How could I apply this information?"Relaxation of the pelvic floor muscle (PFM) is necessary to fully empty the bowel and bladder. Diaphragmatic breathing and relaxation techniques are commonly used to train PFM relaxation in children. The frog jumps in this study were used to fatigue the PFM, thereby inducing relaxation. For children who have difficulty achieving PFM relaxation via diaphragmatic breathing or relaxation techniques, the frog jump intervention may be useful. Alternatively, the frog jumps, followed by child' s pose, may help the child identify the differences between PFM contraction and relaxation. Increasing the child' s awareness of a contracted versus relaxed PFM may help them achieve relaxation more quickly when voiding. Correct toilet posture with pelvis appropriately supported by supporting feet with knees above hips can also assist with PFM relaxation during voiding. "What should I be mindful about when applying this information?"Children who had co-occurring developmental or cognitive diagnoses were excluded from the study. These children often require modifications of interventions due to cognitive, emotional, and mobility impairments and limitations. For example, a child with attention-deficit hyperactive disorder and voiding dysfunction may require additional cues or supports to participate in relaxation techniques. The experimental exercises were designed to achieve relaxation by inducing fatigue of the PFM. It is unclear whether frog hops to fatigue, child' s pose, or the combination of both produced PFM relaxation in subjects. Fatiguing the lower extremities and PFM may result in leakage of bowel and/or bladder prior to arriving to the toilet. In addition, the study only addressed the resting tone of the pelvic floor, rather than the ability of the child to fully void due to the intervention. Finally, norms for PFM relaxation are needed in pediatrics to identify high PFM tone or a contracted state and when the intervention successfully produced low tone or relaxation of PFM.
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