Diaphragmatic Breathing as an Adjunctive Therapy in the Management of Children With Bladder and Bowel Disorders
Bladder and Bowel Disorder, Pediatric
About this trial
This is an interventional treatment trial for Bladder and Bowel Disorder, Pediatric focused on measuring Diaphragmatic breathing (DB), Bladder and bowel disorders (BBD), Autonomic nervous system (ANS), Heart rate variability (HRV), Deep breathing, Randomized controlled trial (RCT)
Eligibility Criteria
Inclusion Criteria:
1. Children with bladder and bowel disorders (BBD) will be diagnosed by the attending pediatric urologists via a combination of thorough clinical history, physical examination, BBD Questionnaire, uroflowmetric evaluation, and voiding and stool diary.
Exclusion Criteria:
- Known anatomic or neurological lower urinary tract abnormalities such as posterior urethral valve, urethral obstruction or stricture, ectopic ureters, congenital abnormalities of the spinal cord, or any previous surgery of the lower urinary tract.
- Current use of medication or treatments which affects bladder or ANS function. These include anti-cholinergics, anti-psychotics, anti-depressants, and neuromodulators.
- Any conditions or disorders that would affect the cardiovascular system or the activity of the ANS.
- Serious pulmonary issues or diaphragmatic problems that would interfere with the practice of diaphragmatic breathing technique.
- Psychological/behavioral abnormalities severe enough to prevent the cooperation of the child with the study coordinator or the urologist.
- Inability to provide consent.
- Inability to speak and/or understand in English.
Sites / Locations
- BC Children's and Women's Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Standard Urotherapy (SU)
Standard Urotherapy (SU) + Diaphragmatic Beathing (DB)
Standard Urotherapy (SU): A non-invasive therapy combining cognitive, behavioral and physical therapy. The study team will explain the problem to the children and their parents and educate them on the following: proper voiding mechanics, sitting, standing positions, how and when to void, techniques on relaxing pelvic floor muscles, and avoiding straining. An assessment of bowel habits will be done and their diet and drinking/voiding habits will be modified to maintain proper hydration with timed voiding. Voiding diaries will be provided for the assessment of the bladder and bowel habits.
Standard Urotherapy (SU) with the addition of Diaphragmatic Breathing (DB): A non-invasive breathing technique that is performed by a marked expansion of the abdomen (contracting diaphragm) rather than chest cavity during inspiration and tightening of the stomach muscles during expiration. Participants will lie on their back on a flat surface. Head is supported with a pillow and knees are bent forward supported by another pillow. Participants will place one hand on chest and the other on the abdomen, then start inhalation by moving their abdomen out against their hand, breathing in through their nose while keeping their chest and the other hand as still as possible. During expiration, the participants will tighten their abdominal muscles by forcing them inward and breathe out through pursed lips while keeping the hand on the chest as still as possible. Participants will be asked to perform this exercise for 10 minutes 3 times daily for 3 months.