Overview
The aim of this study is to incorporate balance exercises into the standard clinical protocol applied to children with lower urinary tract dysfunction (LUTD), and to carry this out using video game-based exercises. It is intended that this approach will lead to positive changes in clinical symptoms and pelvic floor muscle functions. The video game-based balance exercise program will be conducted in addition to the child's ongoing treatment, twice a week for a total of 8 weeks at the same rehabilitation center.
This single-center study will include a total of 30 children aged between 5 and 12 years who have been diagnosed with LUTD. Participants will be randomly assigned into two groups: 15 in the experimental group and 15 in the control group.
No interventional procedures (such as injections or vaccinations) will be performed on participants during the study. Demographic and clinical data of all participants who voluntarily agree to participate will be collected using a Patient Follow-Up Form prepared by the researchers. In order to assess daily bladder functions, a 2-day Bladder Diary will be filled out under parental supervision.
Voiding function will be evaluated using uroflowmetry; the presence of post-void residual urine will be assessed by a pediatric urologist using ultrasonography. Pelvic floor muscle activity will be measured by a physiotherapist using a device with EMG support. The severity of lower urinary tract dysfunction will be determined using the DVSS questionnaire.
Additionally, the child's quality of life will be assessed using the PinQ questionnaire; balance level will be evaluated with the Pediatric Berg Balance Scale and the Single-Leg Balance Test on a Bosu Ball; core stability will be assessed with the McGill Core Endurance Test; and enjoyment of the video game-based exercise program will be evaluated using the Physical Activity Enjoyment Scale (PACES).
Eligibility
Inclusion Criteria:
- Being between 5 and 12 years of age
- Having a diagnosis of "Lower Urinary Tract Dysfunction" made by a pediatric urologist according to the criteria defined by the ICCS
- Voluntary participation of both the parent and the child in the study
Exclusion Criteria:
- Having any neurologically based condition
- Presence of any condition in the parent or child that affects the ability to respond to the assessment tools (e.g., intellectual disability, developmental delay, cognitive problems)
- Having any physical impairment (orthopedic, structural, etc.) that prevents the use of Wii-Fit
- Presence of malformations or anatomical anomalies in the urinary tract system
- History of urological surgery
- Having constipation and/or fecal incontinence
- Previous participation in pelvic floor muscle rehabilitation
- Regular use of medication