title: Are Interferential Electrical Stimulation and Diaphragmatic Breathing Exercises Beneficial in Children With Bladder and Bowel Dysfunction?
abstract: OBJECTIVE
  To evaluate the effects of interferential current (IC) stimulation and diaphragmatic breathing exercises (DBEs) in children with bladder and bowel dysfunction.
  
  
  METHODS
  Seventy-nine children with dysfunctional voiding and chronic constipation who were failures of primary care interventions were included in the prospective clinical study. All the children were checked for their medical history regarding lower urinary tract symptoms and bowel habits. Physical examination, including abdominal and anorectal digital examination, was performed. Children kept a bladder and bowel diary, and underwent urinalyses and urine culture, ultrasound examination of bladder and kidneys, and uroflowmetry with pelvic floor electromyography. Eligible children were divided into 3 groups (A, B, and C). All groups were assigned education and behavioral modifications. Additionally, group A underwent DBEs and IC stimulation, whereas group B received only DBEs. The treatment was conducted for 2 weeks in the clinic in all 3 groups,. The behavioral modifications and DBEs were continued at home for 1 month. Clinical manifestations, uroflowmetry parameters, and postvoided residual urine were analyzed before and after 6 weeks of therapy.
  
  
  RESULTS
  After the treatment, significant improvement in defecation frequency and fecal incontinence was noticed only in group A (P < .001 and P < .05, respectively). These children demonstrated significant improvement in lower urinary tract symptoms and postvoided residual urine (P < .001 and P < .05, respectively). Bell-shaped uroflowmetry curve was observed in 73.3% of group A patients (P < .001).
  
  
  CONCLUSIONS
  IC stimulation and DBEs are beneficial in chronically constipated dysfunctional voiders. Further trials are needed to define the long-term effects of this program.
authors.affiliation: Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Centre Nis, Faculty of Medicine, University of Nis, Nis, Serbia. Electronic address: petvesna67@gmail.com.
authors.forename: Vesna D
authors.initials: VD
authors.lastname: Zivkovic
authors.affiliation: Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Centre Nis, Faculty of Medicine, University of Nis, Nis, Serbia.
authors.forename: Ivona
authors.initials: I
authors.lastname: Stankovic
authors.affiliation: Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Centre Nis, Faculty of Medicine, University of Nis, Nis, Serbia.
authors.forename: Lidija
authors.initials: L
authors.lastname: Dimitrijevic
authors.affiliation: Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Centre Nis, Faculty of Medicine, University of Nis, Nis, Serbia.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Kocic
authors.affiliation: Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Centre Nis, Faculty of Medicine, University of Nis, Nis, Serbia.
authors.forename: Hristina
authors.initials: H
authors.lastname: Colovic
authors.affiliation: Department of Nuclear Medicine, Clinical Centre Nis, Faculty of Medicine, University of Nis, Nis, Serbia.
authors.forename: Marina
authors.initials: M
authors.lastname: Vlajkovic
authors.affiliation: Clinic of Paediatric Surgery, Clinical Centre Nis, Faculty of Medicine, University of Nis, Nis, Serbia.
authors.forename: Andjelka
authors.initials: A
authors.lastname: Slavkovic
authors.affiliation: Institute for Rehabilitation, Belgrade, Serbia.
authors.forename: Milica
authors.initials: M
authors.lastname: Lazovic
mesh_terms: D001945:Breathing Exercises / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003672:Defecation / Q000502:physiology; D003964:Diaphragm / Q000503:physiopathology; D004599:Electric Stimulation Therapy / Q000379:methods*; D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D017773:Pelvic Floor / Q000503:physiopathology; D063189:Symptom Assessment / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014555:Urination Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*