Children, OnlyNCT07576491
Correlation Between Toilet Sitting Position, Ankle Range of Motion, and Lower Limb Strength in Children
An observational study of Children, Only, run by Riphah International University at 1 site in Pakistan.
Trial summary
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. Read more about this study
- Who is it for?
- Ages 6 to 12 years
- Conditions the study is for
- Children, Only
- How many people
- 191 participants
- Where
- 1 sitePakistan
- Study dates
- 13 Apr 2026to 29 Jul 2026
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 6 to 12 years
- All sexes
- No healthy volunteers
- Child
Study population: 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.
Who may be able to join
- 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.
Who cannot join
- 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)
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
City District High School Lahore
Lahore, Punjab Province, 54000
About this study
Official title: 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.
Read the detailed description
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.
- Conditions
- Children, Only
- Keywords
- Squatting Position, Ankle Joint, Lower Extremity Strength, Constipation, Posture
- Medical subject headings
- Constipation
What is being measured
The primary outcome is the main question the study is designed to answer.
Goniometer
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.
Measured: Baeline
1 Minute Sit-to-Stand Test
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.
Measured: Baeline
Standing Long Jump
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.
Measured: Baeline
Patient Assessment of Constipation Symptoms (PAC-SYM) Questionnaire
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.
Measured: Baeline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 May 2026
- Study start13 Apr 2026
- Primary completion10 Jul 2026
- Study completion29 Jul 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Children, OnlyStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Cross-sectional
- Enrolment
- 191 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Ayisha Sana, MS-PT, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07576491
- Sponsor's protocol ID
- REC/RCR&AHS/25/0723
- Status last verified
- Sep 2026
- First submitted
- 4 May 2026
- Last updated
- 30 Sep 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 30 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Correlation Of Different Toilet Sitting On Ankle Range Of Motion, Constipation And Lower Limb Strength In School Going Children
- ClinicalTrials.gov ID
- NCT07576491
- Acronym / sponsor ID
- REC/RCR&AHS/25/0723
- Conditions
- Children, Only
- Keywords
- Squatting Position, Ankle Joint, Lower Extremity Strength, Constipation, Posture
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 191 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 13 Apr 2026 (actual)
- Primary completion
- 10 Jul 2026 (actual)
- Study completion
- 29 Jul 2026 (actual)
- First posted
- 8 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed description
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.
Study design
- Observational model
- Other
- Time perspective
- Cross-sectional
Who may qualify
- Ages
- 6 to 12 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
- Study population
- 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.
Key inclusion criteria (5 listed)
- 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.
Key exclusion criteria (6 listed)
- 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.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Goniometer
Time frame: 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.
1 Minute Sit-to-Stand Test
Time frame: 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.
Standing Long Jump
Time frame: 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.
Patient Assessment of Constipation Symptoms (PAC-SYM) Questionnaire
Time frame: 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.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Sep 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ayisha Sana, MS-PT principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Children, Only, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 30 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Goniometer (time frame: Baeline). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Sep 2026.