This study was undertaken to build upon the work of J. Gordon Zink, DO, FAAO, by developing a novel screening examination (Expanded Zink screen) that can correlate with proper identification of somatic dysfunction, the area of greatest restriction (AGR), and effective treatment in soccer players, which would elevate the osteopathic profession and advance the field of medicine. The objectives of this study are to determine whether the Expanded Zink screen can accurately correlate with the somatic dysfunctions found in soccer players, with what ended up being treated, and with effectiveness of treatment as measured by spirometry. We performed a correlational study that involves female collegiate soccer players during the season who signed up to receive osteopathic manipulative treatment (OMT) after providing written informed consent. We screened 8 University of Pikeville (UPIKE) women's soccer players; exclusion criteria included any pre-existing health problems, such as bleeding disorders, congenital malformations, and spinal cord injuries. Each soccer player underwent pre-OMT spirometry measurements. Next, each soccer player received a screening examination ("Traditional Zink" screen or "Expanded Zink screen") from Operator 1. The soccer player then received the same screening examination from Operator 2. Operator 2 then found somatic dysfunctions and performed OMT. Finally, Operator 1 completed a re-screen of the soccer player utilizing the initial screen and noted any changes in findings. The soccer player then completed post-OMT spirometry measurements. We find that all players in both groups after receiving OMT have a normal lung function pattern or one that improved from an obstructive pattern to a normal pattern as measured by spirometry. All eight soccer players had lumbar somatic dysfunction, innominate somatic dysfunction, and lower extremity somatic dysfunction. All players had all four junctions equalized post-OMT. Seven out of the eight players had cranial somatic dysfunction, and five of them had their cranial somatic dysfunction treated first, including Player 5, who showed clinically significant improvement in lung function post-OMT. Player 5's ribs were treated second in the treatment sequence. A novel Expanded Zink screen accurately correlated OMT of exhaled ribs to lateral asymmetry in rotation at the cervicothoracic junction in Player 5. Spirometry measurement post-OMT in Player 5 revealed clinically significant improvement in lung function showing 32 % change from obstruction to a normal pattern, which we attribute to correction of restrictive ribcage motion/dysfunction utilizing OMT. Both cranium and rib treatments accurately correlate with Expanded Zink screen findings of cranial and rib somatic dysfunctions in Player 5. The Expanded Zink screen can be utilized as a screening model for the hypothesized correlating body regions to identify significant somatic dysfunction and to augment the physician's ability to detect key body regions that need OMT. Through the use of the Expanded Zink screen, we discovered an out-of-pattern rib somatic dysfunction, which may have led to what we call a "restrictive ribcage motion/dysfunction." This type of rib motion may have been the cause of the obstructive pattern on pre-OMT spirometry seen in Player 5. Once the rib was treated, the restrictive ribcage motion resolved, which allowed lung function to be restored to normal.

Depression is a complex neuropsychiatric disorder characterized by affective, cognitive, and somatic dysfunctions, yet its pathophysiology remains poorly understood. Reliable preclinical models are essential for elucidating disease mechanisms and identifying therapeutic alternatives. The present study aimed to develop and characterize a reserpine-induced mouse model of depression using an integrated in-vivo and in-silico approach. Adult male Swiss mice (8-12weeks) received oral reserpine (0.75mg/kg BW/day) for 14 consecutive days. Behavioral assessments revealed significant reductions in food intake, body weight, and sucrose preference, alongside increased immobility time and impaired spatial memory. Biochemical analyses demonstrated elevated oxidative stress markers and diminished antioxidant enzyme activity in brain tissue. Neurochemical profiling confirmed significant depletion of key monoamines (serotonin, dopamine, norepinephrine, and histamine), increased acetylcholinesterase activity, and elevated serum corticosterone and liver enzymes (ALT and AST). Genotoxic and apoptotic evaluations indicated substantial DNA damage, increased apoptosis, and reduced cell viability. Histopathological observations further confirmed neurodegenerative changes and disrupted neuronal architecture in critical brain regions associated with mood and cognition, indicating compromised neuroplasticity. Complementary, molecular docking studies further demonstrated strong binding affinities of reserpine with key molecular targets involved in oxidative stress and neurotransmission, providing a mechanistic support for the observed pathophysiological changes. Overall, the present study establishes a robust and multidimensional model that captures behavioral, biochemical, and structural aspects of depression. The integration of experimental and computational approaches highlights the model's utility for advancing mechanistic insights and facilitating the development of novel antidepressant strategies.

Pregnancy produces numerous physiological and structural changes in the pregnant person as the fetus grows. An increase in the hormone relaxin throughout pregnancy causes ligamentous laxity to allow the body to stretch and make room for the fetus and prepare the body for birth. This relaxation of the musculoskeletal system contributes to lumbar lordosis, pelvic pain, lumbar disc herniation, and joint pain. These changes may persist after delivery, causing years of lumbar and sacral pain. Although multiple reports indicate that 50 % of delivered patients will develop back pain, which is likely multifactorial, few studies have evaluated postpartum people for sacral dysfunctions. Our study focused on investigating the incidence of sacral dysfunctions in recently postpartum patients. The objectives for this study include: (1) to assess the type of sacral somatic dysfunction present in postpartum patients; and (2) to investigate the correlation between various demographic factors (age of mother, gravida, para, gestational age, utilization of anesthesia, postpartum day of osteopathic evaluation, position of baby at delivery, operative delivery via forceps or suction, weight of baby) and sacral somatic dysfunctions. This study was conducted by third year osteopathic medical students recruited during their obstetrics and gynecology clerkship rotation. Study participants were evaluated for sacral dysfunction utilizing a standardized palpatory technique. The findings made by student evaluators at each palpated site were recorded in a password-protected Microsoft Teams account. Principal investigators utilized this data to make a specific sacral diagnosis for each patient. Additional demographic data were recorded and utilized for analysis of risk factors. All data were analyzed and compared utilizing ttest, analysis of variance (ANOVA) methods, chi-square tests, and descriptive statistics with the aid of JASP and SPSS software. A total of 62 patients participated in the study. Sacral dysfunction has been identified in 100 % of patients. The total incidence of each diagnosis includes: three nonphysiologic, 24 physiologic neutral, and 35 physiologic nonneutral. There was a statistically significant association between nonphysiological diagnoses and an increased fetal weight as well as a shorter interval between birth and evaluation. Additionally, vacuum-assisted deliveries were more likely to result in a nonphysiologic or physiologic nonneutral diagnosis. Understanding the incidence of various sacral dysfunctions in postpartum patients can provide us with a deeper understanding of potential causes of back pain following vaginal delivery. In the future, we hope that this pilot study will contribute to further understand factors contributing to sacral dysfunctions in parturient. Our aim is to take a more proactive approach to addressing specific sacral dysfunctions, thereby decreasing postpartum lower backpain.

While medications have their place in the treatment of pain, incorporating the century-old practice of osteopathic manipulative treatment (OMT) into pain treatment protocols may be beneficial. OMT has been administered with positive results in the reduction of pain, but it has been difficult to quantify palpable somatic changes, post-OMT. However, with technological advancement, adding objective documentation could potentially support the many published subjective studies demonstrating OMT effectiveness, reproducibility of OMT techniques, and the effect of OMT in pain reduction. This study documented objective changes in cervical hysteresis, consistent reproducible palpatory diagnosis, and treatment pressures with associated pain levels. A total of 213 subjects were enrolled and randomized into two treatment groups. Subjects reported their cervical pain via pre- and posttreatment questionnaires. One physician measured somatic tissue hysteresis pre- and posttreatment in all cervical segments utilizing the ULTRAlign SA201®. A second physician independently diagnosed for significant somatic dysfunction and treated with cervical OMT (while wearing the IsoTouch® palpation monitoring system). Statistically significant or suggestive overall cervical changes were observed in all four ULTRAlign SA201® hysteresis measurement components. Consistent diagnostic and treatment IsoTouch® pressure measures were documented in the cervical region. Neck pain subjects reported pain reduction posttreatment, with no subjects remaining in the severe pain subgroup. Statistically significant or suggestive objective cervical hysteresis changes were noted after direct method OMT, along with a reduction in pain scores in this subject population. Consistent palpatory pressures for cervical diagnosis and treatment were measured, supporting the reproducibility of these techniques.

Intractable hiccups is a rare medical condition defined as daily hiccups continuing for more than 30 days and is recognized by the National Organization for Rare Disorders (NORD) and NIH Genetic and Rare Diseases (GARD) Information Center. Hiccups are spasmodic contractions of the respiratory muscles, triggered by activation of the hiccup reflex arc. Intractable hiccups can occur if this arc is chronically or aberrantly activated. The hiccup reflex arc has three components: (1) afferent pathways involving the phrenic, sympathetic, and vagal nerves; (2) central processing centers within the central nervous system; and (3) efferent fibers, including the phrenic nerve, vagal branches, and intercostal nerves. Previously published case reports have reported robust improvements to intractable hiccup disease severity after osteopathic manipulative treatment (OMT) for related areas of somatic dysfunction, with one achieving complete remission. However, no structured studies have evaluated this approach todate. The objective of this case series is to determine whether one session of OMT can reduce the severity of intractable hiccups. Five participants aged 18 and older with intractable hiccups were recruited through physician offices, online postings, and flyers placed on and around the Michigan State University (MSU) campus over a 2-year study period. Following eligibility screening, participants recorded their daily hiccup frequency and associated symptoms for 7 days before and after OMT. Each participant received one OMT session after a comprehensive medical history and osteopathic musculoskeletal examination. Identified somatic dysfunctions were treated utilizing appropriate OMT techniques. Muscle energy, counterstrain, and Still Techniques were utilized most frequently. High-velocity, low-amplitude (HVLA) methods were not employed in this study. All treatments were performed by an experienced osteopathic physician at the university-associated osteopathic manipulative medicine (OMM) clinic. Across the participants, we observed common patterns of somatic dysfunction in the cervical spine (C1 and C5), thoracic regions, and the abdominal diaphragm. After OMT, patients experienced clinically meaningful and statistically significant reductions in hiccup frequency. The average number of daily hiccups decreased from 16.37 to 5.66, representing a 65.4 % reduction after intervention (paired t-test, p=0.018). In addition, three out of the five participants experienced statistically significant reductions in their mean number of daily hiccups after treatment (t-test, p<0.05). This case series is the first structured investigation into the use of OMT for intractable hiccups. The findings strongly suggest that OMT can be an effective option for reducing the disease burden of intractable hiccups through the treatment of related areas of somatic dysfunction. Our results also support a plausible mechanistic basis for OMT's effectiveness, because somatic dysfunctions were consistently found along the hiccup reflex arc. Finally, the study raises the possibility that the prevalence of intractable hiccups is underrecognized and may represent a clinical domain in which osteopathic care provides distinct advantages.

Temporary disruptions to epigenetic mechanisms can misroute development and permanently alter cell fate. In particular, it was recently shown that transient loss of Polycomb silencing in flies irreversibly reprograms cells toward cancer (Parreno et al. 2024). Whether somatic dysfunction in parents can create multi-generational heritable susceptibility to tumorigenesis is unknown. In eutelic organisms like Caenorhabditis elegans, adult somatic cells no longer divide, precluding somatic cancer, yet tumors can still form in the continuously dividing germline. Here, we show that disruption of coelomocytes, somatic scavenger cells, just in C. elegans mothers, provokes transgenerationally heritable germline tumorigenesis that persists for multiple generations in genetically wild-type descendants. We found that when the coelomocyte’s phagocytic activity dysfunctions, it impairs clear out of RNA from body fluids, and thus disrupts systemic RNA homeostasis, allowing excess somatic RNAs to access the germline, and leading to widespread transcriptional and small RNA dysregulation and transgenerational loss of germline identity. Converging lines of evidence point towards small RNAs being the heritable agents carrying the pathological information. Together, these findings highlight mechanisms which maintain systemic RNA homeostasis as an important protective barrier against heritable tumorigenesis.

Cryptorchidism is the most common congenital anomaly requiring pediatric surgical correction. Although surgical repositioning of the undescended testis (orchidopexy) is effective anatomically, the molecular and cellular mechanisms underlying ongoing testicular damage after surgery remain poorly understood. We established a surgically induced unilateral cryptorchidism model in adult mice, collected testicular tissues at day 0, 3, 7, 10, and 14 after induction, and performed bulk RNA sequencing on samples collected at day 0, 3, and 7. Differentially expressed genes (DEGs) were analyzed for pathway enrichment and protein-protein interactions. Cell-type-specific gene expression patterns were evaluated using publicly available single-cell RNA-seq data. Histological evaluation was performed to validate tissue-level changes. Transcriptomic profiling revealed rapid upregulation of extracellular matrix remodeling and inflammatory signaling by day 3, primarily in somatic cells such as Sertoli and peritubular myoid cells. By day 7, we observed activation of pro-apoptotic and TGF-β signaling pathways. Key genes including Ddr1, Ltbp1, and Spp1 were enriched in somatic compartments. Histology confirmed progressive seminiferous tubule disorganization and germ cell depletion, consistent with somatic cell-driven structural deterioration. This study provides hypothesis-generating evidence that somatic cell dysfunction may be an early feature of cryptorchidism-associated testicular injury in this adult mouse model. These findings identify candidate genes and pathways for further investigation. Validation in developmental cryptorchidism models and human tissue will be required to establish clinical relevance.

Testicular homeostasis relies on intricate germ cell-somatic cell interactions, yet underlying regulatory mechanisms remain poorly understood. While cilia-related nphp4 mutations cause male infertility, phenotypes show notable interspecies differences and the driving mechanism remains unknown. In this study, we used the Japanese medaka (Oryzias latipes), a model with unique cystic spermatogenesis, to investigate the role of nphp4 in male reproduction. In situ hybridization localized nphp4 transcripts within the spermatogonial niche, particularly in gsdf-positive Sertoli cells. CRISPR/Cas9-mediated deficiency of nphp4 led to age-dependent infertility, characterized by a significant decline in fertilization rates. Although sperm retained normal flagellar structure, they exhibited severe motility defects, head abnormalities, and mitochondrial damage by 6 months of age. Notably, somatic cell dysfunction, including Sertoli cell apoptosis and altered expression of functional markers, occurred early and contributed to premature germ cell depletion. Transcriptomic profiling revealed a coordinated disruption of signaling pathways critical for spermatogonial stem cell maintenance, alongside genes involved in cell communication, ion homeostasis, cytoskeletal organization, and adhesion. Our findings suggest nphp4 is a key regulator of the testicular niche and highlight the utility of the medaka model in uncovering conserved mechanisms of infertility associated with cilia-related genes.

This article analyzes the mechanisms of psychosomatic disorders within the framework of the biopsychosocial model. Modern medicine increasingly considers human health as an integrated interaction of biological, psychological, and social factors. The study highlights neuroendocrine mechanisms of stress, particularly the activation of the hypothalamic–pituitary–adrenal (HPA) axis, autonomic nervous system imbalance, and their impact on the development of somatic dysfunctions.

Congenital heart diseases are the most common congenital malformations, affecting 4 to 9 per 1000 children, with increasing global prevalence. As surgical mortality rates decline, the focus has shifted toward improving the quality of life and perioperative outcomes for pediatric patients. Multidisciplinary rehabilitation, including osteopathic care, is increasingly incorporated into recovery programs. Osteopathic manipulative treatment combines manual techniques with lifestyle guidance to alleviate postoperative pain and promote recovery. This project report describes the impact of osteopathic manipulative treatment (OMT) on pain and somatic dysfunctions in hospitalized pediatric cardiac patients, using validated pain assessment tools. It presents a retrospective analysis of data collected as part of a humanitarian volunteer project. The project report follows a retrospective descriptive study design, using patient note forms from children aged 0-18 years undergoing cardiac surgery at the Sri Sathya Sai Sanjeevani Center in India between October 2023 and March 2024. A total of 29 experienced osteopaths recorded pain assessments at three time points-pre-surgery, post-surgery, and pre-discharge-using age-appropriate pain scales (FLACC, Wong-Baker Faces, and Numerical Rating Scale). Somatic dysfunctions were evaluated and classified using ICD-10 M99 codes. Data analysis involved descriptive statistics and pre-post comparisons using statistical software (Excel and OPENEPI). The study included 564 children (60.5% male, mean age 5.8 ± 4.3 years). The most common congenital defects were ventricular septal defects (38.5%) and tetralogy of Fallot (21.6%). The average hospital stay was 15.9 ± 11.1 days. Significant reductions in pain scores were observed from the Intensive Care Unit to the postoperative ward (p < 0.001). Similarly, somatic dysfunction severity decreased significantly across hospitalization phases (p < 0.001). The thoracic region and rib cage were the most frequently affected areas. No adverse events related to osteopathic manipulative treatments were reported. This project report indicates that osteopathic manipulative treatment is safe and feasible for pediatric patients undergoing surgery for congenital heart disease. Pain scores and somatic dysfunction severity decreased during hospitalization. However, the lack of a control group, the heterogeneity of the patient population, and the short observation period limit the ability to draw causal conclusions. These findings provide a descriptive framework for integrating OMT into multidisciplinary pediatric cardiac care. Future studies should involve prospective, multicenter designs with control groups and longer follow-up periods to assess clinical, functional, developmental, and quality-of-life outcomes.

Osteopathic manipulative treatment (OMT) encompasses a wide range of diagnostic and treatment techniques for many conditions, but few studies have evaluated OMT use on injured patients. We aimed to describe the use of OMT on injured patients from a nationwide sample of emergency department (ED) encounters. We performed a retrospective analysis of the 2018-2022 Nationwide Emergency Department Sample (NEDS) datasets. We included all ED encounters with an injury diagnosis as well as an osteopathic diagnosis or treatment, including International Classification of Diseases-Tenth Revision (ICD-10) Clinical Modification (CM) codes M9900-M9909, ICD-10 Procedure Coding System (PCS) codes 7W00X07-7W09X9Z, and Current Procedural Terminology/Healthcare Common Procedure Coding System (CPT/HCPCS) codes 98925-98929. We calculated the Injury Severity Score (ISS) and the predicted probability of injury-related in-hospital mortality for each encounter utilizing the ROCmax method. Except for counts, all statistics at the encounter level are weighted to account for the complex survey design. Among 29,966,447 ED encounters with an injury diagnosis within the study period, we identified 1,686 with at least one osteopathic diagnosis or treatment code, 6.0 per 100k injury encounters (95 % confidence interval [CI] 4.2 to 8.2). A minority of encounters (574 [35.5 %]) were at level 1 or 2 trauma centers. Although 677 (39.7 %) were admitted, the median ISS was only 1 (interquartile range [IQR 1, 4]), and only 62 (2.9 %) had computed tomography (CT) orders. The predicted probability of injury-related mortality was low, 1.5 % (IQR 1.3, 2.0). Most encounters had a somatic dysfunction diagnosis without an osteopathic treatment code, 1,239 (75.9 %). The most common site of injury, as well as the body area with somatic dysfunction diagnosis and osteopathic treatment, was the thorax. In this nationwide sample, few injured ED patients received OMT, the majority only received a somatic dysfunction diagnosis without osteopathic treatment, and most had minor injuries. These results offer real-world insights into the use of OMT among injured ED patients and may inform efforts to promote its adoption.

Stroke survivors frequently experience multiple co-occurring symptoms that cluster together, significantly affecting their quality of life and rehabilitation outcomes. However, previous research has predominantly focused on individual symptoms in isolation, limiting the potential to inform more comprehensive, symptom cluster-based approaches to post-stroke care. This scoping review aimed to synthesize existing evidence on the assessment tools used to evaluate them, the analytical techniques employed to identify them, and the composition of symptom clusters in people with stroke. A comprehensive literature search was conducted across seven databases (PubMed, EMBASE, APA PsycInfo, CINAHL, Web of Science, China National Knowledge Infrastructure, and Wanfang) for studies published between 2001 and April 2025. Methodological quality was assessed using the JBI Critical Appraisal Checklists. Data were extracted on study characteristics, measurement instruments, analytical techniques, and symptom cluster composition. Fourteen studies comprising 6556 stroke patients were included. A total of 11 assessment tools and six analytical techniques were identified, with exploratory factor analysis being the most commonly used. Seven common symptom clusters were synthesized: pain and fatigue, somatic movement dysfunction, cognitive impairment, affective disturbance, mood and sleep dysregulation, psychological distress, and gastrointestinal symptoms. The most frequently reported symptom cluster was pain and fatigue. Considerable heterogeneity was found across studies in terms of measurement instruments, analytical techniques, and symptom cluster composition. This review highlights the methodological inconsistencies and diversity in symptom cluster research in stroke populations. The findings underscore the need for standardized, culturally adaptable assessment tools and longitudinal designs to capture the dynamic nature of symptom clusters. This comprehensive review summarizes common symptom clusters in stroke patients and provides clinicians and researchers with valuable insights to help them develop more effective symptom management strategies and ultimately improve patient outcomes. PROSPERO: CRD420251069463.

Introduction. The body of a newborn and a child in the first year of life is extremely vulnerable, so it is difficult for them to choose an effective and safe therapy. At the same time, in early postnatal ontogenesis, the organism has high reparative capabilities. It is at this age that primary and secondary prevention of many chronic diseases is highly effective. It is very important to find optimal, preferably non-drug, methods of treating diseases in children in the first months of life, to create conditions for the formation of health for the subsequent life of a person. The aim of the study — according to the literature, to study the results of the use of manual methods of treatment in newborns and children of the first year of life. Materials and methods . A literature search has been carried out on Russian and foreign scientific medical literature databases (PubMed, Cochrane Library, Google Scholar, eLibrary, KiberLeninka, as well as official websites of specialized journals). The main search was carried out from 2014 to 2024. According to the key words, 225 studies were found, of which sufficient level of evidence (presence of a control group, randomized controlled trial (RCT), systematic review, meta-analysis) was in 55 studies, of them 8 metaanalyses and 28 RCT. Nosologies was excluded from further analysis, with less than 5 articles. Publications on the results of treatment for neurological diseases and disorders of the cervical spine were also excluded, as they describe very diverse nosologies, and the quality of research is insufficient. The systematic review included 15 studies describing treatment outcomes for gastrointestinal organ dysfunction, breastfeeding problems and sucking disorders. Results . Summing up all the results described in the publications, it can be stated that manual methods of treatment (most often osteopathic treatment) for functional disorders of the gastrointestinal tract and problems related to breastfeeding in newborns and children of first year of life leads to the following results: Shorten crying time in infant cocos; Improve sleep time; Improve the ability of infants to cling to their breasts; Parents′ complaints related to breastfeeding difficulties are reduced; Increases the likelihood of continued breast-feeding. Conclusion. Over the past 10 years, studies have been conducted on the use of manual methods of treatment, including osteopathic treatment, for various disorders in newborns and children of the first year of life. The articles found often contain studies with a low level of evidence. In foreign studies, which were the overwhelming majority, osteopathic treatment is usually carried out with a certain set of techniques, without taking into account the dominant somatic dysfunction and individual approach to the patient. A detailed analysis of articles on the results of osteopathic treatment of infant colic and problems associated with breastfeeding showed that osteopathic treatment is more effective than no treatment, placebo and routine care. The level of proof is moderate. Chiropractic and other manual methods of treatment have not demonstrated efficacy in these violations. Osteopathic and other types of manual treatment in newborns and children of the first year of life are safe. Further well-designed, reliable studies are needed to provide the necessary evidence that osteopathic treatment is not an alternative but an integral component of pediatric care.

This article describes a case of successful combined treatment of chronic tension headache (CTH) in a 40-year-old female patient using osteopathic and psychotherapeutic correction. After experiencing a psychotraumatic situation (divorce), the patient first experienced episodes of headache that met the criteria for frequent episodic TTH according to the International Classification of Headache Disorders (ICHD-3). Over several months, there was a gradual increase in the frequency of attacks to 20 days per month with an intensity of 6–7 points on the VAS, which indicated the progression of the disease and allowed for the diagnosis of chronic TTH. An osteopathic examination revealed a number of somatic dysfunctions (SD), including global psychovisceral SD and regional SD in the head, neck, chest, pelvis, and dura mater. Given the incomplete relief of symptoms with pharmacotherapy and the pronounced affective background, non-drug treatment was performed, including osteopathic correction and cognitive-behavioral therapy. After two osteopathic and one psychotherapeutic sessions, significant improvement was noted: the frequency of headaches decreased to 1–2 episodes per month, global and regional SD regressed, the level of depression on the Beck scale decreased from 28 to 10 points, anxiety on the Spielberger scale decreased from 48 to 8 points for situational anxiety and from 46 to 10 points for personal anxiety. The results demonstrate the potential of a comprehensive non-pharmacological approach combining osteopathic correction and psychotherapy. The use of osteopathy as part of individualized therapy is consistent with the provisions of the current clinical guidelines for the treatment of tension headaches from the Russian Ministry of Health (2025), which emphasize the validity of including manual and psychotherapeutic methods in the presence of pronounced muscle-tonic and affective components characteristic of chronic tension headaches.

Introduction . Scoliosis is a multifactorial disease of the spine that has a high social significance at school age. There is a involvement in the process of the disease not only of the musculoskeletal system (MS), but also of other organs and systems, and therefore it is advisable to use the term «scoliotic disease» Analysis of the osteopathic status of children with scoliotic disease will potentially help to expand the understanding of its etiopathogenesis, as well as to develop comprehensive schemes of prevention, treatment and rehabilitation. The aim of the study : to study the osteopathic status of children with scoliosis. Materials and methods . Cross-sectional study was carried out at the Children′s Rehabilitation and Education Center № 76 (Moscow) from September 2023 to September 2024. Inclusion criteria: age 10–15 years; scoliosis of I–III degree (according to the Cobb method); incomplete skeletal growth according to the Risser criterion; pathologies of the cardiovascular and respiratory systems in the compensation stage; absence of diseases of the nervous system; absence of acute injuries and infectious diseases; informed consent of the patient′s parents to participate in the study. Criteria for non-inclusion: grade IV scoliosis; history of spinal surgery; epilepsy; spina bifida; vertebral abnormalities; cerebral palsy; osteomyelitis; limb paresis; malignant neoplasms. 100 children (62 girls and 38 boys) were selected. Age 10–15 years, median 13 years. The duration of the disease is 1–14 years, the median is 3 years. According to the results of measuring the Cobb′s angle, 25 people were determined to have grade I scoliosis, 65 people had grade II, and 10 people had grade III. All patients had their osteopathic status assessed according to clinical guidelines. Results. In the examined children with scoliosis, somatic dysfunctions (SD) of all three levels of manifestation were revealed. The most characteristic were dysfunctions at the regional level: pelvic structural and visceral components; thoracic structural and visceral components; neck visceral component; lumbar structural component. Global biomechanical disorders were diagnosed as dominant SDs in 6 % (all with grade III scoliosis), in the remaining patients, regional biomechanical SDs dominated, of which the most common were biomechanical SDs of the thoracic region structural component (37 %). Conclusion. From 1 to 3 biomechanical somatic dysfunction of the axial regions were revealed in all the examined, but only in the III degree of scoliosis there were the signs of a global biomechanical disorder.

Introduction . Low back pain (LBP) is one of the main causes of disability worldwide. The presence of postoperative scars on the anterior abdominal wall contributes to chronic nonspecific LBP and significantly affects the condition of the entire muscular-fascial system. As a result, the axial structures of the body also suffer. In this situation, standard diagnostic approaches are not informative, and pain treatment doesn′t bring desired results. The aim of the study : In this article, we substantiate the use of osteopathic correction in the complex rehabilitation of chronic nonspecific LBP in patients with postoperative scars on the anterior abdominal wall. Materials and methods . The prospective randomized controlled trial was conducted from February 2024 to October 2025 at the Medical Rehabilitation Department of the «RZhD-Medicine» Clinical Hospital (Bataysk Stat.). The participants were 80 women with scars on the anterior abdominal wall after a cesarean section: the study group consisted of 40 women, whose individual medical rehabilitation plan (IMRP) included two osteopathic corrections with an interval of 12–14 days; the control group consisted of 40 women, who received medical rehabilitation without osteopathic treatment. Research methods included osteopathic examination of patients according to clinical guidelines, measuring the distance from the tip of the third finger to the floor with forward and lateral bends, and visual analogue pain scale (VAS). Results . During the osteopathic examination of patients with chronic nonspecific LBP and postoperative scars on the anterior abdominal wall, regional somatic dysfunctions (SD) were detected in all patients; however, SD of the lumbar and pelvic regions dominated. The results of rehabilitation with osteopathic correction demonstrated, among other things, a statistically significant decrease in SD of the structural components in the neck region (p&lt;0,001) and the thoracic region (p=0,03). Likewise, in the study group, there was a statistically significant decrease in the severity of SD in the lumbar region visceral component (p=0,013), the lumbar region structural component (p=0,036), and the pelvic region visceral component (p=0,002). In the control group, only the severity of SD of the lumbar region visceral component decreased (p=0,049). Prior to the treatment, both groups had the same level of severity of pain and active mobility in the lumbar region (p&gt;0,05). In the study group, the severity of pain significantly decreased from the range of 1–7 points (Me=4) to 0–4 points (Me=2), p&lt;0,001, and in the control group, an insignificant decrease in pain was noted (p&lt;0,05). The mobility indicators in the lumbar region improved in patients of the study group: forward bend Me decreased from 12 to 10 cm (p&lt;0,001), whereas lateral bend Me decreased from 47 to 45 cm on the right (p&lt;0,001) and from 47 to 46 cm on the left (p&lt;0,001). In the control group, however, the forward bend test indicator increased from 12 to 13,5 cm, which shows a decrease in mobility (p=0,034). Conclusion. This study demonstrated the effectiveness of including osteopathic correction in the complex of rehabilitation measures for patients with chronic nonspecific low back pain and postoperative scars on the anterior abdominal wall, which is manifested in a decrease in the intensity of pain, improved mobility of the lumbar spine, and a decrease in the severity or complete recovery from regional somatic dysfunctions.

This study evaluated the effectiveness of osteopathic therapy for hyperkinetic biliary dyskinesia against the background of psychoemotional stress in women of reproductive age. A prospective comparative analysis was conducted involving 30 patients randomized to the main group receiving complex treatment with the inclusion of osteopathic methods, and the control group treated with conventional pharmacotherapy and diet therapy. The therapeutic effect was assessed using functional ultrasound examination of gallbladder motility, analysis of vegetative status according to the Kerdo index and psychoemotional state according to the WAM scale. The findings demonstrate that osteopathic treatment improves the gallbladder contractile function and promotes the normalization of vegetative balance. The osteopathy action mechanisms involve the correction of somatic dysfunctions of the internal organs, craniosacral system and spine, which contributes to the restoration of neurovegetative regulation and a decrease in the impact of stress factors on biliary motility. The absence of side effects confirms the safety and good tolerance of this approach. The findings highlight the promise of including osteopathic methods in the complex treatment of biliary dyskinesia, especially in patients with a pronounced psychoemotional component. Further multicenter studies with an enlarged sample size and long follow-up period, as well as the development of standardized osteopathic therapy protocols, are needed to confirm and expand the findings. The integration of multidisciplinary approaches combining osteopathic treatment, diet therapy and psychotherapeutic techniques appears to be a promising strategy for improving outcomes in functional biliary disorders.

No study has systematically measured somatic dysfunction (SD) in patients with acute cerebral ischemia or tested the reliability of a new osteopathic diagnostic construct, called the Functional Pathology of the Musculoskeletal System (FPMSS) model. The methodology assesses the musculoskeletal system (MSS) as an integrated organ system, shifting emphasis of examination away from structural/postural malalignment to whole systemic motion and allows quantification, prioritization, and profiling of disproportionate motion imbalances as compared to traditional diagnostic criteria. This study aims to assess the reliability of a novel, systematic musculoskeletal examination model to identify SD after stroke or transient ischemic attack (TIA) and in healthy participants. Asymptomatic participants and patients admitted with acute brain ischemia were recruited from an academic tertiary referral center to undergo standardized examinations. Participants were anticipated to undergo paired, blinded ratings by two independent raters on the same day. Paired ratings were performed twice in healthy participants (2 weeks apart), once in those with transient cerebral ischemia, and up to three paired instances, 48-72 hours apart, for patients admitted with acute stroke. Each musculoskeletal assessment consisted of 80 unique physical examination tests performed on each participant focusing on specified body regions: innominate, leg, cephalic extremities, spine, hip, and ankles/feet. Diagnostic assessments were performed by passive, specified linkage testing for available motion, and all examiners were required to participate in standardized consensus training of the FPMSS model. The methodology provides a quantifiable scale to measure grades of restricted motion. Inter-rater reliability was estimated by intraclass correlation coefficient (ICC) analysis. A total of 120 participants were enrolled (20 healthy controls, 20 with TIA [disease controls], and 80 with ischemic stroke). A total of 246 examinations were performed by seven examiners with 80 unique paired assessments across the three participant groups. Nearly two-thirds of stroke participants had hemiparesis with, on average, moderate degrees of neurologic disability. By the end of the study, acceptable inter-rater reliability was attained with: moderate agreement testing the innominate and leg; good agreement of the cephalic extremities, spine, and hip; as well as excellent agreement among raters with examination of the ankles/feet. Examiners achieved acceptable levels of inter-rater reliability applying the FPMSS diagnostic construct in asymptomatic participants and in those with acute cerebral ischemia following standardized consensus training.

Abstract Introduction: Autonomic rehabilitation aims to rewire chronic disease states, like chronic pain sensitization, through passively stimulating parasympathetic tone. Informed treatment decisions that include the use of osteopathic manipulative treatment (OMT) may provide a noninvasive and nonpharmacologic modality to temporarily reset the autonomic nervous system (ANS). Heart Rate Variability (HRV) could provide quantifiable evidence for the impact of OMT on autonomic rehabilitation. Reduced HRV is associated with stress, pain, and chronic conditions, making it an important indicator of autonomic function. Objectives: Analyze the impact of post-isometric muscle energy technique (MET) to the upper cervical spine on parasympathetic tone measured through HRV. Design: Within-subject design with 5-minute HRV measurement pre- and post-OMT treatment. Setting: Clinical examination suites. Participants: Thirty-three healthy osteopathic medical school students, faculty, and staff. Interventions: MET treating somatic dysfunction by osteopathic physicians board-certified in neuromusculoskeletal medicine and osteopathic manipulative medicine. Main Outcome Measures: HRV variables related to parasympathetic activity including root mean square of successive differences (RMSSD), percentage of successive normal sinus RR intervals more than 50ms (pNN50), and high frequency (HF). Repeated measures t-test analyzed the difference in mean HRV values after OMT. Results: There were statistically significant increases in most of the HRV measures after OMT. Participants’ mean (95% confidence interval) RMSSD increased from 56.2ms (44.2, 68.2) at baseline to 60.14 (47.8, 72.5, p=0.001) post-OMT. pNN50 increased from 28.8% (21.5, 36.0) to 31.9% (24.5, 39.2, p=0.003) at post-OMT. HF increased from 1237.6ms 2 (756.1, 1719.1, n=32) at baseline to 1456.8ms 2 (875.6, 2037.9) but was not statistically significant (p=0.107) post-OMT. All somatic dysfunctions at spine levels OA, AA, and C2 were either resolved or improved after OMT. Conclusions: MET may provide clinical benefit through increased parasympathetic tone, leading to reestablished autonomic balance, which can supplement rehabilitation practices for those with dysautonomia stemming from persistent sympathetic activation.

This study examines migration’s return and reintegration phases, focusing on stress, mental health, and gender dynamics. A sample of 646 adult Spaniards included returnees (N = 358) and a control group of non-migrants (N = 288). The questionnaire covered socio-demographic and migration variables, using the PSS-14 (stress) and GHQ-28 (mental health) scales. Returnees showed more somatic, depressive, anxious, and social dysfunction symptoms, supporting the acculturation stress hypothesis. Returnee women experience higher levels of stress and more symptoms than returnee men. Migration experiences, objectives, and expectations predicted stress, with added effects of low host-society identification in women. Structural models revealed direct and indirect stress effects.