel symptoms, physical performance, muscle strength, and daily activities.
Main Results:
- Urotherapy significantly reduced LUTD severity, enuresis frequency, and the number of LUTD-related symptoms.
- Lumbopelvic stabilization exercises, when added to urotherapy, did not show superiority in improving lower urinary tract symptoms.
- Supervised lumbopelvic stabilization significantly enhanced functional mobility, muscle strength, and participation in daily activities.
Conclusions:
- Both urotherapy and lumbopelvic stabilization interventions improved bladder and bowel outcomes in children with DMD and LUTD.
- While urotherapy alone was effective for LUTD, the addition of lumbopelvic stabilization offered additional benefits in physical function without further improving urinary symptoms.
Objective:
This randomized controlled trial investigated the effectiveness of supervised lumbopelvic stabilization and urotherapy on factors associated with lower urinary tract symptoms in children with Duchenne Muscular Dystrophy and lower urinary tract dysfunction (LUTD).
Method:
The study included 32 children aged 5-12 years, who were ambulatory and had a Dysfunctional Voiding and Incontinence Symptom Scale (DVISS) of 8.5 or higher. Lower urinary tract symptoms were assessed using the DVISS, a three-day bladder diary, and a nocturnal enuresis diary. Bowel symptoms were assessed with a seven-day bowel diary. Moreover, physical performance tests, the strength of pelvis-related muscle groups, and participation in activities of daily living were evaluated using validated measurement tools. Participants were randomized into two groups: the active control group (n:16, weight:25.81±9.53 kg, height:121.25±18.22 cm) received only urotherapy, while the treatment group (n:16, weight:25.88±9.67 kg, height: 122.69±16.63 cm) additionally performed lumbopelvic stabilization-based exercises for eight weeks under the supervision of a physiotherapist.
Results:
Urotherapy significantly reduced LUTD severity (p < 0.001), enuresis frequency (p = 0.014), and the number of symptoms associated with LUTD (p = 0.001). However, adding lumbopelvic stabilization exercises conferred no superiority over urotherapy alone (p > 0.05). Supervised lumbopelvic stabilization improved functional mobility (p < 0.003), muscle strength (p < 0.05), and participation in activities of daily living (p < 0.049). However, neither urotherapy nor lumbopelvic stabilization training had a significant effect on Gower's time or daytime voiding frequency (p > 0.05).
Conclusion:
Both interventions were effective in improving bladder and bowel outcomes in children with Duchenne Muscular Dystrophy and LUTD, with no superiority observed on lower urinary tract symptoms.
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