Use Of Osteopathic Correction Research Articles

Osteopathic correction in complex rehabilitation of children who have undergone cochlear implantation

Introduction. Currently, the only way to rehabilitate patients with deafness is cochlear implantation (CI). CI includes not only surgery, but also rehabilitation carried out by a whole group of specialists. This is a multi- stage, labor-intensive, complex, long-term process of developing and maintaining speech function, so there is a constant search for new approaches and methods that could increase the effectiveness of ongoing rehabilitation measures. Previous studies have demonstrated that osteopathic correction in preschool children reduces the severity of speech disorders, contributes to the regression of speech therapy disorders, and helps in the correction of certain forms of dysarthria. Of particular interest is the work in which the authors demonstrated the existence of relationships between certain somatic disfunctions and the presence of disturbances in peripheral sound conduction and/or central sound conduction in children with sensorineural hearing loss. The question of the possibility of using osteopathic correction in the rehabilitation of children with pathologies of hearing and speech function (since, in addition to the consequences of highly invasive surgical intervention, children who have undergone CI, as a rule, have delayed speech development), seems promising for study.The aim was to study the results of the use of osteopathic correction in the rehabilitation of children who have undergone CI.Materials and methods. A randomized controlled prospective study was conducted from March 2022 to December 2022 on the basis of the Federal State Budgetary Institution RNTSCAiS FMBA of Russia, FSBI NMCIO FMBA of Russia. 36 children aged from 17 to 37 months were under observation. Depending on the treatment used, all observed patients were divided into 2 groups using a simple randomization method: main (20 people) and control (16 people). Patients in both the main and control groups received standard rehabilitation treatment. Each patient of the main group additionally underwent a single session of osteopathic correction lasting from 45 to 60 minutes. All patients were assessed for osteopathic status, time of connection and adjustment of the cochlear implant, and quality of life.Results. In children after CI, global neurodynamic disorders and regional biomechanical disorders in the regions of the head, neck, and dura mater were most often detected. After treatment, only patients in the main group showed a statistically significant (p<0,05) decrease in the frequency of detection of both global neurodynamic and the above-mentioned regional biomechanical disorders. A single session of osteopathic correction contributes to a significant reduction in the time of connection and adjustment of the cochlear implant, which can be considered as a favorable factor for subsequent rehabilitation measures. Against the background of the ongoing rehabilitation, a statistically significant increase in the level of quality of life was obtained in both groups, however, in the main group this indicator was statistically significantly higher.Conclusion. For children who underwent CI, the most characteristic was the presence of a global neurodynamic disorder, as well as regional biomechanical disorders at the level of the head, neck and dura mater. A single session of osteopathic correction can significantly reduce the time of initial connection and adjustment of a cochlear implant, as well as improve the quality of life of this category of patients. This allows us to recommend the inclusion of osteopathic correction in comprehensive rehabilitation programs for children who have undergone cochlear implantation.

The use of osteopathic correction in the treatment of patients with sciatic neuropathy

Introduction. In recent years, the interest of the medical community in peripheral neuropathies has significantly increased and great progress has been achieved in studying certain issues of etiopathogenesis and treatment of these conditions. The basis of therapy for piriformis syndrome (PS), as a particular form of sciatic neuropathy, is still drug therapy, but its use does not always lead to the desired results. This dictates the need to search for new, primarily non-drug, therapies as a part of the cumulative treatment of this disease. Previous work has demonstrated the possibilities of using reflexology, physiotherapy in the treatment of PS. Manual therapy has also been successfully used for a long time in the treatment of patients with this nosology, but most often only in the form of local approaches. In the available literature, there were no works evaluating the possibilities of using personalized osteopathic correction in this group of patients, as well as objectification of the complex treatment performed using ultrasound scanning. All of the above has predetermined the purpose of our research. The aim of the study was to study the results of complex therapy of patients with sciatic neuropathy (SP) with the inclusion of osteopathic correction. Materials and methods. A controlled randomized trial was conducted in the period from November 2020 to January 2022 on the basis of the profile medical clinic of LLC «Mokhov Institute of Osteopathy». We observed 22 patients aged 18 to 44 years with a diagnosis of sciatic neuropathy. Depending on the treatment used, all the observed patients were divided into the main (11 people) and control (11 people) groups using the simple randomization method. Patients of both groups received pharmacotherapy, and patients of the main group additionally underwent osteopathic correction (3 sessions with an interval of 8–10 days). All patients were assessed for osteopathic status, severity of pain syndrome and ultrasound diagnostics with assessment of the condition of the involved sciatic nerve. Evaluation and measurements were carried out before the start of treatment and 30 days after its start. Results. In patients with sciatic neuropathy, regional biomechanical disorders of the regions were most often detected: pelvis, structural and visceral components (45,5 % and 68,2 % respectively), dura mater (59,1 %), lumbar, visceral component (45,5 %). Among the local somatic dysfunctions (DM), the dysfunction of individual vertebral-motor segments was most often determined at the level of the cervical (18,2 %), thoracic (18,2 %) and lumbar (22,7 %) spine, individual joints of the lower extremities (22,7 %), individual skull sutures (27,3 %). After treatment, only in patients of the main group, a statistically significant (p<0,05) decrease in the frequency of detection of regional biomechanical disorders of the pelvic region (structural and visceral component), TMO was obtained. For the rest of the SD, the differences were not significant. The examined patients were characterized by moderate pain syndrome. The therapy, both with and without osteopathic correction, has shown good results. In patients of both groups, there was a significant (p < 0,05) decrease in the intensity of pain syndrome, but in the main group these changes were significantly more pronounced. Patients with sciatic neuropathy were characterized by an increased thickness of the nerve and a decrease in its echogenicity according to the results of ultrasound diagnostics. Against the background of therapy, patients of both groups have a decrease in nerve thickness, but in the main group these changes were statistically significant (p < 0,05) more pronounced. But normalization of nerve echogenicity was observed only in patients of the main group who received osteopathic correction (significant changes, p < 0,05). Conclusion. The use of osteopathic correction in the framework of complex therapy of patients with sciatic neuropathy allows to achieve a statistically more significant reduction in the intensity of pain syndrome and normalization of nerve structure (according to ultrasound data) compared with the isolated use of drug therapy. It is advisable to continue the study on a larger sample of patients.

Substantiation of the application of osteopathic correction in the complex rehabilitation of patients after anterior cruciate ligament reconstruction surgery

Introduction. For a qualitative restoration of the knee joint function after arthroscopic reconstruction of the anterior cruciate ligament, the process of engraftment, restoration of the strength and viability of the graft (new anterior cruciate ligament) is important. The weakening of the inflammatory process after surgery and the return of strength and tone to the muscles that ensure the proper functioning of the injured knee joint are equally important. Restoring the properties of the damaged fascia, providing proprioceptive control of the periarticular muscles for the stability of the knee joint are the priorities of the rehabilitation process. Somatic dysfunctions that have been previously presented, as well as have appeared at the time of injury or during surgery, slow down recovery. Therefore, the inclusion of osteopathic treatment in the rehabilitation process seems to be a logical step. However, the problem of the osteopathic correction role in the rehabilitation process in case of the anterior cruciate ligament damage has been covered very little in the specialized literature.The aim of the study is to substantiate the use of osteopathic correction in the complex rehabilitation of patients after anterior cruciate ligament reconstruction surgery.Materials and methods. The study involved 47 patients who underwent arthroscopic knee surgery for reconstruction of the anterior cruciate ligament. 23 patients who underwent the recommended rehabilitation course were included in the control group, 24 patients who additionally received a course of osteopathic correction were included in the main group. Before and after the treatment, there were assessed osteopathic status of patients, the range of movements in the operated knee joint, the dynamics of the inflammatory process (according to such indicators as changes in the local temperature of the knee joint and the thermal symmetry, as well as the circumference of the knee joint), and the pain intensity.Results. At the beginning of the study, regional somatic dysfunctions of the lower limb region were most often detected in main and control groups (100 and 65,2 %, respectively) and the pelvic region (91,7 and 87 %, respectively). After the treatment, statistically significant (p<0,05) positive dynamics was observed in the main group in terms of such indicators as the detection frequency of regional dysfunctions of the lower extremities, pelvis, neck and thoracic region. There was no significant dynamics in the control group. In both groups, there was a significant (p<0,05) positive dynamics in such indicators as the range of movements in the joint, local temperature and thermal symmetry, joint circumference, pain intensity. A statistically significantly (p<0,05) more pronounced result was observed in the main group than in the control group for all the listed indicators.Conclusion. The study confirms the positive contribution of osteopathic correction to expanding the possibilities of complex rehabilitation of patients after arthroscopic anterior cruciate ligament plasty. However, it is recommended to continue research in this direction on a larger sample size.

Pathogenetic prerequisites for the use of osteopathic correction in chronic tonsillitis

Chronic tonsillitis is a very common disease in which conventional methods of treatment could be not effective enough. The review describes in detail the etiology and pathogenesis of chronic tonsillitis, as well as anatomical features of the neck region. Based on the knowledge about the mechanisms of the therapeutic effect of osteopathic correction (OC), there are indicated the elements of pathogenesis that can potentially be affect by OC in this disease.

Substantiation of the effectiveness of osteopathic correction in the treatment of patients suffering from post-puncture syndrome

Introduction. Post-puncture syndrome (PPS) is a complex of symptoms that occurs 1–2 days after spinal anesthesia or lumbar puncture, and the headache is a leading symptom. Currently, there is no effective method of non-invasive treatment of PPS. Based on the possible role of dura mater damage in the PPS pathogenesis, it is reasonable to assume that the identification and osteopathic correction of somatic dysfunctions in the respective regions may be effective in the treatment of patients suffering from PPS.The aim of the study is to substantiate the possibility of using osteopathic correction in the treatment of patients suffering from post-puncture syndrome.Materials and methods. The study involved 40 patients with PPS syndrome aged 20 to 50 years who were hospitalized after surgery with spinal anesthesia using. Patients were randomized into two groups — control (20 patients) and main (20 patients). All study participants were prescribed bed and medium drinking (25–30 ml/kg body weight) regimen. Participants of the main group additionally received a single hour session of osteopathic correction on the first day after the operation. All patients were examined at the start of treatment and on the third day after the start of a treatment. The severity of pain was assessed using a visual analogue scale (VAS, from 0 to 10 points), the severity of PPS and the osteopathic status.Results. Patients suffering from PPS are characterized by the presence of intense pain syndrome (5–6 points according to VAS); they are characterized by a headache that worsens during taking a vertical position and is accompanied by dizziness and nausea. These patients are characterized by the presence of biomechanical disorders in the regions of the head, dura mater, lower extremities and neck (structural component). The use of osteopathic correction is accompanied by a statistically significant (p<0,05) decrease in the pain syndrome intensity, relief of PPS symptoms, and a decrease in the detection frequency of the most regional somatic dysfunctions.Conclusion. Based on the results obtained, it seems possible to recommend the inclusion of osteopathic correction in the complex of therapeutic measures for patients suffering from PPS.

The possibilities of osteopathic correction using in adolescents with varicocele: a pilot study

Introduction. Currently, varicocele remains a largely unresolved problem in urology, and this makes it necessary to search for additional, including non-pharmacological, methods of treatment. In recent years, the effectiveness of osteopathic correction of patients with chronic venous insufficiency has been shown. However, at this moment, the use of osteopathic methods in the treatment of varicocele is not widely used, which makes it relevant to conduct research on this topic.The aim is to explore the possibility to use the osteopathic correction in adolescents with varicocele.Materials and methods. The study involved 40 participants aged 13–17 years. Two groups were formed: the main group (20 patients), whose participants received drug treatment and a course of osteopathic correction, and the control group (20 patients, data were collected retrospectively), whose participants received only drug therapy. For both groups, there were collected the parameters (before and after treatment) that characterize the state of the venous network of the spermatic cord (presence/absence of testicular hypotrophy, of cremaster reflex and of a positive Valsalva test; as well as the diameter of the cremaster veins and the value of the resistance index), and information on the presence/absence of pain syndrome.Results. In the control group, whose participants received only drug therapy, there was a significant (p<0,05) increase in the number of detected cases of pain syndrome and a positive Valsalva test, as well as a significant (p<0,05) increase in cremaster vein diameter at the end of treatment. Participants of the main group, who received osteopathic correction in addition to conservative therapy, were characterized by a significant (p<0,05) decrease in the diameter of the cremaster veins and an increase in the resistance index, the results differed significantly (p<0,05) from the corresponding values in the control group. Also, in the main group at the time of completion of treatment, there were recorded a statistically significantly (p<0,05) lower number of cases of pain syndrome, a positive Valsalva test, and the absence of a cremaster reflex in comparison with the control group.Conclusion. The results obtained in the framework of this pilot study allow us to positively assess the prospects for the use of osteopathic correction in the treatment of varicocele in adolescents. It is recommended to continue research in this direction over a longer period of time and on a larger sample size, with the obligatory formation of a parallel control.

Osteopathic treatment of cervicalgia in dentists experiencing prolonged professional overloads

Introduction. Among dentists, the prevalence of major occupational diseases is higher than among medical professionals in general. Thus, under the influence of professional physical exertion, functional and structural changes occur in the joints, changing their mobility. More than 50 % of dentists have various types of musculoskeletal pathology, and at least half of them are disorders in the cervical spine. A number of studies have demonstrated the effectiveness of the osteopathic correction in the treatment of cervical pain syndromes. However, the possibility of osteopathic correction in the treatment of occupational diseases among medical workers has not been specifically considered.The aim of the study is to evaluate the effectiveness of osteopathic treatment of cervicalgia in dentists experiencing prolonged professional overload.Materials and methods. Under observation there were 30 patients — dentists (13 men and 17 women, age 35–55 years) with a previously established diagnosis of Cervicalgia (duration of the disease 1–5 years). The patients were divided into the main (15 people) and control (15 people) groups. The control group of patients received a set of physical therapy exercises. The main group of patients additionally received three sessions (1 every 10 days, duration 45 min) of osteopathic correction. Before and after the course of treatment, the detection frequency of somatic dysfunctions, life quality (a short version of the World Health Organization questionnaire WHOQOL-BREF was used), pain syndrome severity (by a 100-point visual analog scale), and active movements volume in the cervical spine (by a medical goniometer) were evaluated.Results. At the study beginning in the both groups there were most often detected somatic dysfunctions in the following regions: cranio-cervical region (sphenobasillary synchondrosis (SBS), С0–I, СII–III and СVI–VII vertebralmotor segments (VMS) of the cervical spine), pelvic region (sacrum, pubic joint), thoracic region (diaphragm, sternoclavicular joint, ThVI–VII and ThII–III VMS of the thoracic spine). After the treatment, positive statistically significant (p<0,05) dynamics was observed in the main group for all of the above dysfunctions, and in the control group only for disorders of SBS, VMS С0–I, sacrum, VMS ThVI–VII. There were significant (p<0,05) difference between groups by the detection frequency of SBS, pubic articulation and diaphragm dysfunctions. After the treatment, patients in both groups had a statistically significant (p<0,05) improvement in the life quality by the «physical and mental well-being» domain, and in the main group these changes were statistically significantly (p<0,05) more pronounced. After the therapy course completion, the pain intensity in patients of the main group decreased to an average of 6 points, in 13 patients the pain symptom was completely eliminated. In the control group, the pain syndrome intensity decreased to an average of 35 points, none of the patients had a complete pain absence. The differences between the groups were statistically significant (p<0,05). After the therapy course, a statistically significant (p<0,05) increase in flexion, extension, lateroflexion to the right and left, rotation to the left was noted in the main group; and in the control group the significant positive dynamics was noted with respect to flexion and lateroflexion in both directions, rotation to the left. The groups began to differ significantly (p<0,05) by the volume of lateroflexion to the left and inflection in the cervical spine.Conclusion. The obtained data allow us to recommend the use of osteopathic correction in the treatment of occupational diseases of the cervical spine in dentists.

Justifi cation of the use of osteopathic correction in the planned preparation of patients for general anesthesia with tracheal intubation

Introduction. The risk of unsuccessful intubation is a signifi cant problem during elective surgical operations with general anesthesia and tracheal intubation. Taking in consideration the trend towards the development of short-stay surgical hospitals, and the rather low availability of endoscopy services, the search for alternative methods of preparing patients for successful tracheal intubation is in demand. A normal tone of the muscles involved in the work of the temporomandibular joints as well as the tone of the muscles above the hyoid bone and the muscles below the hyoid bone are necessary for successful intubation of the trachea. Based on modern ideas, it can be assumed that an adequate osteopathic effect on the mentioned anatomical structures can provide a decrease in muscle tone. However, there are no publications in the available literature on osteopathic correction of patients at high risk of intubation in order to reduce the risk degree.The aim of the research is to substantiate the use of osteopathic correction in the planned preparation of patients for general anesthesia with tracheal intubation.Materials and methods. The study involved 30 patients with chronic surgical pathology of internal organs who had to undergo elective surgery. The patients were distributed into the control and main groups (15 participants each) by the method of randomization envelopes. The participants of the control group followed the instructions given by the anesthetist, the participants of the main group received additionally a month before the operation two sessions of osteopathic correction with an interval of 14 days. In both groups, the osteopathic status was assessed before the start of the corresponding treatment. The degree of intubation risk and the incision distance were also assessed. After completion of the corresponding treatment, the osteopathic status was re-evaluated in both groups. In the main group, the risk of intubation and the incision distance were re-evaluated.Results. At the beginning of the study, both groups were characterized by a high detection frequency of the following regional biomechanical disorders: neck, thoracic region and dura mater. At the completion of the study, a statistically signifi cant (p<0,05) decrease in the detection frequency of all these disorders was observed in the main group. There was no signifi cant dynamics in the control group. Also in the main group there was a statistically signifi cant (p<0,05) decrease in the intubation risk and an increase in the incision distance value.Conclusion. The obtained results allow recommending the appointment of an osteopath consultation and osteopathic correction during the planned preparation of patients with a high risk of intubation. At the same time, it is recommended to continue the study on a larger sample.

The impact of osteopathic correction on the life quality of pregnant women

Introduction. The development of pregnancy is accompanied by a number of regular structural and functional changes in a woman′s body, which, in turn, can both reduce the level of life quality and serve as a background or a cause for the formation of somatic dysfunctions, the level of manifestation and severity of which depend on the compensatory capabilities of the female body. Therefore during this period a woman needs to ensure a high level of life quality. At the present stage the pregnancy′s support dictates the need to use an integrated approach to solving the issues of preventing the development of complications during pregnancy, as well as reducing perinatal risks for the mother and fetus. At the same time, issues of the life quality of pregnant women are often not given due attention. This dictates the need to search for methods (primarily non-drug) that contribute to improving the life quality.The aim of the study was to evaluate the impact of osteopathic correction on the life quality of pregnant women.Materials and methods. A prospective controlled randomized study conducted in the period from 03.2018 to 03.2022 on the basis of the Mokhov Institute of Osteopathy LLC Medical Clinic included 90 somatically healthy pregnant women aged 25–45 years, whose gestation period was 13–27 weeks. All pregnant women, depending on the used correction technique, were divided by a randomization envelopes method into three groups: the main (30 people), control (30 people) and comparison group (30 people). The patients of the main group received osteopathic correction (3 procedures with an interval of 10–14 days). The control group patients used physical exercises 2 times a week for 1,5 months as prescribed by a physical therapy doctor. The patients of the third group were dynamically monitored. Before and after the correction an osteopathic examination of all pregnant women was conducted with the formation of an osteopathic conclusion, and also their life quality was assessed according to the criteria of the SF-36 questionnaire.Results. For pregnant women, as the pregnancy period increases, a decrease in both the physical and psychological components of the life quality is characteristic. In the main group, compared with the control group, after osteopathic correction, there was a statistically significant increase in the indicators of the physical and psychological components of the life quality (p=0,0024). The use of physical therapy exercises by healthy pregnant women leads to the fact that quality of life indicators tend to increase as pregnancy progresses.Conclusion. The development of pregnancy is accompanied by a number of regular structural and functional changes in a woman′s body, which in turn can reduce the quality of life. The use of osteopathic correction during pregnancy makes it possible to improve the life quality of pregnant women, and so it can be used to improve medical care for this contingent of the population.

Multidisciplinary approach in the treatment of chronic tension headache on the background of COVID-19

The new coronavirus infection probably affects the pathomorphosis of the disease, aggravating the course of the tension headache that the patient previously had. In the above clinical observation, the high effectiveness of the complex treatment of TH and autonomic dysfunction with central thermoregulation disorder in the framework of postcovid syndrome with the use of osteopathic correction, acupuncture and drug treatment was noted. The effectiveness of osteopathic techniques can be reinterpreted and explained through the identification of the glymphatic system. Further studies are needed to clarify the main mechanisms of action of osteopathy in patients with the consequences of a coronavirus infection.

The possibility of osteopathic correction methods in the treatment of facial pain

The problem of the headaches occurrence is currently relevant among medical specialists of various profi les due to the fact that this symptom does not have a clear etiopathogenetic picture, and when patients come in with such a complaint, it sometimes requires a rather complex differential diagnosis. This is especially true for certain types of headaches (for example, facial pain — prosopalgia), the diagnosis of the causes of which is diffi cult due to the possible involvement of the ENT organs, the organ of vision, the dentoalveolar system and, of course, due to the complex system of innervation. Despite the fact that a lot of attention has been paid to this issue in the literature, there are still many such patients, and in a large number of cases this reduces not only their ability to work and life quality, but also brings signifi cant socio-economic damage to the whole society. The question of competent and effective care for this category of patients remains open, since often complex drug treatment does not bring the desired result, or it brings a temporary positive effect, and all these open up opportunities for the introduction of non-drug approaches, both in the form of monotherapy and in the form of combined treatment, taking into account features of the pain syndrome course and its occurrence causes in each patient individually. The article describes a clinical case from practice devoted to the isolated use of osteopathic correction in a patient with symptoms of prosopalgia.

The use of osteopathic correction in the complex rehabilitation of patients with acute cerebrovascular accident

Introduction. Acute disorders of cerebral circulation - strokes - are the most important medical and social problem, due to their high proportion in the structure of morbidity and mortality of the population, signifi cant indicators of temporary labor losses and primary disability. In this regard, one of the main tasks of Russian healthcare is to slow down the increase in the disability of the population, which is carried out through the active development of the rehabilitation system in our country, including neurorehabilitation. Osteopathic correction can become one of the new areas of rehabilitation for this group of patients. There have already been made previous attempts to study the osteopathic status in patients with acute cerebrovascular accident and to assess the possible contribution of somatic dysfunctions to the pathogenesis of this disease. At the same time, there are no publications in the available scientifi c literature about the possibility of osteopathic correction using in the rehabilitation of patients with acute cerebrovascular accident in the early recovery period. All of the above predetermined the purpose of the study.The aim of the study is to substantiate the possibility of osteopathic correction methods using in the complex rehabilitation of patients with acute cerebrovascular accident in the early recovery period.Materials and methods. A prospective randomized controlled study was conducted from February 2019 to March 2020 on the basis of the neurorehabilitation department of the State Clinical Hospital № 11 (Omsk). 40 patients with a diagnosis of acute cerebrovascular accident, early recovery period were under observation. The sample was entire. Patients, depending on the method of used treatment, were divided with using the method of simple randomization into two comparable groups of 20 people: main and control. All patients received complex rehabilitation treatment, which included drug therapy, physiotherapy, kinesiotherapy, massage, and acupuncture. Additionally, patients of the main group received osteopathic correction (3 sessions). All patients, regardless of the group, before the start, as well as after the completion of the rehabilitation course, were assessed for osteopathic status, the level of self-care, daily activity and mobility of patients was determined using functional scales, and muscle strength of the hands was studied using dynamometry.Results. Patients with ischemic stroke in the early recovery period are characterized by the presence of somatic dysfunctions, mainly at the global and regional levels. 100 % of the examined participants had a global rhythmogenic cranial disorder. The most characteristic regional somatic dysfunctions were of the neck region, the structural component (29 %), and of the dura mater region (24 %). After completion of rehabilitation, global rhythmogenic cranial somatic dysfunction remained in all patients (100 %), however, in the group that received osteopathic correction, its severity was statistically signifi cantly reduced (p<0,05). Also, in the main group, the average number of regional somatic dysfunctions and their severity changed statistically more signifi cantly (p<0,05). At the background of complex rehabilitation treatment, all patients had an increase in the level of self-care, daily and physical activity according to neurorehabilitation scales, and also increased arm muscle strength according to dynamometry. However, in the group receiving additional osteopathic correction, these indicators were statistically signifi cantly higher (p<0,05).Conclusion. Rehabilitation of patients with vascular pathology, including those with ischemic stroke, is one of the most important directions in the development of the modern healthcare system. This dictates the need to search and study new methods and means of rehabilitation, one of which could be osteopathy. This study showed that the inclusion of osteopathic correction in the program of complex rehabilitation of patients with ischemic stroke in the early recovery period will achieve better results in terms of restoring lost functions and improving self-care skills. In order to introduce the new method more widely, it is advisable to continue the study on an even larger sample.

Long-term results of combined use of speech therapy and osteopathic correction in 5–6 year old children with dysarthria

Introduction. Dysarthria is a disorder of motor dynamics, which manifests itself in oral speech in the form of illegibility and indistinctness. Also motor realization is impaired, the mobility of the organs of speech (soft palate, tongue, lips) is limited, and so articulation is difficult. Correction of dysarthria only with the help of exercises with a speech therapist is not always effective enough; therefore, there is a constant search for methods that would make it possible to solve speech therapy problems more efficiently and in a shorter time. In this regard, there is great interest in osteopathic correction. The somatic dysfunctions and the results of osteopathic correction of children with dysarthria are described in sufficient detail in the available literary, but only for the end of treatment. The question of preservation of the achieved osteopathic correction results is practically not covered.Aim is to study the long-term results of osteopathic correction of somatic dysfunctions in children aged 5–6 years with dysarthria.Materials and methods. The study involved children with an established diagnosis of dysarthria at the age of 5–6 years. The study participants were divided into the control (15 people) and the main (26 people) groups. The participants in the control group received speech therapy, the participants in the main group received speech therapy and osteopathic correction. The logopaedic, osteopathic and neurological examinations were performed at the start of the study. The logopaedic examination was repeated 12 months after the completion of the correction. The osteopathic examination was repeated immediately after the completion of the correction, after 6 and 12 months. The neurological examination was repeated 6 and 12 months after the completion of the correction.Results. During the study of the long-term results of the correction performed in the both groups, there was a positive trend in several indicators characterizing the severity of speech impairment, including impaired speech pronunciation and dysarthria. In the main group, the dynamics was statistically significantly (p<0,05) more pronounced than in the control group. In the main group, there was a statistically significant (p<0,05) decrease in the severity of global and regional somatic dysfunctions, as well as a decrease in the detection frequency of local disorders of the craniosacral system and local visceral dysfunctions. Also in the main group there was a significant (p<0,05) decrease in the detection frequency of disorders of several indicators characterizing neurological status, including such indicators as convergence, facial symmetry, pharyngeal reflex, neck muscle tension, Romberg posture, local soreness, maskiness, the location of the tongue in the center, the condition of the muscles of the floor of the mouth, the tension of the muscles of the neck, fi nger-nose test.Conclusion. The study demonstrated not only the clinical efficacy of the combined use of osteopathic correction and speech therapy, but also the preservation of the achieved results according to the follow-up evaluation data. The obtained results make it possible to recommend the inclusion of osteopathic correction in the complex correction of dysarthria in preschool children.

Study of the combined use of osteopathic correction and EEG-biofeedback training in children with attention deficit hyperactivity disorder

Introduction. Attention deficit hyperactivity disorder (ADHD) is becoming more common in modern society being the most common behavioral disorder in childhood and adolescence. Drug treatment for ADHD is often associated with a number of potential adverse events. Recently, the method of ADHD correction under the control of electroencephalogram-dependent biofeedback (EEG-BFB trainings) has become very popular. Based on the complex nature of ADHD and based on the osteopathic concept of cranial bone mobility, it can be assumed that the combination of EEG-biofeedback training and osteopathic correction can achieve a greater effect in a shorter period of time than using only EEG-biofeedback trainings.The aim is to research the effectiveness of the combined use of osteopathic correction and EEG-BFB correction of children with attention deficit hyperactivity disorder.Materials and methods. The study involved 70 children aged 6–9 years, suffering from attention deficit hyperactivity disorder. Two groups were formed by the method of simple randomization: control and main. Participants in both groups received EEG-biofeedback trainings. The participants of the main group additionally received a course of osteopathic correction. Before and after the completion of the course of treatment, the osteopathic status of the participants, the number of behavioral disorders, indicators of the level of attention and concentration were assessed. The obtained results were analyzed by methods of nonparametric statistics.Results. The use of osteopathic correction in addition to EEG-biofeedback training in children with ADHD is accompanied by a statistically significant (p<0,05) decrease in the behavioral deviations amount, an increase of the attention span duration, a decrease of the detection frequency of regional disorders of the dura mater and local disorders of the spinal motion segment C0-I.Conclusion. The obtained results make it possible to recommend the inclusion of osteopathic correction in the complex therapy of primary school children suffering from ADHD.

Combined use of osteopathic correction and transcranial micropolarization of the brain in the treatment of children with attention deficit hyperactivity disorder

Introduction. Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder that occurs in 5-8 % of school-age children and persists into adulthood in 60 % of cases. At the present stage of neurology development, a number of significant drawbacks have been noted in the pharmacological correction of ADHD: the need for a long course of medication, the problem of polypragmasia, side effects and allergic reactions. Thus, there is a real need to develop non-drug ways to correct ADHD. Previous studies have demonstrated a sufficiently high clinical efficacy of transcranial micropolarization of the brain in the treatment of this patients group. Some studies have shown the effectiveness of the osteopathic correction use, which can increase the effectiveness of selective and sustained attention in children with ADHD. At the same time, the question of the possibility of combining various non-drug methods of treatment is quite acute.The aim of the study is to research the feasibility of osteopathic correction using in combination with transcranial micropolarization of the brain in the complex treatment of children with ADHD.Materials and methods. A controlled randomized trial was conducted in the period from January 2018 to February 2020 in Ekaterinburg and St. Petersburg. 68 patients with the established diagnosis attention deficit hyperactivity disorder aged 6 to 10 years, including 42 boys and 26 girls, were under observation. All patients, depending on the used treatment method, were divided by simple randomization into two comparable groups: the main group — 34 people, 22 boys and 12 girls, average age 7,4±1,2 years; the control group consisted of 34 people, 20 boys and 14 girls, with an average age 7,8±1,1 years. Patients received drug therapy with hopanthenic acid in age-related dosages (30 mg/kg body weight), course duration of 2 months, and transcerebral micropolarization of the brain. Each patient received one course of micropolarization, consisting of 15 sessions, the duration of each session was 30 minutes. Patients of the main group received osteopathic correction in addition to the therapy described above. In total, 4 sessions of 60 minutes each were held. The interval between the first sessions was 10 days, between subsequent sessions — from 10 to 14 days. There were evaluated the osteopathic status, the severity of ADHD manifestations and the short-term memory indicators, and the type and properties of the nervous system were determined for all patients, regardless of the group, before the start of treatment, as well as after the completion of the course of complex therapy.Results. After the therapy, there was a statistically significant decrease (p<0,05) in scores quantity on the ADHD assessment scale (ICD-10 criteria) both in the main and in the control groups, which reflects a decrease in the severity of clinical manifestations of this syndrome and demonstrates the effectiveness of the used therapy methods. In patients of the main group who received osteopathic correction, compared with the control group, there was also a significant (p<0,05) decrease in the number of regional dominant somatic dysfunctions, an increase in short-term memory indicators and a change in the type and properties of the nervous system (from weak to stable).Conclusion. The therapy carried out both with the use of osteopathic correction and without it, equally leads to a decrease in the degree of manifestations of ADHD. This indicates the clinical effectiveness of both studied integrated approaches to the treatment of children with ADHD. At the same time, osteopathic correction in the treatment of patients with ADHD significantly increases the indicators characterizing short-term memory and changes the type of response of the nervous system. These changes can be regarded as a potential opportunity to increase the learning ability of children and improve their socialization.

Osteopathy as a method of correction and prevention of the formation of somatic dysfunctions of the musculoskeletal system in office workers

Introduction. According to Russian and foreign studies, the frequency of musculoskeletal system pathology continues to grow. To improve the life quality and reduce the level of the musculoskeletal system diseases, an urgent task is to increase the volume of available non-drug methods of prophylaxis.The aim of the research was to develop measures to prevent the formation of somatic dysfunctions of the musculoskeletal system and their relapses in office workers using osteopathic correction.Materials and methods. In the period from 2016 to 2020, a prospective controlled randomized study was carried out on the basis of the ANO TIMM. The work is based on the results of osteopathic care in combination with a controlled change in the ergonomics of the workplace after the correction of somatic dysfunctions of the musculoskeletal system in office workers. The study involved 426 people who were divided into two comparable groups: the main and control groups of 212 and 214 people, respectively. All patients underwent osteopathic diagnostics before the start of the treatment, during therapy, and at its completion in accordance with the approved clinical guidelines. Patients of both groups received osteopathic care provided in accordance with the developed algorithm. The patients of the main group underwent correction of their workplaces ergonomics.Results. The study showed that office workers are characterized by the presence of somatic dysfunctions at the regional and local levels. Somatic dysfunctions of the spine, pelvis, abdominal and pelvic diaphragms were most often observed. As a result of osteopathic correction in combination with a change in the ergonomics of the workplace in patients of the main group, the frequency of recurrences of the somatic dysfunctions formation decreased significantly (p<0,05) compared with patients in the control group. It also was accompanied by a significant decrease in the pain syndromes recurrence.Conclusion. The use of osteopathic correction in combination with the workplace ergonomics change effectively contributes to the prevention of the formation of the musculoskeletal system somatic dysfunctions and their recurrence in office workers.

Application of computer stabilometric technologies with biofeedback in patients with lumbosacral pain

Introduction. Low back pain is one of the most common sufferings of modern humans. In developed countries, such manifestations are a serious medical and economic problem. Lumbosacral pain in many cases is caused by the occurrence of somatic dysfunction of the bones of the pelvis and sacrum. The main methods of treatment are prescribing drug therapy and non-drug treatment. Today, osteopathic techniques are highly effective for the diagnosis and correction of somatic dysfunctions of the pelvic region. Such treatment in patients with pain in the lower back helps to reduce pain and restore the functional state of patients. Equally important are computer technologies with biofeedback (BFB) with the possibility of effective correction of proprioceptive innervation and muscle-tonic syndromes. The stabilometric platform allows you to register the parameters of the static-dynamic function of support and balance maintenance. The resulting changes in the position of the sacrum and pelvic bones create a distortion of proprioceptive somatosensory afferentation, postural tonic reflexes of the axial skeleton and limbs are blocked, the sequence of activation of the motor units of the locomotor apparatus is disrupted, the mechanisms for maintaining support and walking change. The aim — to study the effectiveness of using a stabiloplatform with biofeedback in the diagnostic mode of coordinating and static-dynamic disorders in patients with somatic dysfunctions of the pelvic and sacral bones in a training mode in combination with osteopathic correction for pain in the lumbosacral region. Materials and methods. In a prospective controlled study in patients with lumbosacral pain with somatic dysfunctions of the pelvic bones, the results of treatment were analyzed in 66 patients aged 23–56 years. Diagnosis of dysfunctions of the iliac bones was carried out according to the generally accepted rules of osteopathic examination — osteopathic examination and determination of the position of bone landmarks. The observed patients were divided into groups and subgroups depending on the type of dysfunction. The main group consisted of patients with clinical and osteopathic signs of somatic dysfunctions of the pubic bone and ilium. The patients were followed up for 14 days. The observation and treatment program included: osteopathic correction of diagnosed somatic dysfunction and stabilometric examination (3 control points) with a training regimen (3 sessions). Stabilometric testing was carried out at the stage of diagnosis and selection of patients for inclusion in the study. Re-examination was carried out 14 days after the moment of treatment. The clinical effect was compared with the results of stabilometric tests. In addition, the intensity of the pain syndrome and the severity of muscle-tonic reactions were analyzed. According to the results of the test regime, the stability in the «eyes open» and «eyes closed» modes was assessed. Results. A decrease in the intensity of pain is achieved, normalization of the balance in axial parameters with an improvement in the function of coordination of movements is noted. The Romberg coefficient decreases most significantly in somatic dysfunctions of the iliac bones in the position of anterior rotation without a significant difference in lateralization: on the right, a decrease from 570 ± 12% to 295 ± 23% and on the left from 550 ± 22 to 260 ± 25% (p <0.05). Conclusion. In the event of somatic dysfunctions of the pelvic bones with lumbosacralgia, the combined use of osteopathic correction and physiotherapy exercises on a stabiloplatform in a training mode with biofeedback has a significant effect. The training regimen promotes pain regression in acute and chronic pain. The best results have been achieved in patients with dysfunction in the anterior rotation of the ilium. Stabilometric testing in the diagnostic mode allows you to obtain objective data on the nature of imbalance and imbalance. The training regime ensures the achievement of a therapeutic result in 3 sessions and can be used in inpatient and outpatient conditions of medical institutions.

Possibility of osteopathic correction in the complex therapy of patients with Parkinson′s disease

Introduction. Parkinson′s disease (PD) is a slowly progressive chronic disease and currently all available treatments are aimed at alleviating the symptoms of the disease and improving the quality of patients′ life. The main correction is drug therapy. Taking into account the progressive nature of the disease, the insuffi cient effectiveness of drug therapy, as well as early and frequent complications from drug therapy, the search for new pathogenetic and symptomatic drugs, as well as additional non-drug methods of treatment, is constantly being conducted. A number of authors have also previously demonstrated positive changes in the state of motor functions and regression of some neurological manifestations in PD patients with the use of certain osteopathic correction techniques. The above suggests that osteopathic correction may become one of the new directions in the treatment of PD within the framework of complex therapy.The aim of the study is to substantiate the possibility of the inclusion of osteopathic correction of patients with Parkinson′s disease in complex therapy.Materials and methods. A controlled, randomized prospective study was carried out at the Bakhrushin Brothers City Clinical Hospital and the «Ear, Throat and Nose Clinic» (Moscow) medical center from April 2019 to January 2020. The study included 24 patients aged 60 to 78 years with a diagnosis of Parkinson′s disease stage I–II according to Hoehn and Yahr. Depending on the applied treatment method, the patients were divided by simple randomization into two comparable groups (main and control) of 12 people each. All observed patients received common drug therapy and exercise therapy. Additionally, the patients of the main group underwent osteopathic correction (within 3 months, once every 14 days, a total of 6 sessions were performed). All patients, regardless of the group, underwent an osteopathic examination before and after treatment, with the formulation of an osteopathic conclusion; the quality of life was assessed according to the Medical Outcomes Study 36-Item Short-Form Health Survey, and the impact of motor and non-motor symptoms of PD on the daily activity of patients was assessed using the unifi ed PD assessment scale of the International Society of Movement Disorders (MDS UPDRS).Results. The use of osteopathic correction together with drug therapy in PD patients leads to a statistically signifi cant (p<0,05) improvement in quality of life indicators (vitality scale and physical health scale) and daily physical activity (depression level). There is also a change in the structure of the dominant somatic dysfunctions (SD) in the form of a signifi cant decrease in the number of global SD.Conclusion. To increase the effectiveness of complex therapy for patients with PD, the common drug therapy can be supplemented with osteopathic methods of correction.

Estimation of the effi ciency of treatment of somatic dysfunctions of the pelvis bones using the technology of computer stabilography with biological feedback

Introduction. Somatic dysfunctions of the pelvic and sacral bones are one of the most common causes of lumbosacral pain with impaired spine statics, functional disorders of internal organs and other manifestations. Remote symptoms include torsional dural dysfunctions. Distortion of proprioceptive somatosensory afferentation blocks postural tonic reflexes of the axial skeleton and extremities, disrupts the sequence of activation of motor units of the locomotion system, changes the mechanisms for providing support and walking. Osteopathic correction of somatic dysfunctions in the region improves the condition of patients, however, in some cases, it is not possible to achieve complete regression of the identified syndromes. One of the effective corrective methods are computer technologies with the registration of the parameters of the static-dynamic function of support and maintaining balance. The possibilities of restoring reflex mechanisms can be obtained using computer stabilometry with a biofeedback program (BFB). Testing was carried out at the stage of diagnosis and follow-up: at the stage of screening, immediately after the treatment session, and 14 days after the moment of treatment. The clinical effect was compared with the results of stabilometric testing. The training sessions were carried out after registering the statokinesiogram.The aim of the research was to study the possibilities of using a stabiloplatform with BFB in in the mode of diagnosis of coordination and static-dynamic disorders of the axial skeleton in patients with various types of somatic dysfunctions of the pelvic bones and in the training mode together with the osteopathic correction of the somatic dysfunctions identified in patients.Materials and methods. In a prospective controlled study, the results of examination and treatment of 66 patients aged 23–56 years (median — 33) were analyzed, including 36 women and 39 men with somatic dysfunctions of the pelvic bones. In the main group, clinical and osteopathic signs of somatic dysfunctions of the pubic bone and ilium were revealed. The observation was carried out for 14 days. Osteopathic treatment of the corresponding type of dysfunction and stabilometric examination (3 control points) and training (3 sessions) were performed. Among the analyzed clinical manifestations, the intensity of pain syndrome and muscle-tonic reactions was taken into account. According to the results of the stabilometry, stability (RC) was assessed in the «eyes open» and «eyes closed» modes. The primary checkpoint is the start of observation and the correction procedure. Stage control after 7 days and the final observation point — 14 days. In total, 3–4 osteopathic sessions were carried out, stabilometric control was the screening stage, before and after the session, observation after 14 days from the last session.Results. There was detected decrease in pain intensity, normalization of axial balance and coordination of movements. The most significant was the decrease in the Romberg coefficient in patients with dysfunction of the iliac bones in the anterior rotation, regardless of the side: dynamics on the right: decrease from 570±12 to 295±23 % and on the left from 550±22 to 260±25 % (p<0,05).Conclusion. The combined use of osteopathic correction and physiotherapy exercises on a stabiloplatform in a training mode with BFB promotes regression of neurological and clinical symptoms, which is confirmed by all diagnostic methods used in the study — clinical neurological, clinical osteopathic, stabilometric with BFB. The best results were achieved in patients with somatic dysfunction anterior rotation of the ilium. The use of a stabiloplatform with BFB in the diagnostic mode allows obtaining objective data on the nature of the imbalance and balance disorders. The training regime contributes to the achievement of a therapeutic result in a short time (3 sessions) and can be used in inpatient and outpatient conditions of medical institutions.

Results of osteopathic correction of myopia and accommodation spasm in children: systematic review using meta-analysis

Introduction. The incidence of myopia tends to grow steadily, and therefore, it can be characterized as a disease of the 21st century. Even with complex ophthalmological treatment, refractive indices do not improve, and only in 18 % of cases these indices are stabilized. The effect of osteopathic correction (OC) on visual acuity is insufficiently studied. A comprehensive review of the evidence on this issue may help estimate the use of OC in existing health care programs for myopia and accommodative spasm in children.The goal of research — to study, according to the literature, the effect of osteopathic correction of somatic dysfunctions in children of different ages on the state of refraction in myopia, spasm of accommodation. Materials and methods. The selection of scientific papers according to the following criteria. Inclusion criteria: children aged 5 to 18 years with a history of diagnosis: myopia of varying degrees, spasm of accommodation; the dividing patients into 2 groups: in the experimental group — osteopathic and ophthalmological treatment, in the control group — standard ophthalmological treatment; the results of an ophthalmological examination are described; the duration of observations is from 3 to 6 months. Exclusion criteria: description of a single clinical case; the diseases are not associated with disorders of the visual apparatus; the study sample is less than 30 patients. The Jamovi statistical analysis software was used to perform the meta-analysis. The Newcastle-Ottawa scale was used to assess the risk of bias in cohort studies.Results. There were selected 3 scientific works studying the influence of osteopathic correction on the state of refraction in myopia, spasm of accommodation in children. On the Newcastle-Ottawa scale, all three studies had a total score of 8, indicating a low risk of bias. The odds ratio was 20.884, which is a high indicator revealing the effectiveness of the OC together with ophthalmological treatment of myopia, accommodation spasm in children of different ages. Thus, we can say that when similar studies will be repeated, the achievement of a positive effect when using OC as part of a complex treatment in 95 % of cases will be higher than the use of only ophthalmological treatment of children with myopia, accommodation spasm.Conclusion. Based on the studied literature and the conducted meta-analysis, we can make a preliminary conclusion that the inclusion of osteopathic correction in the complex treatment can give an additional advantage over standard treatment in children with refractive disorders.