Postural alignment differences in children with urinary incontinence

This study examined whether postural alignment differs between children with urinary incontinence and asymptomatic children. Participants were children aged 5-14 with daytime urinary incontinence (n = 14), monosymptomatic nocturnal enuresis (n = 13), non-monosymptomatic nocturnal enuresis (n = 13), and asymptomatic children (n = 13). Postural alignment was assessed with the PostureScreen Mobile application. Lower urinary tract symptoms were evaluated using the Dysfunctional Voiding and Incontinence Scoring System, Vancouver Bladder/Bowel Dysfunction Questionnaire, and Childhood Bladder and Bowel Dysfunction Questionnaire. Core muscle function was measured with surface electromyography and ultrasound. Left lateral total body angulation was significantly greater in urinary incontinence subgroups than in the asymptomatic group (p = 0.002). Left lateral, right lateral, and posterior hip-pelvis angulations were also higher (p = 0.001, p = 0.045, and p = 0.013), especially in the non-monosymptomatic nocturnal enuresis subgroup. Children with urinary incontinence and greater postural deviation had higher symptom scores. In exploratory analyses, postural alignment parameters correlated with core muscle function in urinary incontinence subgroups (p < 0.05). However, these relationships did not remain significant after correction for multiple comparisons. This study showed that children with urinary incontinence had different postural alignment compared to asymptomatic children. The most pronounced differences were found in the hip-pelvis region. Furthermore, a tendency towards left deviation in postural alignment was observed. These changes in postural alignment appeared to be primarily related to the function of core muscles at a peripheral level. However, these exploratory correlations did not remain significant after correction for multiple comparisons. Additionally, the left deviation suggests a possible contribution from lateralisation of postural control at the central level. Therefore, future neuroimaging studies are recommended to investigate the possible relationship between postural alignment changes and the central nervous system.