Frequency and Associated Risk Factors of Bowel and Bladder Problem Among Children with Spastic Cerebral Palsy

Authors

  • Arshad Ali Pediatrics Physiotherapist at NHS Somerset Trust Foundation, UK.
  • Zavata Afnan Riphah International University, Islamabad, Pakistan.
  • Amnah Anum Riphah International University, Islamabad, Pakistan.
  • Iqra Bibi Riphah International University, Islamabad, Pakistan.
  • Sibghatullah Khyber Medical University, Islamabad, Pakistan.
  • Fatima Aslam Riphah International University, Islamabad, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i2.724

Keywords:

Bowel and Bladder Problem, Spastic Cerebral Palsy

Abstract

Background: Cerebral paralysis (CP) is a neuro-developmental condition starting in childhood and continuing throughout life. Bowel and bladder problems are a very common problem in children with cerebral palsy, and it affects 1 in every 5 children with cerebral palsy. Objective: To find out the frequency and associated risk factors of bowel and bladder problem in spastic cerebral palsy. Methodology: A cross-sectional survey in Peshawar was conducted including 139 participant, age 5-12 years and spasticity level I-IV with spastic cerebral palsy Data was collected using convenience sampling technique. Children with any neurological disease affecting bowel and bladder issues and children with renal and genitourinary surgery were excluded. Tools used for data collection were, Gross Motor Functional Classification System for functional limitations, and Childhood bowel and bladder dysfunction questionnaire (CBBDQ) for bowel and bladder problems in children. Data was analyzed using SPSS version 22. Results: The mean age of the 139 participants was 8.33±2.29 years, with 83 males and 56 females. Bowel and bladder issues affected 68.34% of the patients. Bowel and bladder problems were significantly correlated with age group, CP type, CMFCS level, speech issue, and spasticity level (p<0.05). However, there was no significant association between bowel and bladder problems and gender, caregiver education status, Socio-economic status, positive UTI history, toilet training, use of medications and BMI (p>0.05). Conclusion: The study concluded that there is high frequency of bowel and bladder problems in children with spastic cerebral palsy. The significant risk factors associated with bowel and bladder problems were type of CP, level of spasticity, GMFCS level, speech problem and age group.

Downloads

Download data is not yet available.

References

Te Velde, A., Morgan, C., Novak, I., Tantsis, E., & Badawi, N. (2019). Early diagnosis and classification of cerebral palsy: An historical perspective and barriers to an early diagnosis. Journal of Clinical Medicine, 8(10), 1599. https://doi.org/10.3390/jcm8101599

McGuire, D. O., Tian, L. H., Yeargin-Allsopp, M., Dowling, N. F., & Christensen, D. L. (2019). Prevalence of cerebral palsy, intellectual disability, hearing loss, and blindness, national health interview survey, 2009–2016. Disability and Health Journal, 12(3), 443-451. https://doi.org/10.1016/j.dhjo.2019.01.005

Carvalho, A. L., Ventura, P., Taguchi, T., Brandi, I., Brites, C., & Lucena, R. (2019). Cerebral palsy in children with congenital Zika syndrome: A 2-Year neurodevelopmental follow-up. Journal of Child Neurology, 35(3), 202-207. https://doi.org/10.1177/0883073819885724

Gulati, S., & Sondhi, V. (2017). Cerebral palsy: An overview. The Indian Journal of Pediatrics, 85(11), 1006-1016. https://doi.org/10.1007/s12098-017-2475-1

Shevell, M. (2019). Cerebral palsy to cerebral palsy spectrum disorder. Neurology, 92(5), 233-235. https://doi.org/10.1212/wnl.0000000000006747

Pringsheim, T., Fiest, K., & Jette, N. (2014). The international incidence and prevalence of neurologic conditions. Neurology, 83(18), 1661-1664. https://doi.org/10.1212/wnl.0000000000000929

Ahmad, A., Akhtar, N., & Ali, H. (2017). Prevalence of cerebral palsy in children of district Swabi, Khyber Pakhtunkhwa-Pakistan. Khyber Medical University Journal, 9(2).

Ibrahim, S. H., & Bhutta, Z. A. (2013). Prevalence of early childhood disability in a rural district of Sind, Pakistan. Developmental Medicine & Child Neurology, 55(4), 357-363. https://doi.org/10.1111/dmcn.12103

Palsi, P. Ç. S. (2014). Cerebral palsy in Pakistani children: A hospital-based survey. Cukurova Medical Journal, 39(4), 705-711.

Moster, D., Wilcox, A., Vollset, S., Markestad, T., & Lie, R. (2011). Cerebral palsy among term and post-term births. Obstetric Anesthesia Digest, 31(3), 155. https://doi.org/10.1097/01.aoa.0000400297.56442.fd

Damiano, D. L., Martellotta, T. L., Sullivan, D. J., Granata, K. P., & Abel, M. F. (2000). Muscle force production and functional performance in spastic cerebral palsy: Relationship of cocontraction. Archives of Physical Medicine and Rehabilitation, 81(7), 895-900. https://doi.org/10.1053/apmr.2000.5579

Gawande, R. (2014). The effects of whole-body vibrations on salivary cortisol in young females in squat position.

Nieuwhof-Leppink, A. J., Schroeder, R. P., Van de Putte, E. M., De Jong, T. P., & Schappin, R. (2019). Daytime urinary incontinence in children and adolescents. The Lancet Child & Adolescent Health, 3(7), 492-501. https://doi.org/10.1016/s2352-4642(19)30113-0

Marciniak, C., O'Shea, S. A., Lee, J., Jesselson, M., Dudas-Sheehan, D., Beltran, E., & Gaebler-Spira, D. (2013). Urinary incontinence in adults with cerebral palsy: Prevalence, type, and effects on participation. PM&R, 6(2), 110-120. https://doi.org/10.1016/j.pmrj.2013.07.012

Caldwell, P. H., Deshpande, A. V., & Gontard, A. V. (2013). Management of nocturnal enuresis. BMJ, 347(oct29 11), f6259-f6259. https://doi.org/10.1136/bmj.f6259

Gündoğdu, G., Kömür, M., Avlan, D., Sarı, F. B., Delibaş, A., Taşdelen, B., Naycı, A., & Okuyaz, Ç. (2013). Relationship of bladder dysfunction with upper urinary tract deterioration in cerebral palsy. Journal of Pediatric Urology, 9(5), 659-664. https://doi.org/10.1016/j.jpurol.2012.07.020

Elbasan, B., & Bezgin, S. (2018). The effects of reflexology on constipation and motor functions in children with cerebral palsy. Pediatrics & Neonatology, 59(1), 42-47. https://doi.org/10.1016/j.pedneo.2017.01.005

Charalambous, C. P. (2013). Interrater reliability of a modified Ashworth scale of muscle spasticity. Classic Papers in Orthopaedics, 415-417. https://doi.org/10.1007/978-1-4471-5451-8_105

Van Engelenburg-van Lonkhuyzen, M. L., Bols, E. M., Bastiaenen, C. H., Benninga, M. A., & De Bie, R. A. (2017). Childhood bladder and bowel dysfunction questionnaire. Journal of Pediatric Gastroenterology and Nutrition, 64(6), 911-917. https://doi.org/10.1097/mpg.0000000000001461

Paulson, A., & Vargus-Adams, J. (2017). Overview of four functional classification systems commonly used in cerebral palsy. Children, 4(4), 30. https://doi.org/10.3390/children4040030

Ko, J., Woo, J., & Her, J. (2011). The reliability and concurrent validity of the GMFCS for children with cerebral palsy. Journal of Physical Therapy Science, 23(2), 255-258. https://doi.org/10.1589/jpts.23.255

Downloads

Published

2025-02-28

How to Cite

Frequency and Associated Risk Factors of Bowel and Bladder Problem Among Children with Spastic Cerebral Palsy. (2025). Indus Journal of Bioscience Research, 3(2), 458-464. https://doi.org/10.70749/ijbr.v3i2.724