In 2008, Nemett, et. al., conducted the study about Pediatric dysfunctional voiding (DV). DV is a condition that poses physical and emotional challenges to children, while also carrying the risk of progression to renal disease. While manual physical therapy and osteopathic treatment have been effective in addressing DV in adult women, there is a lack of research on the effectiveness of manual physical therapy based on an osteopathic approach (MPT-OA) in pediatric patients. This study aimed to investigate whether adding MPT-OA to standard treatment (ST) could lead to more significant improvements in DV compared to ST alone.

A randomized controlled trial was conducted, involving 21 children aged 4 to 11 years who were diagnosed with DV. The participants were randomly assigned to either receive MPT-OA in addition to standard treatment (treatment group) or standard treatment alone (control group). Pre-treatment and post-treatment evaluations were conducted to assess DV symptoms, MPT-OA evaluations, and inter-rater reliability of DV symptom resolution.

The findings revealed that the treatment group demonstrated greater improvement in DV symptoms compared to the control group (Z=-2.63, p=0.008, Mann-Whitney U-test). Furthermore, the treatment group showed more notable improvements in vesicoureteral reflux and elimination of post-void urine residuals.

This study indicates that MPT-OA treatment can lead to short-term improvements in children with DV, surpassing the benefits observed with standard treatments. Additionally, both children and parents expressed satisfaction with the MPT-OA approach. These promising results highlight the need for a larger multi-center randomized clinical trial to further explore the efficacy of MPT-OA in children with vesicoureteral reflux and/or post-void urinary retention. Such research would provide valuable insights into the potential of MPT-OA as a therapeutic intervention in pediatric DV.

Reference: Nemett, D. R., Fivush, B. A., Mathews, R., Camirand, N., Eldridge, M. A., Finney, K., & Gerson, A. C. (2008). A randomized controlled trial of the effectiveness of osteopathy-based manual physical therapy in treating pediatric dysfunctional voiding. Journal of Pediatric Urology, 4(2), 100-106.