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. 2023 Jan;42(1):146-152.
doi: 10.1002/nau.25060. Epub 2022 Oct 8.

Home pelvic floor exercises in children with non-neurogenic Lower Urinary Tract Symptoms: Is fitball an alternative to classic exercises?

Maria Laura Sollini  1   2   3 , Maria Luisa Capitanucci  2 , Calogero Foti  1 , Ugo Nocentini  1   3 , Enrico Castelli  4 , Giovanni Mosiello  2
Affiliations

Home pelvic floor exercises in children with non-neurogenic Lower Urinary Tract Symptoms: Is fitball an alternative to classic exercises?

Maria Laura Sollini et al. Neurourol Urodyn. 2023 Jan.

Abstract

Introduction: Biofeedback with home pelvic floor exercises were recommended as non-pharmacologic treatment for non-neurogenic Lower Urinary Tract Symptoms (LUTS) in children. Fitball is recommended to improve all-over flexibility, balance, and coordination, especially for pelvic floor. Aim of the study was to investigate efficacy of standard home pelvic floor exercises versus exercises using fitball.

Methods: From April 2021 to February 2022 to all children arrived in our clinic with non-neurogenic LUTS nonresponder at urotherapy, our pelvic floor rehabilitative program was proposed. During the rehabilitation children performed: standard urotherapy, pelvic floor animated biofeedback therapy and pelvic floor exercises in a standard way and using a fitball. After the first session, patients received prescription to repeat at home the same exercises performed at hospital. Children who chose classic exercises were enrolled in group A and they who chose fitball in group B. Continence rate, pelvic floor muscles activity, adherence and satisfaction were evaluated by means of bladder diary, external pubococcygeus test and Likert-type psychometric scale (from 1 = very unsatisfied to 5 = very satisfied) respectively.

Results: Twenty-six children affected by LUTS were enrolled: 13 in group A and 13 in B. At 4th control urinary incontinence was reduced by 72,5% in A and 71.4% in B. Pubococcygeus test increased in both groups. Adherence at home was 92% in group A and 62% in group B. Satisfaction with the treatment (4 or 5 points) was 95% in both groups. Four patients of group A and all of group B decided to maintain home exercises including fitball.

Conclusions: Our preliminary study shows that efficacy of home exercises, with or without fitball, is comparable. Satisfaction with fitball is high, regardless results obtained, because parents and children have learned a new, interesting and stimulating way to manage urinary problems. The opportunity to perform these exercises using fitball, it's an important finding for pediatric population.

Keywords: LUTS; children; fitball; incontinence; kegel; pelvic floor; rehabilitation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Position of external external sensors, placed at the 3 and 9 o'clock positions at the perineum
Figure 2
Figure 2
(A, B) First exercise with fitball: patient sat down on the ball reproducing the proper position on the toilet, 5 s of pelvic floor muscles' contraction, followed by 10 s of relaxation
Figure 3
Figure 3
(A, B) Second exercises with fitball: after the contraction of pelvic floor the child must rise up and maintained the position for 5 s, then she returned at starting position for the 10 s' relaxation
See this image and copyright information in PMC

References

    1. Kaya C, Radmayr C. Clinical evaluation: History taking and urological, gynaecological and neurological evaluation. In: Mosiello G, Del Popolo G, Wen J, De Gennaro M, eds. Clinical Urodynamics in Childhood and Adolescence. Urodynamics, Neurourology and Pelvic Floor Dysfunctions, 2018; pp. 11–20. Springer International Publishing.
    1. Chang SJ, Van Laecke E, Bauer SB, et al. Treatment of daytime urinary incontinence: a standardization document from the International Children's Continence Society. Neurourol Urodyn. 2017;36(1):43‐50. - PubMed
    1. Nieuwhof‐Leppink AJ, Hussong J, Chase J, et al. Definitions, indications and practice of urotherapy in children and adolescents: a standardization document of the International Children's Continence Society (ICCS). J Pediatr Urol. 2021;17(2):172‐181. - PubMed
    1. Schulman SL, Von Zuben FC, Plachter N, Kodman‐Jones C. Biofeedback methodology: does it matter how we teach children how to relax the pelvic floor during voiding? J Urol. 2001;166(6):2423‐2426. - PubMed
    1. Ladi‐Seyedian S, Kajbafzadeh AM, Sharifi‐Rad L, Shadgan B, Fan E. Management of non‐neuropathic underactive bladder in children with voiding dysfunction by animated biofeedback: a randomized clinical trial. Urology. 2015;85(1):205‐210. - PubMed

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