The Prevalence of Bladder and Bowel Dysfunction in Children with Cerebral Palsy and its Association with Motor, Cognitive, and Autonomic Function

Figures & data

Figure 1. Flow chart of the participants.

Table 1. “Participants” demographic and impairments characteristics.

	N=39
Age (years) 8 9 10	4(10.3) 20(51.3) 15(38.5)
Gender male female	20(51.3) 19(48.7)
Classification Spastic diplegia hemiplegia quadriplegia Dyskinetic Ataxic Mixed	27 (69.2) 10 (25.6) 6 (15.4) 11 (28.2) 2 (5.4) 0 (0) 6 (15.4)
GMFCS I II III IV V	4(10.3) 5(12.8) 4(10.3) 8(20.5) 5(12.8)
WeeFIM ranking on items Dressing- lower extremities Transfer to toilet Communication- comprehension Communication- verbal Cognition- interaction Cognition- problem solving Cognition- memory	1[1–7] 2[1–7] 7[1–7] 7[1–7] 5[1–7] 5[1–7] 7[1–7]
Autonomic signs Cold extremities pain Sleeping disorders constipation	16(41.0) 11(28.2) 12(30.8) 17(43.6)
No. of autonomic signs per child 0 1 2 3 4	14(35.9) 7(17.9) 8(20.5) 7(17.9) 3(7.7)

Values are presented as number (percentage), median [min- max].

Table 2. Bladder and Bowel dysfunction characteristics.

Answer to the question“The age in which your child was toilet trained … ”
Reported on being toilet trained	20(51.3)
Reported age at toilet training (in years)	3.5 [2–10]
Reported toilet training without reservation*	10(25.6)
Reported age at toilet training without accidents (in years)	4 [2–10]
Yes to “Has your child been treated for Baldder and Bowel Dysfunction?	7(17.9)
If so, what was the treatment Pediatric pelvic floor physiotherapy and urotherapy Incontinence clinic Urology Emotional Medication	2 2 1 1 1
Treatment for constipation taken from “Autonomic signs” questionaire Enema Polyethylene Glycol Magnesium Dietary changes Physical activity Combination treatment of the above	4 13 1 2 1 4
PQ-EnU- number of BBD signs	N=39
Daytime wetting Nighttime wetting Constipation Daytime soiling Nighttime soiling Urgency Frequency	24(61.5) 19(48.7) 13(33.3) 19(48.7) 7(17.9) 14(35.0) 4(11.4)
Baldder and bowel dysfunction Index (0–3) 0 1 2 3	10(25.6) 10(25.6) 11(28.2) 8(20.5)

*laughter/fatigue/physical stress.

Values are presented as number (percentage), median [min- max].

Table 3. Motor, cognitive and autonomic function by continence.

	Overall continence			Urinary continence			Fecal continence
The measure	Yes N = 10	No N = 29	p-value	Yes 11=N	No 28=N	p-value	yes 13=N	no 26=N	p-value
GMFCS	2.2[1–4]	4.0[1–5]	<0.01	2.2[1–4]	4.0[1–5]	<0.01	3.1[1–5]	4.2[3–5]	0.06
Dressing- lower extremities	4.4[1–7]	2.2[1–7]	0.04	4.6[1–7]	2.1[1–7]	<0.01	3.4[1–7]	1.6[1–7]	0.01
Transfer to toilet (1–7)	5.5[1–7]	2.9[1–7]	0.01	5.6[1–7]	2.8[1–7]	0.01	4.2[1–7]	2.3[1–7]	0.03
Cognition sum (5–35)	33.3[26–35]	20.3[5–35]	<0.01	33.2[26–35]	20.4[5–35]	0.01	28.4[5–35]	15.2[5–33]	<0.01
No. of autonomic signs (0–4)	0.4[0–2]	1.8[0–4]	<0.01	0.6[0–3]	1.8[0–4]	0.18	0.8[0–3]	2.7[1–4]	<0.01

Values are presented as median [min- max], p-value-Mann Whitney.

Table 4. Spearman’s rank correlation coefficients and partial coefficients between motor function, cognitive ability, and autonomic function characteristics, and BBD index.

		Partial correlation coefficients (discounting the character in the head of the column)
	Correlation	GMFCS	Dressing- lower extremities (WeeFIM)	Cognition (WeeFIM)	Number of autonomic signs
GMFCS	0.68**		0.39	0.36	0.62*
Dressing- lower extremities (WeeFIM)	-0.72**	-0.24		-0.41	-0.58*
(WeeFIM)Transfer to toilet	-0.60**	-0.05	0.59	-0.37	-0.56*
(WeeFIM)Cognition	-0.73**	-0.65**	-0.71**
Number of autonomic signs	0.74**	0.58*	0.60*	0.24

Values are presented spearman’s rank *p-value<.05, **p-value<.01.