Lower urinary tract symptoms in children with mild to moderate spastic cerebral palsy: Associations with functional level, trunk and respiratory parameters

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dc.contributor.authorNacar, Emine
dc.contributor.authorSuner-Keklik, Sinem
dc.contributor.authorNumanoglu-Akbas, Ayse
dc.date.accessioned2026-04-04T13:34:59Z
dc.date.available2026-04-04T13:34:59Z
dc.date.issued2026
dc.departmentİnönü Üniversitesi
dc.description.abstractIntroduction and objective Lower urinary tract symptoms (LUTS) are common in children with cerebral palsy (CP). Increased severity of functional impairment and impairments in trunk-related structures may be associated with increased severity of LUTS. The aim of our study was to examine the distribution of LUTS in children with mild to moderate spastic type CP and to investigate the relationship between LUTS severity and functional level, trunk control, trunk muscle strength and endurance, respiratory functions and rib cage mobility. Methods Fifty-three children with spastic CP with Gross Motor Functional Classification System (GMFCS) levels I-II and III were included in the study. LUTS was assessed using Dysfunctional Voiding and Incontinence Scoring System (DVISS); functional levels were assessed using GMFCS; and trunk control was assessed using Trunk Control Measurement Scale (TCMS). Transversus Abdominis (TrA) muscle strength was measured with Stabilizer Compression Biofeedback Unit; trunk muscle strength was measured with Sit-ups and Modified Push-up test; trunk muscle endurance was measured with McGill's trunk flexion, trunk extension, lateral bridge tests and prone bridge test. Pulmonary function was assessed by Contec SP10 Spirometer and chest mobility was assessed by chest circumference measurement. Results There was statistically significant difference between GMFCS level I and level III mean DVISS scores (p = 0.002). There was moderate negative correlation between DVISS and TCMS score (p = 0.002; r =-0.416), moderate positive correlation between TrA muscle strength (p = 0.001; r = 0.482), modified push-up test (p = 0.025; r =-0.308), trunk extension test (p = 0.021; r =-0.316), prone bridge test (p = 0.008; r =-0.362), FEV1/FVC (p = 0.020; r =-0.320), FEV1 (p = 0.005; r =-0.384), PEF (p = 0.007; r =-0.367). Conclusion This study shows that LUTS is common in children with mild to moderate spastic CP and that the severity of these symptoms increases significantly as the severity of functional impairment increases. In addition, it was determined that the decrease in trunk control, trunk muscle strength and endurance, respiratory functions and chest mobility were associated with an increase in LUTS. These findings suggest that isolated pelvic floor training alone may not be sufficient to improve lower urinary tract health in children with CP, but instead, a holistic rehabilitation approach that supports motor function, trunk stability and respiratory capacity should be adopted.
dc.description.sponsorshipSivas Cumhuriyet University Scientific Research [SBF-2022-098]
dc.description.sponsorshipThis study was funded by Sivas Cumhuriyet University Scientific Research and Project Unit with project number SBF-2022-098.
dc.identifier.doi10.1016/j.jpurol.2025.07.007
dc.identifier.issn1477-5131
dc.identifier.issn1873-4898
dc.identifier.issue1
dc.identifier.pmid40744762
dc.identifier.scopus2-s2.0-105012149477
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1016/j.jpurol.2025.07.007
dc.identifier.urihttps://hdl.handle.net/11616/109510
dc.identifier.volume22
dc.identifier.wosWOS:001694517800001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier Sci Ltd
dc.relation.ispartofJournal of Pediatric Urology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WOS_20250329
dc.subjectCerebral palsy
dc.subjectLower urinary tract symptom
dc.subjectTrunk
dc.subjectEndur ance
dc.subjectRespiratory function
dc.titleLower urinary tract symptoms in children with mild to moderate spastic cerebral palsy: Associations with functional level, trunk and respiratory parameters
dc.typeArticle

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