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Correlation Between Toilet Sitting Position, Ankle Range of Motion, and Lower Limb Strength in Children

4. maj 2026 opdateret af: Riphah International University

Correlation Of Different Toilet Sitting On Ankle Range Of Motion, Constipation And Lower Limb Strength In School Going Children

This study investigates the relationship between different toilet sitting styles (squat vs. western) and their effects on ankle range of motion (ROM), constipation symptoms, and lower limb strength in school-going children aged 6-12 years. With increasing urbanization, the shift from traditional squat toilets to sitting toilets may influence children's musculoskeletal development and bowel health. Squatting involves greater ankle dorsiflexion and muscle activation, which may contribute to better lower limb strength and improved bowel function compared to sitting postures.

A comparative cross-sectional design will be used, including participants from public and private schools. Data on toilet usage habits will be collected along with demographic information. Ankle ROM will be measured using a goniometer, lower limb strength will be assessed through the 1-minute sit-to-stand test and standing long jump, and constipation symptoms will be evaluated using the PAC-SYM questionnaire. Data analysis will be conducted using SPSS version 26. Ethical approval will be obtained from the Research Ethics Committee of Riphah International University, Lahore.

Studieoversigt

Status

Rekruttering

Betingelser

Detaljeret beskrivelse

This study aims to explore the correlation between different toilet sitting styles and their effects on ankle range of motion (ROM), constipation symptoms, and lower limb strength in school going children. With modernization and urbanization, there has been a significant shift from traditional squat toilets to western-style sitting toilets, especially in schools and households.This change in toileting posture may have a direct impact on musculoskeletal development and gastrointestinal health in growing children. Prolonged use of sitting toilets might limit the natural ankle dorsiflexion used during squatting and reduce muscle activation in the lower limbs, potentially contributing to strength limitations and altered bowel habits. The study intends to investigate whether habitual use of squat toilets promotes better ankle flexibility, stronger lower limbs, and fewer constipation-related symptoms in comparison to sitting toilet users.

A comparative cross-sectional study design will be employed, targeting children aged 6 to 12 years from selected public and private schools. After obtaining informed consent from guardians and assent from children, demographic data will be collected along with their toilet usage history. Ankle ROM will be measured using a goniometer, while lower limb strengthwill be assessed using the 1 minute sit-to-stand test and estimated long standing jump testing.Constipation symptoms will be evaluated using the Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaire. Data will be analyzed through SPSS version26.0.Descriptive statistics will be used to determine the association between toilet type and the selected outcome variables. The synopsis will be presented to the Research Ethical committee of Riphah International University, Lahore, for ethical approval to conduct this study.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

191

Kontakter og lokationer

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Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Rekruttering
        • City District High School Lahore
        • Kontakt:
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

The study population will consist of school-going children aged 6 to 12 years enrolled in selected public schools. Both boys and girls will be included. Participants will be grouped based on their habitual toilet usage (squat toilet users and western-style sitting toilet users).Only children who are healthy, ambulatory, and able to perform physical tests will be included. Children with neurological conditions, musculoskeletal deformities, recent lower limb injuries, congenital abnormalities, or known gastrointestinal disorders (other than functional constipation) will be excluded.

Informed consent will be obtained from parents or guardians, along with assent from the children before participation.

Beskrivelse

Inclusion Criteria:

  • Students age group: 6-12 year.
  • Both male and female groups
  • Normal developing children
  • Children who have been using either sitting or squatting toilet type .
  • Children's who are willing to participate and perform functional tasks.

Exclusion Criteria:

Children with abdominal surgery

  • Children with lower limb surgery
  • Children with acute or chronic disease like irritable bowel syndrome
  • Children using both toilet postures
  • Children with neurological or developmental delays affecting toilet independence like Cerebral Palsy and autism.
  • Children on medications that affect bowel movement (e.g., laxatives, opioid)

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Goniometer
Tidsramme: Baeline
A goniometer is a reliable tool used to measure ankle range of motion (ROM), including dorsiflexion and plantarflexion. The axis is placed at the lateral malleolus, with arms aligned along the fibula and fifth metatarsal. Assessment is done in a seated or supine position** with the knee flexed or extended.
Baeline
1 Minute Sit-to-Stand Test
Tidsramme: Baeline
1-minute Sit-to-Stand Test (1-MSTST) is a simple and reliable test to assess lower limb strength and endurance in children. The participant sits on a standard chair with arms crossed and performs maximum sit-to-stand repetitions in 60 seconds. Each full stand and return to sitting is counted as one repetition. The total number of repetitions is recorded, showing **high reliability in pediatric populations.
Baeline
Standing Long Jump
Tidsramme: Baeline
The Standing Long Jump (SLJ), also known as the standing broad jump, is a field test used to evaluate explosive lower-limb power in children and adolescents. Participants start with both feet together just behind a marked line, execute a countermovement by flexing the knees and hips, swing their arms, and leap forward as far as possible, landing on both feet without falling backward. The distance from the take-off line to the back of the heel nearest the line is measured in centimeters. No shoes or minimal footwear are allowed to ensure consistency .Each participant performs two trials, and the longest valid jump is recorded as their score .Research including large pediatric samples confirms that the SLJ test exhibits excellent test-retest reliability.
Baeline
Patient Assessment of Constipation Symptoms (PAC-SYM) Questionnaire
Tidsramme: Baeline
The PAC-SYM (Patient Assessment of Constipation Symptoms) is a validated questionnaire used to assess constipation severity over the past two weeks. It includes 12 items covering abdominal, stool, and rectal symptoms, rated on a 5-point Likert scale (0-4). Scores indicate severity ranging from minimal to very severe symptoms.
Baeline

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Riphah International University

Efterforskere

  • Ledende efterforsker: Ayisha Sana, MS-PT, Riphah International University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

13. april 2026

Primær færdiggørelse (Anslået)

10. juli 2026

Studieafslutning (Anslået)

30. august 2026

Datoer for studieregistrering

Først indsendt

4. maj 2026

Først indsendt, der opfyldte QC-kriterier

4. maj 2026

Først opslået (Faktiske)

8. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

8. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • REC/RCR&AHS/AYISHASANA

Plan for individuelle deltagerdata (IPD)

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