Clinical trial

Target Physiotherapy Versus Exercise Support Intervention for Bladder-bowel Dysfunction in Adolescents With Obesity

Opening soon · Not applicable · 1 countries · Registry ID NCT07724158

Opening soonNot applicableInterventional

What this study is about

Bladder and bowel dysfunction (BBD) is a common condition that includes problems such as urinary urgency, daytime urinary incontinence, bedwetting, constipation, or difficulties emptying the bladder or bowel. These symptoms can negatively affect quality of life, emotional well-being, school participation, and social relationships. Adolescents with obesity may be at a higher risk of developing BBD, but few studies have evaluated effective treatments specifically for this population. The OBE-BBD trial is a randomized controlled study designed to evaluate whether two different non-drug interventions can improve bladder and bowel symptoms in adolescents with obesity when added to standard obesity care. Adolescents aged 13 to 18 years receiving treatment for obesity at the Pediatric Outpatient Clinic of Hospital de Santa Maria (Lisbon, Portugal) will be randomly assigned to one of three groups: (i)Target physiotherapy, consisting of individualized urotherapy and bowel-management education combined with pelvic floor muscle training, breathing exercises, lumbopelvic mobility exercises, stretching, strengthening exercises, and a structured home exercise program; (ii) Exercise support intervention, consisting of supervised physical exercise sessions and a standardized home-based high-intensity interval training (HIIT) program designed for adolescents with obesity; or (iii) Usual care, consisting of the standard multidisciplinary obesity treatment provided at the clinic. Both intervention programs will last 12 weeks. Participants will be assessed before the intervention, immediately after the 12-week intervention period, and again 3 months later. The main objective is to determine whether either intervention reduces the severity of bladder and bowel dysfunction symptoms compared with usual care. The study will also examine whether the interventions improve urinary symptoms, constipation, urinary tract infections, quality of life, psychological well-being, physical activity, sedentary behavior, sleep, dietary habits, and obesity-related outcomes. In addition, the study will investigate whether changes in lifestyle behaviors and obesity-related measures help explain improvements in bladder and bowel symptoms. The results of this study are expected to provide new evidence on effective, non-pharmacological treatment strategies for adolescents with obesity and bladder-bowel dysfunction and may support more comprehensive, multidisciplinary care for this population.

A promising-looking record is not the same as confirmed eligibility. The study team must review the full criteria and current recruitment status.

Basic eligibility

Age13 Years to 18 Years
SexAll
Healthy volunteersNot accepted
ConditionBladder-Bowel Dysfunction, Obesity & Overweight

Full registry criteria

Inclusion Criteria: * Male or female adolescents aged 13 to 18 years. * Obesity defined as BMI z-score ≥2, according to the WHO growth reference for school-aged children and adolescents. * Currently receiving obesity treatment at the Pediatric Outpatient Clinic, Department of Pediatrics, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal. * Able to understand the study procedures and comply with study requirements. * Written informed consent provided by a parent or legal guardian. * Written assent provided by the adolescent. Exclusion Criteria: * Known neurological disorder affecting bladder or bowel function. * Structural urinary tract or gastrointestinal malformation. * Previous pelvic surgery affecting urinary or bowel continence. * Diabetes mellitus or uncontrolled endocrine or monogenic disorders affecting obesity or bladder/bowel function. * Severe psychiatric disorder requiring immediate specialized treatment and likely to interfere with study participation or adherence. * Major orthopedic or musculoskeletal condition preventing safe participation in the exercise intervention. * Current participation in another interventional clinical trial.

Treatments and study arms

Target physiotherapy

Behavioral

Participants will receive a 12-week physiotherapy program integrating urotherapy and bowel management. The intervention includes one individual 60-minute session followed by five group sessions delivered every two weeks. The program provides education on bladder and bowel habits, hydration, toileting posture, pelvic floor muscle relaxation and training, diaphragmatic breathing, lumbo-pelvic mobility exercises, stretching, strengthening exercises, and individualized progression according to clinical needs. Participants will also complete a structured home-based exercise program (25-30 minutes, three times per week) and receive telephone support between face-to-face sessions to reinforce adherence.

Exercise support intervention

Behavioral

Participants will receive a 12-week supervised exercise support program consisting of one initial 60-minute supervised session followed by five 30-minute follow-up sessions every two weeks. The intervention supports adherence to routine physical activity recommendations through supervised practice, exercise progression, and correction of movement technique. Participants will perform a standardized home-based high-intensity interval training (HIIT) program lasting approximately 25-30 minutes, three times per week. The intervention does not include urotherapy or bladder-bowel management education.

Usual obesity care

Other

Participants will continue the standard multidisciplinary obesity treatment routinely delivered at the Pediatric Outpatient Clinic. Standard care includes regular follow-up appointments with a pediatrician, nutritionist, and exercise physiologist approximately every three months, including medical evaluation, nutritional counseling, and individualized physical activity counseling according to routine clinical practice. No targeted bladder-bowel dysfunction treatment will be provided during the intervention period unless clinically indicated.

Primary outcomes

Change in bladder-bowel dysfunction symptom severityBaseline and 12 weeks (end of intervention)

Change in bladder-bowel dysfunction (BBD) symptom severity from baseline to 12 weeks, assessed using the Vancouver Symptom Score (VSS). The VSS is a validated 14-item questionnaire with total scores ranging from 0 to 52, where higher scores indicate greater symptom severity. The primary analysis will compare changes in VSS scores between the two intervention groups and the usual care group. A validated version of the instrument for Portuguese will be used.

Study locations

1 locations were listed when this page was built. The first 40 are shown.

Hospital de Santa Maria, ULS SM🇵🇹 Lisbon, Portugal
Antonio Videira-Silva, PhDContact