The possibilities of osteopathic correction using for the treatment of children with attention defi cit hyperactivity disorder

Abstract

Introduction. Attention defi cit hyperactivity disorder (ADHD) is diagnosed in childhood and is the most common mental disorder in children — about 5–7 % among school-age children. None of the treatment methods, as clinical observations showed, is completely effective for the treatment of ADHD. In most cases, the main method of treatment is pharmacotherapy. But despite the proven short-term effectiveness, pharmacotherapy may have limitations: partial response or no response, side effects, questionable long-term benefi ts, poor adherence to the treatment regimen, negative attitude of parents. Limitations of existing pharmacological treatment methods emphasize the need to develop effective non-pharmacological interventions that improve short- and long-term results in regard to neuropsychological defi ciency symptoms and disorders of other general activity fi elds. Currently, there are publications noting the positive clinical effect of osteopathic correction on the children′s health state in various mental sphere disorders. But only a few studies are aimed at studying the effect of osteopathic correction in ADHD. At the same time, there are no publications about the osteopathic correction use in the ADHD treatment without pharmacotherapy.The aim of the study is to investigate the possibility of osteopathic correction using for the treatment of children with attention defi cit hyperactivity disorder.Materials and methods. The study was conducted on the basis of the medical organization «Health′ Clinic» Tver from March 2021 to February 2022. Inclusion criteria: children age 7–10 years; established ADHD diagnosis; absence of diseases and conditions that are an absolute contraindication for osteopathic correction; parental consent to osteopathic examination and correction. Criteria for non-inclusion: age of children younger than 7 and older than 10 years; not confi rmation of the diagnosis according to the «ADHD Assessment Scale — ICD-10 criteria»; the presence of diseases and conditions that are an absolute contraindication for osteopathic correction. Exclusion criteria: failure to attend repeated examinations. The total number of children was 38 people. The patients were distributed by randomization envelopes into 2 groups of 19 people each. The main group: the osteopathic correction and the behavioral psychotherapy were used. The comparison group: the drug hopanthenic acid and the behavioral psychotherapy were used. Before and after the treatment, osteopathic status was assessed in both groups, and the severity of ADHD was assessed according to the ADHD assessment scale (ICD-10 criteria), and an attention test was conducted in the form of a Bourdon correction test.Results. At the beginning of the study, the patients were characterized by regional biomechanical disorders of the head region — in 100 % of participants in both groups, as well as the neck (structural component) — in 63 % of participants in both groups, and the dura mater — in 89 % of participants in the comparison group and 79 % of the main group. After the course of treatment, a signifi cant (p<0,05) positive dynamics was observed in the main group according to the three above indicators, and there was no signifi cant dynamics in the comparison group. After the treatment, the statistically signifi cant (p<0,05) positive dynamics was observed in both groups with respect to the severity of ADHD and the main characteristics of attention: the indicators of the ADHD assessment scale (ICD-10 criteria) decreased, the accuracy coeffi cients and concentration of attention increased, and the fatigue index decreased. At the same time, in the main group, the fatigue index decrease was statistically signifi cant (p<0,05) more pronounced than in the comparison group.Conclusion. The obtained results allow us to recommend osteopathic correction in the treatment of children with ADHD, especially in the cases where, for some reasons, there are restrictions on the medications use.