Pelvic Floor Muscle Training and Dynamic Neuromuscular Stabilization Exercises in Pediatric Patients

NCT07267364 | Recruiting

• 1 other identifier: 23743.R1
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 2

Brief Summary

Dysfunctional voiding (DY) is one of the most common conditions in children. Various treatments are available. Participants will be randomly assigned to either PFMT (Group I) or PFMT+DNS (Group II). PFMT is the gold standard and routinely administered in hospitals for children diagnosed with dysfunctional voiding who are referred by a urologist. The PFMT group serves as the control group, and treatment will be scheduled for a total of 10 weeks, three days a week. During PFMT, children receive instruction about the pelvic floor using video visuals and increase awareness of their pelvic floor muscles. They are then instructed on how to contract and relax their muscles to control urination. DNS training is an exercise model that begins with spinal stabilization and addresses muscle synergies. Patients included in the study will be evaluated twice, at the beginning and at the end of the treatment: Voiding Disorders Symptom Score (VODS), Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), Pediatric Incontinence Questionnaire (PIN-Q), Bladder Bowel Dysfunction Scale (BDS), Bristol gaita scale, and Children's Body Image Scale.

Conditions

Urology; Pediatric Disorder

Keywords

Voiding dysfunction; pelvic floor muscle training; neuromuscular stabilization; quality of life

Outcome Measures

Primary Outcomes (2)

• Voiding Disorders Symptom Scoring (VDSS)

  There are 13 questions about lower urinary tract symptoms and 1 question about quality of life. Regarding nocturnal enuresis, the frequency and severity of nocturnal enuresis are questioned. The total score ranges from 0 to 35 points, with higher scores indicating greater symptom severity.

  10 week

• Bladder and Bowel Dysfunction Scale (BBDS)

  The BBDS assesses the severity of bladder and bowel dysfunction symptoms in children. It comprises 14 items, with the first 13 evaluating symptom severity and the last item assessing questionnaire completion difficulty. Each item uses a 5-point Likert scale; higher scores reflect greater symptom severity. Turkish validity and reliability have been confirmed.

  10 week

Secondary Outcomes (6)

• Pediatric Quality of Life Questionnaire (PEDSQL)

  10 week

• Children's Body Image Scale

  10 week

• Depression Scale for Children

  10 week

• Pediatric Incontinence Questionnaire (PIN-Q)

  10 week

• Pelvic Floor Muscle strength and endurance

  10 week

Study Arms (2)

Pelvic Floor Muscle Training group (PFMT)

ACTIVE COMPARATOR

Children diagnosed with dysfunctional voiding will receive pelvic floor training using superficial video visuals, and pelvic muscle strength and endurance will be increased with EMG and biofeedback. Exercises will be administered three days a week for ten weeks. They will be assessed before and after treatment with the Voiding Disorders Symptom Score (VDSS), Children's Depression Scale, Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), Bladder and Bowel Dysfunction Scale (BDS), Pediatric Incontinence Questionnaire (PIN-Q), Bristol gaita scale, and the Children's Body Image Scale.

Behavioral: PFMT

PFMT+DNS group

ACTIVE COMPARATOR

In addition to PFME, an exercise model that begins with Dynamic Neuromuscular Stabilization (DNS) spine stabilization and addresses muscle synergies will be applied for 10 weeks. hey will be assessed before and after treatment with the Voiding Disorders Symptom Score (VDSS), the Children's Depression Scale,Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), the Bladder and Bowel Dysfunction Scale (BDS), Pediatric Incontinence Questionnaire (PIN-Q), Bristol gaita scale,and the Children's Body Image Scale.

Behavioral: PFMT

Interventions

PFMT BEHAVIORAL

During PFMT, children are taught about the pelvic floor using video visuals and their awareness of the pelvic floor muscles is increased. They are then instructed on how to contract and relax their muscles to control urination. DNS exercises, on the other hand, is an exercise model that begins with spinal stabilization and focuses on muscle synergies. Participants in the study will be assessed twice: at the beginning and end of treatment, using the Voiding Disorders Symptom Score (VDSS), Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), the Bladder and Bowel Dysfunction Scale (BBS), Pediatric Incontinence Questionnaire (PIN-Q), Bristol gaita scale, Children's Depression Scale (CDS) and the Children's Body Image Scale.

Also known as: PFMT+DNS

PFMT+DNS group; Pelvic Floor Muscle Training group (PFMT)

Eligibility Criteria

• Age: 5 Years - 18 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Having been diagnosed with voiding dysfunction according to ICCS diagnostic criteria in a urology outpatient clinic,
• Being 5-18 years old,
• The child and their parent/guardian agree to participate in the study voluntarily and provide signed consent.

You may not qualify if:

• Organic pathologies such as urethral obstruction, ectopic ureter, spinal dysraphism, and diabetes
• Diagnosis of VUR or neurogenic bladder
• Cognitive and mental impairment
• Having spina bifida
• Being under 5 years of age
• Receiving treatment such as PTC training or electrical stimulation

Sponsors & Collaborators

• Necmettin Erbakan University: lead

Study Sites (2)

Necmettin Erbakan University

Konya, Konya, (507) 534-6142, Turkey (Türkiye)

RECRUITING

Hanife Dogan

Konya, Konya, Turkey (Türkiye)

RECRUITING

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physıcal Therapy and Rehabilitation

Study Record Dates

• First Submitted: November 18, 2025
• First Posted: December 5, 2025
• Study Start: November 11, 2025
• Primary Completion: February 1, 2026
• Study Completion: April 30, 2026
• Last Updated: May 4, 2026

Record last verified: 2026-04

Locations

TU (2)