A Randomized Controlled Trial Of The Effectiveness Of Osteopathy-Based Manual Physical Therapy In Treating Pediatric Dysfunctional Voiding

Main Category: Urology / Nephrology
Also Included In: Pediatrics / Children's Health;  Clinical Trials / Drug Trials
Article Date: 10 May 2008 - 0:00 PDT

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UroToday.com - A study by Nemett, et al evaluated the implementation of an osteopathic of manual physical therapy to children with dysfunctional voiding. This type of therapy has been proven to be successful in adult women. The group did a trial of manual physical therapy based on an osteopathic approach in children they followed for dysfunctional voiding. They implemented this in conjunction with standard treatment and evaluated if it was more effective than just their standard treatment alone.

In a prospective manner, 21 children between the ages of 4-11 years with dysfunctional voiding were randomly assigned to receive the manual physical therapy with standard treatment or just given standard treatment alone. The later is the control group. Pretreatment and post treatment evaluations of dysfunctional voiding symptoms, physical therapy evaluations, and inter-rater reliability of dysfunctional voiding symptoms resolution were completed. The group found that the treatment group exhibited a greater improvement in dysfunctional voiding symptoms than did the control group. If the patients had vesicoureteral reflux and/or a high post void residual, the improvement and resolution of these phenomenon were more prominent in the treatment group.

The group concluded that the physical therapy in conjunction with standard treatment for dysfunctional voiding does show improvement in these children. Subjectively it was felt that the children and the parents liked the treatment therapy. They also go on to further state that a multi centered randomized trial of physical therapy and an osteopathic based approach for these children with reflux and/or high post void residual is warranted when dysfunctional voiding is part of their diagnosis. Children with dysfunctional voiding can be a very difficult population to treat mostly based on the parents and child's expectations that things should move along more quickly than they actually do most of the time. Adding another hands on approach with physical therapy will not only help the child become more involved but it can be mentally satisfying for the family that something is actually being "done."

Reported by UroToday.com Medical Editor Pasquale Casale, MD

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