OBJECTIVE: The aim of the study was to examine the impact of a combined approach involving connective tissue manipulation (CTM) and pelvic floor muscle (PFM) exercises on symptoms, uroflowmetry parameters, and PFM activation in children with lower urinary tract disorders. METHODS: Forty children with lower urinary tract disorder were randomized into 2 groups: (1) PFM group and (2) CTM plus PFM exercise group (CTG). The treatment was performed 3 times a week for 8 weeks. Children were evaluated with electromyography-uroflowmetry, bladder ultrasonography, bladder diary, electromyography-PFM activation, and the Dysfunctional Voiding and Incontinence Scoring System at baseline and 8 weeks after interventions. RESULTS: A comparison of the 2 groups revealed that the CTG group demonstrated greater improvement in mean flow rate (Q-Ave), maximum voiding volume, incontinence frequency, PFM contraction activation (work average), and Dysfunctional Voiding and Incontinence Scoring System scores (p < 0.05). CONCLUSION: Connective tissue manipulation applied in addition to pelvic floor muscle exercises was more effective on certain uroflow and bladder diary parameters, symptom severity score, and certain PFM activation parameters. Connective tissue manipulation applied together with PFM exercises may be a novel approach in children with lower urinary tract disorders, a noninvasive and accessible manual therapy method.
Reprinted from the Journal of Manipulative and Physiological Therapeutics with copyright permission from the National University of Health Sciences.

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