Osteopathic Treatment Research Articles

Tissutal and Fluidic Aspects in Osteopathic Manual Therapy: A Narrative Review.

Over the years, several authors have discussed the possibility of considering somatic dysfunction (SD) as a “nosological element” detectable on palpation. There are many aspects to consider regarding the etiology and diagnosis of SD, and the literature on osteopathic issues provides details on physiological signs that characterize it, including tissue texture changes. Recent knowledge suggests that how tissue and, in particular, connective tissue, responds to osteopathic treatment may depend on the modulation of the inflammation degree. Low-grade inflammation (LGI) may act on the extracellular matrix (ECM) and on cellular elements; and these mechanisms may be mediated by biological water. With its molecules organized in structures called exclusion zones (EZ), water could explain the functioning of both healthy and injured tissues, and how they can respond to osteopathic treatment with possible EZ normalization as a result. The relationship between inflammation and DS and the mechanisms involved are described by several authors; however, this review suggests a new model relating to the characteristics of DS and to its clinical implications by linking to LGI. Tissue alterations detectable by osteopathic palpation would be mediated by body fluids and in particular by biological water which has well-defined biophysical characteristics. Research in this area is certainly still to be explored, but our suggestion seems plausible to explain many dynamics related to osteopathic treatment. We believe that this could open up a fascinating scenario of therapeutic possibilities and knowledge in the future.

Оценка влияния остеопатического лечения на динамику психовегетативных симптомов у пациентов с тревожно-фобическими расстройствами

The article highlights the materials of the influence of complex rehabilitation measures with the inclusion of osteopathic treatment on the symptom’s dynamics in patients with anxiety-phobic disorders. The study involved patients of both sexes, aged from 23 to 49 years, the treatment lasted from 6 to 8 weeks. It has been determined that against the osteopathic treatment, the number of complaints in patients decreases, the indices of vegetative status return to normal, and the frequency of incidences of somatic dysfunctions decreases.

Variant Femoral Nerve: The Path Beneath the Iliacus Muscle and Into Neuropathic Symptoms

Introduction and ObjectiveOriginating from the lumbar plexus, the femoral nerve has a native course along the anterior surface of the iliacus then travels deep to the inguinal ligament, branching into separate anterior and posterior divisions that provide innervation to the anterior thigh muscles (Figure 1). Clinically, the spatial relationship between the iliopsoas complex and the femoral nerve has been noted for the potential risk of entrapment and compressive neuropathies. Variations in the femoral nerve course following surgical and medical interventions can produce symptoms related to muscle weakness and sensory loss in patients. Relevant literature regarding variant femoral nerve distributions is most often related to aberrant slips of the iliacus muscle and following surgical or medical intervention. In this case study, we describe a variation in the descent of the femoral nerve that travels within the belly of the iliacus muscle without evidence of an aberrant slip or surgical intervention and discuss the clinical implications and appropriate non‐invasive osteopathic treatment options.MaterialsThis anatomical variation was revealed in one donor being evaluated at Sam Houston State University College of Osteopathic Medicine’s anatomy lab. The donor was previously dissected by medical students for a first‐year anatomy course. The iliacus and surrounding structures were left intact. Additional dissection necessary for this study was performed from March 2021 to April 2021.ResultsIn a 70‐year‐old male cadaver, the right femoral nerve originated from the lumbar plexus, descended, and then bifurcated (Figure 2A). Most of the femoral nerve remained within the Iliacus muscle (Figure 2B) while a small portion of the femoral nerve followed the typical course anterior to the iliacus (Figure 2C). The bulk of the femoral nerve traveled within the iliacus, exiting inferior to the inguinal ligament, then merged with the smaller portion of the nerve (Figure 2D). The left femoral nerve followed a typical course.Significance/ConclusionPrevious discussions report an aberrant slip of the iliacus splitting the femoral nerve and having the potential for nerve compression, although unlikely due to the smaller muscle belly involved. This highlighted variant is significant because the bulk of the femoral nerve remains beneath the iliacus as it crosses over the pubic eminence. This pathway would be predisposed to a greater degree of compression against the pubic eminence, with potential for certain movements to increase these forces.This patient presentation is hypothesized to include anterior thigh weakness during hip flexion and knee extension activities, such as stair‐climbing, as well as sensory loss to the anteromedial thigh and medial leg via the saphenous nerve. Sensation to the lateral thigh should remain intact as the lateral femoral cutaneous nerve would be unaffected. conservative treatments, such as osteopathic manipulative techniques, could be an effective form of treatment. Techniques including counterstrain to the psoas and iliacus or muscle energy to the hip flexors could lessen such nerve compression and improve patient symptoms.Awareness of this variation could provide clinicians with another potential diagnosis to consider when managing femoral neuropathy, as well as rationale for a non‐invasive treatment option.

Osteopathy in the treatment of irritable bowel syndrome symptoms in adults: study protocol for a randomized controlled trial

<p><strong>Background: </strong>Osteopathy is chosen by patients as a treatment for irritable bowel syndrome (IBS) but evidence for its effectiveness is poor. The purpose of this study is to evaluate the effectiveness of osteopathy for IBS at 1 month follow-up in IBS adults.</p><p><strong>Methods: </strong>Design: a multicenter, two-group parallel, randomized, double-blind, placebo-controlled trial. Inclusion criteria: adult IBS patients (Rome IV criteria) with similar baseline symptom severity, and comparable expectations of active and sham osteopathic treatment before. Treatment group included active osteopathic treatment. Control group included sham osteopathic treatment. Randomization was in allocation ratio 1:1. Assessment time was carried as inclusion and baseline assessment (day-1; initial visit V0), day 8, day 15 and follow-up (1 month and 3 months), treatments (day 0, day 8, day 15). Primary endpoint was effectiveness at 1 month (response to treatment defined as at least a 50-point reduction in IBS severity on the IBS-symptom severity score). Secondary endpoint was effectiveness at 3 months (response to treatment) and changes in total IBS quality of life scores up to 3 months. Sample size was 404 individuals to achieve 90% power to detect a 15% difference in treatment response at 1 month between the two groups (20% of patients lost to follow-up).</p><p><strong>Conclusions: </strong>The two-group parallel, randomized, double-blind, placebo-controlled trial (sham therapy) in which the expectations and experiences of patients in the control group are comparable to the experimental group is the most accurate design for demonstrating the effectiveness of osteopathy on IBS symptoms. Future studies could use such a design to assert causality.</p><p><strong>Trial registration:</strong> The trial has been registered in clinicalTrials.gov. Registration number: NCT05230277; registered on 7 February 2022.</p>

Effects of osteopathic techniques of balancing SEB and separating the front-ethmoid suture in children with narrow palate

The use of the disjunction by dentists, to solve the problem of narrow palate, allows to maintain flexible tissues and permeable sutures. The opening of the palatal suture by means of the dental disjunction confers greater freedom of movement to the upper jaw and the palatine but given the close relationship of this bones with the vomer, the ethmoid and even the spheno-basilar synchondrosis, it is hypothesized that osteopathy could contribute not only to accelerate the process of disjunction, but also to avoid the recurrences of it. The maneuvers proposed here take into consideration the cranial structures that are in direct relation with the bony palate.The aim is to analyze whether the osteopathic maneuver of the balancing of the spheno-basilar synchondrosis and the front-ethmoidal separation influence the angle of the sella turcica, the joint angle and the distance between the central fossae in children with narrow palate who use a disjunction.A controlled, randomized, longitudinal and double-blind clinical trial was conducted; with experimental group and control group and two external evaluators. Measurements have been made prior to treatment, and after 45. It was shown that the two osteopathic maneuvers used were sufficient to cause significant increases in the angle of the sella turcica and the joint, and the distance between fossa and fossa of the first permanent molars. Osteopathic interventions were performed before placing the circuit breaker, 15 days and 35 days later.

ОЦЕНКА ЭФФЕКТИВНОСТИ ОСТЕОПАТИЧЕСКОГО ЛЕЧЕНИЯ ПАЦИЕНТОВ, ПЕРЕНЕСШИХ ТРАНЗИТОРНУЮ ЦЕРЕБРАЛЬНУЮ ИШЕМИЧЕСКУЮ АТАКУ

The article highlights the study records on the influence of complex rehabilitation measures combined with the osteopathic treatment on the condition of patients who have had a transient ischemic attack. The study involved patients of both sexes aged 50-64 years, over the period from 3 to 10 days of inpatient treatment. It has been determined that, with the inclusion of osteopathic treatment in the complex of rehabilitation measures, the number of complaints in patients decreases, main Doppler indicators are normalized, and life quality improves.

ДИНАМИЧЕСКАЯ НЕВРОПАТИЯ НАДЛОПАТОЧНОГО НЕРВА – «БОЛЬ В ЛОПАТКЕ И ПЛЕЧЕ». МАНУАЛЬНАЯ ДИАГНОСТИКА И ЛЕЧЕНИЕ

Dynamic suprascapular nerve neuropathy is a cause of shoulder pain and weakness that is often overlooked. The difficulty in diagnosing the nerve dynamic damages is conditioned by the fact that the symptoms are provoked by physical exertion(s) or a certain position of the limb due to compression and(or) overstretching as well as violations of the longitudinal and transverse sliding of the nerve. These symptoms subside when the provoking factor ceases to act and return when movements repeat. Neurologic examinations and nerve conduction studies performed at rest usually show no change. The suprascapular nerve dysfunction is closely related to rotator cuff pathology. The nerve damage is often caused by a dynamic microtrauma during repetitive arm movements over the head with maximum deflection and external rotation of the arm. Suprascapular neuropathy can be caused by the nerve compression or traction in the suprascapular notch or spinoglenoid region. The nerve damage in the suprascapular notch causes weakness in both the supraspinatus and infraspinatus muscles, while damage under the spinoglenoid ligament affects only the infraspinatus muscle. Diagnostics should include manual testing of the supraspinatus and infraspinatus muscles with a neutral position of the arm and neck of the patient being examined and during provocative neurodynamic tests of stretching the suprascapular nerve. Therapeutic measures should be directed to all interdependent components of the peripheral nervous system in the following sequence: osteopathic treatment of the nerve trunk interface (tissues surrounding the nerve trunk); osteopathic treatment of the innervated tissue; osteopathic treatment of the connective tissue of the suprascapular nerve.

Дети первого года жизни после искусственной вентиляции легких при рождении. Новые подходы к реабилитации

Objective. To improve rehabilitation of infants who received respiratory support at birth. Patients and methods. This prospective comparative study was conducted in the Children's City Polyclinic No 13 of Yekaterinburg and included 131 infants who received different types of artificial lung ventilation (ALV) for some respiratory disorders. All patients were followed up by a pediatrician, neurologist, pulmonologist, and an infectious disease specialist; all of them received appropriate therapy. The experimental group comprised 99 infants who additionally received a course of osteopathic (manual) correction for 8–10 weeks, whereas the control group included 32 infants who received standard therapy only. Patients in the experimental and control groups were matched for all parameters. In addition to chest X-ray, all study participants underwent an assessment of their neurological, somatic, and biomechanical statuses. Osteopathic treatment (4 to 6 sessions lasting 30–40 minutes each) was performed by one osteopathic doctor. Statistical analysis was conducted using the SPSS Statistics.26 software; we calculated Pearson's linear correlation coefficient and used Fisher's exact test and McNemar's test. Differences were considered significant at p < 0.05. Results. Seventy-nine infants (79.8%) initially had both neurological and somatic disorders. Ten patients (10.1%) had either somatic disorders (such as labored nasal breathing, regurgitation, constipation, thermoregulation disorder) or neurological disorders (weather sensitivity, sleep disorders, delayed motor and/or neuropsychiatric development, impaired blood and cerebrospinal fluid dynamics) alone. We identified three groups of major somatic dysfunctions (SDs) in the biomechanical status: local (levels: С0–СI, sternum, thoracoabdominal diaphragm, sacrum); regional (cervical spine–level СII–СVI, laryngopharyngeal complex, lungs, abdominal cavity, skull); and global dysfunction of the dura mater. After treatment, the frequency of all neurological and somatic disorders, as well as the frequency of all SDs reduced in the experimental group (p < 0.001). Pathological changes on chest X-rays (elevated diaphragm, low mobility of the thoracic diaphragm, bullae, pleurodiaphragm atic adhesions, etc.) were detected in 89 patients (67.9%), including 66 infants from the experimental group (66.7%) and 23 infants from the control group (71.8%). Osteopathic (manual) treatment significantly reduced the number of patients with abdominal diaphragm dysfunction (56.6% vs. 26.3%), bullae (35.3% vs. 11.1%), and middle lobe syndrome (8.1% vs. 2%) (p < 0.001). The number of patients with thoracoabdominal diaphragm dysfunction in the control group did not change (n = 18; 56.2%). Positive radiological dynamics was observed in 90.9% of patients from the experimental group and 43.5% of patients from the control group. Moreover, only infants from the control group demonstrated negative radiological dynamics (17.4%). Conclusion. Newborns (both preterm and full-term) with different respiratory disorders who had received all types of ALV were found to have a typical spectrum of SDs. The key aspect of their pathogenesis is primary lesions to the phrenic nerve. Correction of SDs using osteopathic manipulations significantly increased the efficacy of comprehensive treatment, which is confirmed by the results of X-ray examination. Key words: somatic dysfunctions, thoracic diaphragm, phrenic nerve, artificial ventilation, manual therapy, preterm newborns, newborns, osteopathic correction

A Glymphatic System and New Etiopathogenic Hypothesis on Glaucoma Patients Who Underwent Osteopathic Manipulative Treatment: A Pilot Study

Purpose Malfunction of the lymphatic or glymphatic system recently shown in the brain, seems to play an important role in central neurodegenerative pathologies through a build-up of neurotoxins. Recent studies have shown functional links between aqueous humour and cerebrospinal fluid via the glymphatic system, offering new perspectives and unifying theories on the vascular, biomechanical and biochemical causes of chronic and openangle glaucoma (POAG). The aim of this randomized pilot study is to compare the variations in intraocular pressure between 20 cases of compensated POAG under pharmacological therapy and 20 glaucoma patients undergoing osteopathic treatment, hypothesizing that this manipulation can influence intraocular pressure. Materials and Methods The 40 patients under study, all covered by the Helsinki convention, were randomly divided into 2 groups (treated group or TG and control group or CG). The 40 patients were chosen from compensated glaucoma sufferers, who required neither changes in therapy nor operations which would affect their eye pressure which was measured both before and after manipulative osteopathic treatment scheduled into 4 sessions at intervals of 7.3 and 150 days, then compared with the control group (20 patients) who were undergoing pharmacological treatment only. Results The average IOP in the TG was compared with the CG throughout the entire treatment cycle showing a statistically inconclusive reduction in the right eye RE P-value (0.0561), while for the left eye a significant effect was shown LE (0.0073). The difference between the reduction in IOP between TG and CG was observable 10 months after the first session or rather 5 months after the last, and demonstrable during a check-up 13 months after the beginning of the study, or rather 8 months in absence of treatment with a highly significant statistical p-value (0.000434). Conclusions This study has shown that manipulative osteopathic treatment can affect intraocular pressure after each session and that the pressure is significantly lower even months after the last treatment session.

The Glymphatic System and New Etiopathogenic Hypotheses Concerning Glaucoma Based on Pilot Study on Glaucoma Patients Who Underwent Osteopathic Manipulative Treatment (OMT)

Purpose Malfunction of the lymphatic or glymphatic system recently shown in the brain, seems to play an important role in central neurodegenerative pathologies through a build-up of neurotoxins. Recent studies have shown functional links between aqueous humour and cerebrospinal fluid via the glymphatic system, offering new perspectives and unifying theories on the vascular, biomechanical and biochemical causes of chronic and open angle glaucoma (POAG). The aim of this randomized pilot study is to compare the variations in intraocular pressure between 20 cases of compensated POAG under pharmacological therapy and 20 glaucoma patients undergoing osteopathic treatment, hypothesizing that this manipulation can influence intraocular pressure. Materials and Methods The 40 patients under study, all covered by the Helsinki convention, were randomly divided into 2 groups (treated group or TG and control group or CG). The 40 patients were chosen from compensated glaucoma sufferers, who required neither changes in therapy nor operations which would affect their eye pressure which was measured both before and after manipulative osteopathic treatment scheduled into 4 sessions at intervals of 7.3 and 150 days, then compared with the control group (20 patients) who were undergoing pharmacological treatment only. Results The average IOP in the TG was compared with the CG throughout the entire treatment cycle showing a statistically inconclusive reduction in the right eye RE P-value (0.0561), while for the left eye a significant effect was shown LE (0.0073). The difference between the reduction in IOP between TG and CG was observable 10 months after the first session or rather 5 months after the last, and demonstrable during a check-up 13 months after the beginning of the study, or rather 8 months in absence of treatment with a highly significant statistical p-value (0.000434). Conclusions This study has shown that manipulative osteopathic treatment can affect intraocular pressure after each session and that the pressure is significantly lower even months after the last treatment session.

Effectiveness of cranial osteopathy therapy on nociception in equine back as evaluated by pressure algometry

A horse needs to move in different gaits and carry a rider during riding. Therefore, the equine back must be in a good functional state. Preventing back disorders is one of the keys to ensuring a horse’s health. This study aimed to assess cranial osteopathy therapy as a treatment and prevention method for preventing and reducing back pain. Thirty-two thoroughbred horses were categorised by their backs’ functional status (16 without back pain and 16 with back pain). The mechanical nociceptive threshold was determined before and after osteopathic treatment by an algometer (pain test FPX 100) with pressure points between T14-T15, T18-L1, and L5-L6. The data were analysed with a significance of P < 0.05. The study found that cranial osteopathic therapy raised the mechanical nociceptive threshold average in 83.3% measured points for horses without back pain and in 50% measured points for those with back pain. This study revealed that both horses without back pain and horses with back pain had a positive response to cranial osteopathic therapy, as evidenced by the increased nociceptive threshold limits, indicating that osteopathic therapy can be used as a primary or additional treatment method for back dysfunction.

Intra-articular osteotomy for correction of neglected malunion of medial femoral condyle Hoffa's fracture

Hoffa fractures are distal coronal femoral fractures which are intra-articular and involve one or both of the condyles. The lateral condyle is three times more likely to sustain an injury than the medial condyle. Malunion is one of the late complications in neglected instances or following nonoperative management. Medial femoral condyle injuries are quite uncommon. In this case study, a 23-year-old male with a neglected medial Hoffa's malunion is discussed. The patient presented with pain, deformity, and restriction of movements in the left knee for 6 months. Pain aggravates walking and was affecting his daily activities. He allegedly had a past trauma 18 months back for which he took osteopathic treatment. On examination, fixed 10° varus knee deformity is noted, and there is a fixed flexion deformity of 10° with further flexion up to 100°, i.e., there is an extension block terminally. X-rays and computed tomography scan showed medial condyle Hoffa's malunion with obvious intra-articular step. Treatment aims to reduce the articular surface anatomically and provide rigid and stable fixation. Treatment's objectives included easing pain and addressing deformities and improving the range of movements and early mobilization. The patient was assessed clinically with a Knee Society Score. The primary method of treatment for Hoffa's malunion is surgical. Intra-articular osteotomy should be taken into consideration as a salvage option in the younger population to prevent arthritis. The use of an antiglide plate in conjunction with screws provides rigid and stable fixation.

ЗОЛОТОЕ СЕЧЕНИЕ В КРАНИОЛОГИИ, ПРИКЛАДНОЕ ЗНАЧЕНИЕ ДЛЯ ОСТЕОПАТИЧЕСКИХ ДИАГНОСТИКИ И ЛЕЧЕНИЯ

The concept of health is unthinkable without the norm, everything in the world around us has a Golden Ratio, this proportion is important for the location of the skull bones and for osteopathic diagnosis and treatment of the patient.

Osteopathic Evaluation and Positional Plagiocephaly: A Descriptive Study on a Population of Children with ASD

The discipline of osteopathy is a whole person approach that incorporates medical and scientific knowledge using an array of manipulative techniques for diagnosis and treatment of several types of diseases (WHO). The ostheopathic examination allows to locate somatic dysfunctions which are the hallmarks of health imbalance caused by stressful events, external or internal to the body, such as trauma and / or other pathologies. The objective of osteopathic treatment is to improve posture and motor skills, which are the prerequisites for a balanced and harmonious development of the body. The osteopathic evaluation of children with autism spectrum disorder allows the identification of dysfunctional aspects at a somatic level that can enrich the understanding of the child's health and behavior, starting from the structure / function relationship, including craniofacial dimorphisms and plagiocephaly. The present exploratory research has made it possible to detect the presence of signs of plagiocephaly in about half of a sample of 250 preschool and school age children with autism spectrum disorder; the 44% of these, shows signs of craniofacial dysmorphism, which indicates a continuous morphostructural adaptation not yet sufficiently considered as an interferent element in the overall development of the child. The observed incidence is consistent with the incidence of plagiocephaly in the pediatric population and supports the hypothesis that in children with autism spectrum disorder it may be useful to integrate the osteopathic expertise with the other health professionals involved in the diagnostic and therapeutic process. The authors conclude that osteopathic observation can contribute to the definition of the functioning profile of the children with autism spectrum disorder and their needs, in a global perspective of taking charge and individualization of care.

The effectiveness of orthodontic and osteopathic correction in patients with dental anomalies and musculoskeletal dysfunction of the temporomandibular joint in the presence of concomitant somatic dysfunctions and without it

Introduction. The influence of the dental apparatus on the balance of the body in an upright position has been widely discussed in the literature for several decades. Examination of the patient taking into account his postural balance makes it possible to clarify the reasons for the low effectiveness of pain syndromes treatment of the craniocervical region caused by malocclusion, as well as ineffective correction of musculoskeletal dysfunction of the temporomandibular joint (MSD TMJ) associated with posture disorders.The aim of the study is to evaluate the effectiveness of treatment of patients with dental anomalies and musculoskeletal dysfunctions of the temporomandibular joint and concomitant somatic dysfunctions (if any) by methods of orthodontic and osteopathic correction.Materials and methods. The study involved 102 patients aged from 18 to 45 years with TMJ. All patients underwent orthodontic and osteopathic examination. 3 groups of patients were formed: № 1 — exclusively with dental anomalies TMJ (occlusive dysfunction), who received only orthodontic treatment, № 2 with concomitant somatic (extra-occlusive) dysfunctions, who received only orthodontic treatment, and №3 with concomitant somatic (extra-occlusive) dysfunctions, who received both orthodontic and osteopathic treatment. Orthodontic treatment of musculoskeletal dysfunction of the TMJ consisted of the occlusive kappa manufacturing. Osteopathic correction was carried out individually, taking into account the identified somatic dysfunctions, on average 3 sessions. Patients also received drug therapy, and they performed myohymnastics for the masticatory muscles. The clinical dysfunction index (Helkimo M.) was used to control the elimination dynamics of the TMJ's musculoskeletal dysfunction symptoms. The assessment of the pain dynamics in the TMJ was carried out by a visual-analog scale (VAS). The evaluation of the osteopathic treatment effectiveness was carried out on the basis of computer stabilometry data and osteopathic examination data. A stabilometric study was performed on the «ST-150» («Biomera») stabiloplatform in the Romberg sample (European foot installation) with open and closed eyes in two positions of the lower jaw: 1) in a state of physiological rest (tooth rows are separated); 2) in the kappa with closed tooth rows.Results. The MSD TMJ symptoms were eliminated 10 weeks after the start of treatment in all (100 %) patients of group № 1 and group № 3. Among the patients in group № 2, only 12,1 % of patients had complete absence of MSD TMJ symptoms, while all patients in this group had a statistically significant decrease in the clinical index of Helkimo dysfunction. In one third of the group № 2 patients on the 12th week of orthodontic treatment, headaches and/or pains in other parts of the musculoskeletal system (neck, back, shoulders, arms) prevailed among complaints and which were previously indicated in the anamnesis. This occurred after the elimination of the MSD TMJ symptoms. The absolute majority of patients in group № 3 (97,1 %) noted the complete disappearance of headaches and/or pains in other parts of the musculoskeletal system (neck, back, shoulders, arms). Also, in patients of this group, stabilometric indicators were normalized in a state of physiological rest and in the kappa.Conclusion. Patients with somatic dysfunctions need complex treatment with the participation of an osteopath and a dentist. When assessing the osteopathic status of a patient, it is important to determine whether the patient has only occlusive dysfunctions or there are also extra-occlusive ones. Additional osteopathic correction is recommended for patients with extraocclusive dysfunctions in order to achieve treatment results comparable in effectiveness and timing.

The effect of osteopathic correction on the function of external respiration in patients after <i>COVID</i> -19 coronavirus pneumonia

Introduction. The 2019 coronavirus infection (COVID-19) pandemic caused by a novel coronavirus strain (SARS-CoV-2) posed a serious threat to public health around the world. Postcoid syndrome (post-COVID-19 condition, according to ICD-10 code U09 State after COVID-19 or Postcoid state, Postcoid syndrome) is a pathological condition after a coronavirus infection, accompanied by cardio-respiratory, neurological, musculoskeletal, metabolic disorders. According to a number of studies, osteopathic methods of correction increase the lymph flow, immunological protection of the body, help to reduce pain, reduce the restriction of mobility in the chest, and therefore improve the function of external respiration. There are practically no studies that allow assessing the effect of osteopathic correction methods on the function of external respiration at the modern evidence-based level in patients who have undergone COVID pneumonia.The aim was to study the effect of a single procedure of osteopathic correction on the function of external respiration in patients during the rehabilitation period after coronavirus pneumonia.Materials and methods. On the basis of the Primorsky Institute of Vertebroneurology and Manual Medicine (Vladivostok) the rehabilitation of patients after coronavirus pneumonia was carried out using osteopathic correction. The study included 73 patients over the age of 60 years with varying degrees of lung damage and impaired respiratory function. To assess the function of external respiration, spirometry was performed and the vital capacity of the lungs was assessed; pulse oximetry was performed to measure the saturation of arterial blood hemoglobin with oxygen (SpO2). Osteopathic testing and treatment were carried out according to clinical guidelines, and the biomechanics of the chest was additionally investigated. The Statistica-10 software package was used for the statistical analysis of the obtained data.Results. Osteopathic examination revealed the presence of local somatic dysfunctions in 98,8 % of patients (spinal dysfunction, rib dysfunction, diaphragm dysfunction). 87,6 % of patients were diagnosed with regional somatic dysfunctions of thoracic region. Global somatic dysfunctions were diagnosed in 78,4 % of patients. After a single procedure of osteopathic correction, patients had a statistically significant improvement of the external respiration function, manifested in an increase in vital capacity from 78,27±2,79 to 85,36±3,38 % (p=0,0006). Also, the effectiveness of osteopathic correction is confirmed by a significant increase in the average hemoglobin saturation of arterial blood with oxygen. Thus, in patients with low SpO2 levels, the index increased from 94,21±0,21 to 95,09±0,3 % (p=0,02). After a single osteopathic correction procedure, the number of patients with local somatic dysfunctions decreased from 98,8 to 17,7 %; global somatic dysfunctions were revealed only in 16,3 % of patients. All patients noted an improvement in their general condition, a decrease in symptoms of respiratory discomfort and shortness of breath, and an increase in chest excursion.Conclusion. A single procedure of somatic dysfunctions' osteopathic correction in patients after coronavirus pneumonia leads to a statistically significant improvement in respiratory function. The vital capacity and the oxygen saturation of the blood increase in patients. This is caused by the increase of the mobility of the chest (increase in its excursion), diaphragm, ribs, spine. The obtained results allow recommend the inclusion of osteopathic correction in the rehabilitation programs for patients who have undergone coronavirus infection.

Osteopathic Treatment and Evaluation in the Clinical Setting of Childhood Hematological Malignancies.

Simple SummaryChildren: adolescents, and young adults who are affected by hematological malignancies and who are undergoing intensive phases of cancer treatment including hematopoietic stem cell transplantation, experience diminished functional ability. This study was aimed at assessing if osteopathic treatment and evaluation can be used when an 11-week precision-based exercise program is run inside the hospital. Our results support that osteopathy plus precision-based intervention could be a desirable support in the clinical prise en charge of these children and adolescents. Osteopathy is a safe method for the evaluation of clinical conditions and requires strong multidisciplinary synergy between pediatricians and exercise physiologists.Children: adolescents, and young who are adults affected with hematological malignancies (CAYA-H) and who are undergoing intensive phases of cancer treatment, including hematopoietic stem cell transplantation (HSCT), experience diminished functional ability. This study was aimed at assessing the feasibility, efficacy, safety, and satisfaction of an osteopathic intervention in CAYA-H attending an 11-week precision-based exercise program (PEx). All of the participants were given 4–10 treatments according to the prescription ordered by the sports medicine doctor in charge of the PEx, and the following outcomes were assessed: (1) spinal column range of motion (ROM) by palpation; (2) lower and upper limb joints ROM by a goniometer; (3) orthostatic posture by plumb line assessment; (4) chest and abdomen mobility by inspection and palpation; (5) cranial-sacral rhythmic impulse (CRI) by palpation; and (6) adverse effects. Goal attainment scaling (GAS) was used to identify the accomplishment of a desired clinical result. Moreover, HSCT patients who were affected with graft-versus-host disease and/or osteonecrosis had their joints assessed in terms of ROM as tools to monitor the effectiveness of immunosuppressive treatment. A total of 231 CAYA-H were identified, and 104 participated in the study (age 10.66 ± 4.51 yrs; 43% F). PEx plus osteopathy reached positive GAS scores by improving the ROMs of the spinal column and/or limbs (81% and 78%, respectively), chest and abdomen mobility (82%), and CRI (76%). Only minor reversible adverse effects were noticed during the study. Together, our data seem to initiate a new course where osteopathy could be useful in evaluating structural edges due to the clinical history of each CAYA-H. Given the contributions that were obtained by the GAS scores, osteopathic treatment seems to reveal interesting potential that can be targeted in the future.

Results of osteopathic treatment of infants with psychomotor developmental disorders

Aim. To compare the effectiveness of osteopathic treatment of infants with psychomotor development disorders with standard treatment in terms of functional status.
 Methods. The study was conducted at the Yaroslav-the-Wise Novgorod State University and the Institute of Osteopathic Medicine named after V.L. Andrianov, between 2020 and 2021. The study included 49 children with delayed psychomotor development, of which: the main group consisted of 26 children receiving osteopathic treatment; the control group consisted of 23 children treated with standard therapies. Data gathered included the indicators of the functional health state, complaints of parents, assessed neurological, vegetative, and osteopathic statuses, the psychomotor development in the children according to the ZhurbaMastyukova scale, performed neurosonography. The results were processed using descriptive statistics followed by checking for the significance of the difference by using the Student's t-criterion for related samples.
 Results. A comparison of the effectiveness of osteopathic and standard treatment of infants with a delay in psychomotor development by indicators of the functional status was carried out. The need for an integrated approach to therapeutic and diagnostic procedures was substantiated. The number of subjective complaints about the health of children from parents in the main group decreased, while in the control group, it remained the same. Neurological status in children of both groups improved, but the changes are more pronounced in the main group (p 0.05). The outcomes of the treatments indicate for improving psychomotor development of the children in the main group, in the control group, such an increase was only 13.0% (p 0.001).
 Conclusion. The results of the study showed that osteopathic treatment of infants with psychomotor development disorders is more effective than standard complex treatment, which is reflected in the improvement of functional health indicators.

An Osteopathic Approach to Complex Regional Pain Syndrome (CRPS)

Abstract Complex Regional Pain Syndrome (CRPS) is a chronic neuropathic pain condition in a region of the body where the pain experienced by the patient is disproportionate to the stimuli preceding the pain. In this case, a 52-year-old post-menopausal woman presents with chronic distal limb pain due to a left ankle contusion from a work injury. Previous treatments that focused on specific symptoms failed. However, the patient was then evaluated and treated comprehensively by an osteopathic physician. Treatment was tailored to individual patient needs based on the five models of osteopathic care. Within a 1.5 years period of integrative osteopathic treatment that utilized osteopathic manipulative treatment (OMT) in addition to medications and supplements, the patient was able to start walking again with only mild discomfort. This individualized approach seemed to improve her quality of life, and overall satisfaction with her health, psyche, and well-being. The patient is now discharged from the practice, has resumed normal daily activities, and is working full-time as a cashier.

Decreasing Headache Pain Secondary to a Subarachnoid Hemorrhage with the use of Osteopathic Manipulative Medicine

Abstract Background: Controlling a headache (HA) secondary to a subarachnoid hemorrhage (SAH) can be challenging for most physicians. At Maine Medical Center in Portland, Maine, the neurointensivist and staff noticed a trend in decreasing HA pain caused by a SAH in patients treated with osteopathic cranial manipulative medicine and osteopathic manipulative medicine (OMM), more so than those treated solely with the traditional opioid approach. It was requested that a chart review of these patients be evaluated for an objective analysis of this observation. Hypothesis: A decrease in HA caused by SAH will be observed in the group treated with OMM in comparison to those treated with opioids alone. Methods and Materials: A retrospective, IRB approved, and exempted study reviewed 21 subjects with a SAH that were treated with OMM. This population was analyzed for a decrease in pain score following osteopathic treatment as well as for adverse events 6-month post treatment. Results: Pain scores were consistently reduced when comparing pre-and-post OMM treatment. After the first treatment, pain scores decreased by an average of 4 points, after the second treatment scores decreased by an average of 3 points and after the third treatment pain scores decreased by an average of 2.5 points. The number of adverse events recorded were found to be less than the national averages. Conclusion: The use of OMM as an adjunct with traditional treatments for a SAH can lead to a decrease in HA pain caused by a SAH. Minimal adverse events were observed.