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In this study, the effect of dynamic neuromuscular stabilization (DNS) exercise on urinary flow and quality of life in individuals with dysfunctional voiding was investigated. The 34 participants included in the study were randomized into two groups: the experiment in which DNS exercises were applied and the standard therapy group in which the manual application was applied. Uroflowmetry, Voiding Symptom Score (DVSS), Short Form-36 Quality of Life Assessment Short Form were applied to all participants at baseline and at week 6.
In this study, the effect of dynamic neuromuscular stabilization (DNS) exercise on urinary flow and quality of life in individuals with dysfunctional voiding was investigated. This experimental study was conducted with patients who applied to UroKlinik in Istanbul between March 2021 and June 2023 and were diagnosed with dysfunctional voiding. The 34 participants included in the study were randomized into two groups: the experiment in which DNS exercises were applied and the standard therapy group in which the manual application was applied. Voiding Symptom Score (DVSS), Short Form-36 Quality of Life Assessment Short Form and Uroflowmetry test were applied to all participants before and at week 6.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dynamic Neuromuscular Stabilisation Exercise | Experimental | The participants performed DNS exercises addition to standard therapy |
|
| Standard therapy | Other | Patient education, massage, diaphragmatic breathing, kegel exercise |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exercise | Other | Dynamic Neuromuscular Stabilisation Exercise |
|
| Measure | Description | Time Frame |
|---|---|---|
| Uroflowmetry - Maximum flow rate (Qmax) | Uroflowmetry gives information about urine flow rate and voiding pattern. *Qmax (mL/s): Qmax is the fastest stream measured in mL/s. | at the baseline and at week 6. |
| Uroflowmetry - Average flow rate (Qave) | Uroflowmetry gives information about urine flow rate and voiding pattern. *Qave (mL/s): Qave is the average stream measured in mL/s. | at the baseline and at week 6. |
| Uroflowmetry - Corrected maximum flow rate (cQmax) | Uroflowmetry gives information about urine flow rate and voiding pattern. *cQmax (mL/s/√ mL): cQmax is the precise assessment of fastest stream, especially at high volumes. Is it estimated Qmax/√ VV. | at the baseline and at week 6. |
| Uroflowmetry - Flow time (FT) | Uroflowmetry gives information about urine flow rate and voiding pattern. *FT (s): FT is the time over which measurable flow actually occurs. | at the baseline and at week 6. |
| Uroflowmetry - Voiding volume (VV) | Uroflowmetry gives information about urine flow rate and voiding pattern. *VV (ml): VV indicates the amount of voiding. | at the baseline and at week 6. |
| Uroflowmetry - Residual urine (RU) | Uroflowmetry gives information about urine flow rate and voiding pattern. *RU (ml): RU is the amount of urine that is left behind in the bladder after you are done urinating. | at the baseline and at week 6. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Seda Saka, PhD | Haliç University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Haliç University | Istanbul | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 15711352 | Result | Akbal C, Genc Y, Burgu B, Ozden E, Tekgul S. Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. J Urol. 2005 Mar;173(3):969-73. doi: 10.1097/01.ju.0000152183.91888.f6. | |
| 30130020 | Result | Altunkol A, Abat D, Sener NC, Gulum M, Ciftci H, Savas M, Yeni E. Is urotherapy alone as effective as a combination of urotherapy and biofeedback in children with dysfunctional voiding? Int Braz J Urol. 2018 Sep-Oct;44(5):987-995. doi: 10.1590/S1677-5538.IBJU.2018.0194. |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| D059039 | Standard of Care |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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| Standard therapy | Other | Patient education, massage, diaphragmatic breathing, kegel exercise |
|
| Dysfunctional Voiding and Incontinence Symptom Score |
It gives information about voiding and incontinence symptoms. The questionnaire contains fourteen questions about symptoms and quality of life. The total score ranges from 0 to 35 and a score above 8.5 indicates abnormalities. |
| at the baseline and at week 6. |
| Short Form 36 | It gives information about health related quality of life. The total score of the scale ranges from 0 to 100, and a high score indicates a high quality of life. | at the baseline and at week 6. |
| 25772695 | Result | Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, Rittig S, Walle JV, von Gontard A, Wright A, Yang SS, Neveus T. The standardization of terminology of lower urinary tract function in children and adolescents: Update report from the standardization committee of the International Children's Continence Society. Neurourol Urodyn. 2016 Apr;35(4):471-81. doi: 10.1002/nau.22751. Epub 2015 Mar 14. |
| 2765766 | Result | Haylen BT, Ashby D, Sutherst JR, Frazer MI, West CR. Maximum and average urine flow rates in normal male and female populations--the Liverpool nomograms. Br J Urol. 1989 Jul;64(1):30-8. doi: 10.1111/j.1464-410x.1989.tb05518.x. |
| 31950895 | Result | Mahdieh L, Zolaktaf V, Karimi MT. Effects of dynamic neuromuscular stabilization (DNS) training on functional movements. Hum Mov Sci. 2020 Apr;70:102568. doi: 10.1016/j.humov.2019.102568. Epub 2020 Jan 13. |
| 22669134 | Result | Zivkovic V, Lazovic M, Vlajkovic M, Slavkovic A, Dimitrijevic L, Stankovic I, Vacic N. Diaphragmatic breathing exercises and pelvic floor retraining in children with dysfunctional voiding. Eur J Phys Rehabil Med. 2012 Sep;48(3):413-21. Epub 2012 Jun 5. |
| D019984 | Quality Indicators, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |