Trunk strength and mobility changes in children with slow transit constipation.
OBJECTIVE
It appears that there are no published reports on childhood slow transit constipation (STC) that have considered the state of the musculoskeletal components of the trunk in these children. The present study aimed to determine whether children with STC have different trunk musculoskeletal characteristics that might be related to their defecation difficulties, compared to controls.


METHODS
With the aid of computer-analyzed photographs and clinical testing, 41 children with STC and 41 age-matched controls were examined for Marfanoid features, sitting posture, spinal joint mobility and trunk muscle strength. The latter was assessed by measuring maximum voluntary abdominal bulging and retraction in sitting, and active trunk extension in prone-lying. Levels of general exercise and sedentary activities were evaluated by questionnaire.


RESULTS
STC subjects were more slumped in relaxed sitting (P < or = 0.001), less able to bulge (P < or = 0.03) and less able to actively extend the trunk (P = 0.02) compared to controls. All subjects sat more erect during abdominal bulging (P < or = 0.03).


CONCLUSIONS
The results show that STC children have reduced trunk control and posture, which indicates that clinicians should include training of trunk muscles and correction of sitting posture. There was no evidence that children with STC exercised less than the controls.
Chase
Janet W
JW
Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Australia. janchase@vicnet.net.au
Stillman
Barry C
BC
Gibb
Susan M
SM
Clarke
Melanie C C
MC
Robertson
Val J
VJ
Catto-Smith
Anthony G
AG
Hutson
John M
JM
Southwell
Bridget R
BR
D000009:Abdominal Muscles / Q000503:physiopathology*; D000293:Adolescent; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D002648:Child; D003248:Constipation / Q000503:physiopathology*; D003672:Defecation; D015444:Exercise; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D053580:Muscle Strength; D011187:Posture; D016059:Range of Motion, Articular; D057185:Sedentary Behavior; D013131:Spine / Q000503:physiopathology*; D011795:Surveys and Questionnaires