Evaluation of the clinical effectiveness of the osteopathic correction in children with chronic bronchitis in a sanatorium

Introduction. Possible causes of chronic bronchitis are anatomically incorrect location of internal organs, the presence of congestion, impaired blood circulation, impaired mobility level, disorders of innervation and metabolic processes in the respiratory organs, decreased mobility of the chest, tension of the thoracic diaphragm, imbalance of the myofascial system, diseases of the spine (osteochondrosis, scoliosis, etc.). These disorders and dysfunctions are extremely rarely taken into account in the prescription of conventional therapy regimens in children with chronic bronchitis. At the same time, it is known that many drugs and various therapeutic effects in some cases are not able to give long-term remission and recovery. This causes the need to search for new methods of treating chronic bronchitis in children, one of which could be osteopathic correction. At the same time, in the available literature sources, there is very little information on this problem, and the presented data are sometimes contradictory.

The aim of the study is to evaluate the clinical effectiveness of osteopathic correction in the treatment of children with chronic bronchitis in a sanatorium.

Materials and methods. The controlled randomized trial was conducted from June 2020 to April 2021. The study included 40 patients with chronic bronchitis at the age from 6 to 16 years, 24 boys, 16 girls, who were undergoing sanatorium-resort treatment in the children′s sanatorium «Raduga» (Sterlitamak). Depending on the applied treatment method, the patients were divided by simple randomization into two comparable groups (main and control) of 20 people each. All patients received sanatorium resort treatment, which included physical therapy, halotherapy, inhalations, phytotherapeutic procedures. Patients of the main group, in addition to the above-described therapy, received osteopathic correction. In total, 2 sessions were carried out with an interval of 7 days. All patients, regardless of the group, before the start of treatment, as well as after the completion of the therapy course, underwent an assessment of the osteopathic status, chest excursion and respiratory function.

Results. During the treatment with inclusion of osteopathic correction, in patients of the main group, there is a significant decrease in the frequency of detection of somatic dysfunctions (global rhythmogenic disorder, neck region, chest region), as well as a significant positive dynamics of indicators characterizing the external respiration function (chest excursion, forced vital capacity of lungs, peak exhalation rate), compared with patients receiving only conventional therapy. Positive changes in the chest excursion and peak exhalation rate against the background of osteopathic correction persist reliably even 3 months after the completion of the therapy course, and it allows to suppose the prolonged effect of the therapy.

Conclusion. The study showed that osteopathic correction increases the clinical effectiveness of the conventional methods of sanatorium resort treatment for pediatric patients with chronic bronchitis. This allows to recommend the inclusion of osteopathic methods of correction in complex treatment programs for this group of patients in a sanatorium.

1. Alexandrova E. A., Zakharova I. A. Comparative analysis of the frequency of respiratory symptoms depending on age // In: Current issues of medical science. Yaroslavl; 2014: 81–82 (in russ.).

2. Bezrodnov I. B. Treatment and prevention of the disease by methods of Western, Eastern and alternative medicine. M.: Phoenix; 2009; 192 p. (in russ.).

3. Zakharova I. A. The prevalence of chronic obstructive pulmonary disease among young people living in a large industrial city. Postgraduate doctor. 2014; 1.1 (62): 222–225 (in russ.).

4. Kokosov A. N. Bronchitis. SPb.: Esby; 2007; 174 p. (in russ.).

5. Shchetinin M. N. Diseases of the bronchi and lungs. M.: Book Club; 2009; 128 p. (in russ.).

6. Mokhov D. E., Belash V. O. Methodology of clinical osteopathic examination: Study guide. St. Petersburg: Izdatel′stvo SZGMU im. I. I. Mechnikova; 2019; 80 p. (in russ.).

7. Mokhov D. E., Egorova I. A., Trofimova T. N. The principles of osteopathy. SPb: Publishing house SPbMAPO; 2004; 78 p. (in russ.).

8. Budylin S. P. Complex treatment of patients with chronic obstructive pulmonary diseases using myofascial techniques of manual therapy and sodium chloride baths: Abstract Dis. Cand. Sci. (Med.). M.; 2015 (in russ.).

9. Ignatova G. L., Zakharova I. A. Comparative analysis of the incidence of acute respiratory diseases in young patients with chronic bronchitis. Prac. Med. 2014; 7 (83): 47–49 (in russ.).

10. Chervinskaya A. V. Controlled halotherapy — the modern development of the method of speleotherapy. National Bull. Physiother. 2009; (1): 16–17 (in russ.).

11. Mokhov D. E., Aptekar I. A., Belash V. O., Litvinov I. A., Mogelnitsky A. S., Potekhina Yu. P., Tarasov N. A., Tarasova V. V., Tregubova E S., Ustinov A. V. The basics of osteopathy: A textbook for residents. M.: Geotar; 2020; 400 p. (in russ.).

12. Mokhov D. E., Belash V. O., Kuzmina Ju. O., Lebedev D. S., Miroshnichenko D. B., Tregubova E. S., Shirjaeva E. E., Yushmanov I. G. Osteopathic Diagnosis of Somatic Dysfunctions: Clinical Recommendations. St. Petersburg: Nevskij rakurs; 2015; 90 p. (in russ.).

13. Propedeutics of Childhood Diseases / Eds. V. V. Yuriev, M. M. Khomich. M.: GEOTAR-Media; 2012; 720 p. (in russ.).

14. Chuchalin A. G., Aysanov Z. R., Chikina S. Yu., Chernyak A. V., Kalmanova E. N. Federal guidelines of Russian Respiratory Society on spirometry. Pulmonologiya. 2014; (6): 11–24 (in russ.). https://doi.org/10.18093/0869-0189-2014-0-6-11-24

15. Lukina O. F. Pulmonary Function Tests in Children and Adolescents. Pract. Pulmonol. 2017; (4): 39–44 (in russ.).

16. Novik G. A., Borichev A. V. Spirometry and peak fl owmetry in bronchial asthma in children (practice of assessment and monitoring): Training manual. St. Petersburg: GPMA Publishing House; 2005; 68 p. (in russ.).

17. Samorukov A. E., Budylin S. P. Manual therapy and sodium chloride baths in the treatment of patients with chronic obstructive bronchitis and bronchial asthma during incomplete remission (abstracts). Materials of the International Congress «Reflexology and Manual Therapy in the XXI Century» May 19–21, 2006. M.; 2006: 59–60 (in russ.).

18. Myers T. W. Anatomy Trains. St. Petersburg: MERIDIAN-S LLC; 2012; 320 p. (in russ.).

19. Busquet L. Muscle chains. Vol. 2: Lordosis, kyphosis, scoliosis and chest deformities. M.—Ivanovo: MIK; 2011; 195 p. (in russ.).

20. Svechnikova I., Lebedev D. Influence of the Sternum Mobilization Technique on the Spirometry Data. Russian Osteopathic Journal. 2016; 3–4: 84–90 (in russ.). https://doi.org/10.32885/2220-0975-2016-3-4-84-90

21. Zanotti E., Berardinelli P., Bizzarri C., Civardi A., Manstretta A., Rossetti S., Fracchia C. Osteopathic manipulative treatment effectiveness in severe chronic obstructive pulmonary disease: A pilot study. Complement. Ther. Med. 2012; 20 (1–2): 16–22. https://doi.org/10.1016/j.ctim.2011.10.008