Pişirici Pelin, Kurt Aygül Köseoğlu, Atalay Tuğçe, Ünal Melis, Saatçı Ece Zeynep, Tuğtepe Halil
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bahçeşehir University, Ihlamur Yıldız Caddesi No. 8, Gayrettepe, İstanbul, Beşiktas, 34353, Türkiye.
Graduate Education Institute, Physiotherapy and Rehabilitation Doctoral Program, Bahçeşehir University, İstanbul, Türkiye.
Eur J Pediatr. 2025 Aug 7;184(9):537. doi: 10.1007/s00431-025-06369-1.
This study aimed to determine whether children with bladder and bowel dysfunction (BBD) show deviations in motor developmental milestones and to examine the correlations between motor development timing and pelvic floor parameters. In this retrospective, cross-sectional study, 58 children aged 5-12 years diagnosed with BBD by a pediatric urologist between 2022 and 2025 were evaluated. Motor milestone ages, pelvic floor muscle activity (work/rest average, deviation, and maximum voluntary contraction), uroflowmetry, daily voiding frequency, and weekly defecation frequency were assessed. A total of 28 girls and 30 boys with a mean age of 8.9 ± 2.5 years were included. BMI percentile analysis showed that 67.2% of children had normal weight, with normal weight more common in girls (73.3%) than in boys (61.3%). The mean months for head control, unsupported sitting, crawling, unsupported standing, and unsupported walking were 3.0 ± 1.2, 7.0 ± 1.3, 8.2 ± 1.4, 12.1 ± 13.9, and 13.1 ± 2.5, respectively. The average birth month was 38 ± 1.8 weeks. The work average muscle activity was found to have a weak-to-moderate positive correlation with unsupported walking (r = 0.36, p = 0.006; p < 0.05). Voided volume was positively correlated with head control (r = 0.38, p = 0.03), unsupported sitting (r = 0.26, p = 0.044), and unsupported walking (r = 0.08, p = 0.047), with weak to moderate effect sizes. A negative correlation was found between the daily urination frequency and unsupported sitting (r = - 0.26, p = 0.042; p < 0.05). A negative correlation was also observed between the age of unsupported walking and weekly defecation frequency (r = - 0.27, p = 0.040; p < 0.05).
The results suggest that in children with BBD, head control, sitting, and walking milestones are positively associated with voided volume and pelvic floor muscle activity. Additionally, earlier walking and sitting were associated with lower frequencies of urination and defecation.
• As infants grow, the caudal shift in the center of gravity activates the postural role of pelvic floor muscles. • The link between pelvic floor dysfunction and motor milestones has not been explored.
• Pelvic floor muscle activity and voided volume are positively associated with head control, sitting, and walking. • Urination and defecation frequency are negatively associated with unsupported sitting and walking.
本研究旨在确定膀胱和肠道功能障碍（BBD）儿童在运动发育里程碑方面是否存在偏差，并研究运动发育时间与盆底参数之间的相关性。在这项回顾性横断面研究中，对2022年至2025年间由儿科泌尿科医生诊断为BBD的58名5至12岁儿童进行了评估。评估了运动里程碑年龄、盆底肌肉活动（工作/休息平均值、偏差和最大自主收缩）、尿流率、每日排尿频率和每周排便频率。共纳入28名女孩和30名男孩，平均年龄为8.9±2.5岁。BMI百分位数分析显示，67.2%的儿童体重正常，女孩（73.3%）体重正常的情况比男孩（61.3%）更常见。头部控制、独坐、爬行、独站和独走的平均月龄分别为3.0±1.2、7.0±1.3、8.2±1.4、12.1±13.9和13.1±2.5。平均出生月龄为38±1.8周。发现工作平均肌肉活动与独走之间存在弱至中度正相关（r = 0.36，p = 0.006；p < 0.05）。排尿量与头部控制（r = 0.38，p = 0.03）、独坐（r = 0.26，p = 0.044）和独走（r = 0.08，p = 0.047）呈正相关，效应大小为弱至中度。每日排尿频率与独坐之间存在负相关（r = -0.26，p = 0.042；p < 0.05）。独走年龄与每周排便频率之间也存在负相关（r = - 0.27，p = 0.040；p < 0.05）。
结果表明，在BBD儿童中，头部控制、独坐和行走里程碑与排尿量和盆底肌肉活动呈正相关。此外，较早的行走和独坐与较低的排尿和排便频率相关。
• 随着婴儿成长，重心的尾端移动激活了盆底肌肉的姿势作用。• 盆底功能障碍与运动里程碑之间的联系尚未得到探索。
• 盆底肌肉活动和排尿量与头部控制、独坐和行走呈正相关。• 排尿和排便频率与独坐和行走呈负相关。
