Influence of osteopathic correction on range of motion and quality of life in patients with arthrosis of the shoulder joint of I–II degrees

Introduction. Shoulder pain in the shoulder joint arthrosis is a difficult problem to treat. The search for effective therapy of the shoulder region pathology is an urgent medical and socio-economic task, since the peak of morbidity is during the period of active human labor activity — 40 years. As a rule, nonsteroidal anti-inflammatory drugs and glucocorticoid drugs are used to treat patients with shoulder pain syndrome and arthrosis of the shoulder joint of I–II degrees, but it is associated with potential risk of adverse reactions. Therefore, the search for non-drug methods of treatment is in demand. Osteopathic correction has proven itself well in the complex therapy of a number of degenerative joint diseases and pain syndrome. At the same time, there are currently few works devoted to the problem of restoring function in the shoulder joint and the life quality of a patient with the shoulder joint arthrosis of I–II degrees from the position of osteopathic correction. The aim of the study was to investigate the effect of osteopathic correction on the motion range and life quality of patients with the shoulder joint arthrosis of I–II degrees.

Materials and methods. The study involved 26 patients with arthrosis of the shoulder joint of I–II degrees. The study was conducted from January 2020 to December 2021 at the «Tuya» Center of Traditional Medicine, Ufa. Using the method of randomization envelopes in a ratio of 1:1, there were formed two groups: control (13 patients) and main (13 patients too). All participants received standard conservative treatment. The participants of the main group additionally received a course of osteopathic correction (3 sessions, an interval is 2–3 weeks, and the duration of treatment is 1–2 months). Before and after the treatment, there were assessed the pain syndrome intensity using a 10-point visual-analog scale, the motion range in the diseased joint using a goniometer, the severity of pain syndrome and limitations in the shoulder joint using the Oxford Shoulder Score questionnaire, the life quality using the SF-36 questionnaire, and the osteopathic status according to approved clinical recommendations.

Results. Standard treatment of patients in the control group was accompanied by a statistically significant (p<0,05) decrease of the pain syndrome intensity, an increase of the motion range in the shoulder joint and a decrease of restrictions in the shoulder joint area. The inclusion of a osteopathic correction course in the treatment was accompanied by a statistically significant (p><0,05) more pronounced positive dynamics in all of these indicators. In addition, patients of the main group were characterized by a significant (p><0,05) improvement in the life quality by all indicators according to the SF-36 questionnaire. In most of the examined patients, the regional somatic dysfunctions (SD) of the thoracic region (structural and visceral components), and the dura mater region were revealed. In 100 % of patients, local SD of the shoulder joint were detected. The course of osteopathic correction was accompanied by a significant (p><0,05) decrease of the detection frequency of thoracic region and dura mater regional SD, and of the local SD of the shoulder joint. There was no significant dynamics in the control group. Conclusion. It is recommended to include a course of osteopathic correction in the complex treatment of patients with arthrosis of the shoulder joint of I–II degrees.><0,05) decrease of the pain syndrome intensity, an increase of the motion range in the shoulder joint and a decrease of restrictions in the shoulder joint area. The inclusion of a osteopathic correction course in the treatment was accompanied by a statistically significant (p<0,05) more pronounced positive dynamics in all of these indicators. In addition, patients of the main group were characterized by a significant (p<0,05) improvement in the life quality by all indicators according to the SF-36 questionnaire. In most of the examined patients, the regional somatic dysfunctions (SD) of the thoracic region (structural and visceral components), and the dura mater region were revealed. In 100 % of patients, local SD of the shoulder joint were detected. The course of osteopathic correction was accompanied by a significant (p<0,05) decrease of the detection frequency of thoracic region and dura mater regional SD, and of the local SD of the shoulder joint. There was no significant dynamics in the control group.

Conclusion. It is recommended to include a course of osteopathic correction in the complex treatment of patients with arthrosis of the shoulder joint of I–II degrees.

1. Brand R. A. 50 Years ago in CORR: Ruptures of the rotator cuff: Julius Neviaser MD CORR 1954;3:92-98. Clin. Orthop. Relat. Res. 2010; 468 (6): 1711–1712. https://doi.org/10.1007/s11999-009-1227-6

2. Тарасова Л. А. Профессиональные заболевания сенсомоторной системы от функционального перенапряжения (клинико-гигиенические исследования): Автореф. дис. докт. мед. наук. М.; 1991. [Tarasova L. A. Occupational diseases of the sensorimotor system from functional overstrain (clinical and hygienic studies): Abstract Dis. Doct. Sci. (Med.). M.; 1991 (in russ.)].

3. Прудников О. Е. Повреждения вращающей манжеты плеча, сочетанные с поражением плечевого сплетения: Автореф. дис. докт. мед. наук. СПб.; 1995. [Prudnikov O. E. Injuries of the rotator cuff associated with lesions of the brachial plexus: Abstract Dis. Doct. Sci. (Med.). St. Petersburg; 1995 (in russ.)].

4. Зверева Т. В., Смирнов В. В., Розанов А. Л., Ширяева Е. Е., Усупбекова Б. Ш. Сравнительная оценка эффективности остеопатического лечения и рефлексотерапии при правостороннем шейно-плечевом синдроме с помощью электропунктурной диагностики. Российский остеопатический журнал. 2016; 1–2: 75–86. [Zvereva T., Smirnov V., Rosanov A., Shyryaeva Е., Usupbekova B. Evaluation of the Effectiveness of Osteopathic Treatment of the Right Sided Cervicobrachial Syndrome with the Help of Electropunctural Diagnostics. Russian Osteopathic Journal. 2016; 1–2: 75–86 (in russ.)]. https://doi.org/10.32885/2220-0975-2016-1-2-75-86

5. Беленький А. Г. Плечелопаточный периартрит. Прощание с термином: от приблизительности — к конкретным нозологическим формам. Consilium medicum. 2004; 6 (2): 72–77. [Belen′kiy A. G. Shoulder periarthritis. Farewell to the term: from approximation to specifi c nosological forms. Consilium medicum. 2004; 6 (2): 72–77 (in russ.)].

6. Труфанов Г. Е., Фокин В. А. Магнитно-резонансная томография: Рук. для врачей. СПб.: ФОЛИАНТ; 2007; 688 с. [Trufanov G. E., Fokin V. A. Magnetic resonance imaging: A guide for physicians. St. Petersburg: FOLIANT; 2007; 688 p. (in russ.)].

7. Sanders T. G., Jersey S. L. Conventional radiography of the shoulder. Seminars Roentgenol. 2005; 40 (3): 207–222. https://doi.org/10.1053/j.ro.2005.01.012

8. Пилипович А. А. Синдром «замороженного плеча». Рус. мед. журн. 2016; 24 (20): 1379–1384. [Pilipovich A. A. Frozen Shoulder. Russ. med. J. 2016; 24 (20): 1379–1384 (in russ.)].

9. Кузнецова А. В. Опыт лечения болевого синдрома в плечевых суставах. Здоровье. Мед. экология. Наука. 2013; 4 (53): 17–21. [Kuznetsova A. V. Experience treatment of pain in the shoulder joint. Health. Med. Ecol. Sci. 2013; 4 (53): 17–21 (in russ.)].

10. Parsons J. Sport injuries // In: Osteopathy. Models for Diagnosis, Treatment and Practice. Churchill Livingstone; 2006: 299–303.

11. Козлова Н. С., Амелин А. В. Эффективность дополнительных методов лечения постинсультной периартропатии плечевого сустава. Российский остеопатический журнал. 2019; 1–2: 34–42. [Kozlova N. S., Amelin A. V. The effectiveness of additional treatment methods for post-stroke periarthropathy of the shoulder joint. Russian Osteopathic Journal. 2019; 1–2: 34–42 (in russ.) (in russ.)]. https://doi.org/10.32885/ 2220-0975-2019-1-2-34-42

12. Мохов Д. Е., Мирошниченко Д. Б. Общее остеопатическое лечение: Учеб. пособие. СПб.: Изд-во СЗГМУ им. И. И. Мечникова; 2018; 80 с. [Mokhov D. E., Miroshnichenko D. B. General osteopathic treatment: A textbook. St. Petersburg: Publishing house of the I. I. Mechnikov′ NWSMU; 2018; 80 p. (in russ.)].

13. Scott J., Huskisson E. C. Graphic representation of pain. Pain. 1976; 2 (2): 175–184. https://doi.org/10.1016/ 0304-3959(76)90113-5

14. Макарова Г. А., Локтев С. А. Медицинский справочник тренера. М.: Сов. спорт; 2006; 587 с. [Makarova G. A., Loktev S. A. Trainer′s Medical Handbook. M.: Sov. Sport; 2006; 587 p. (in russ.)].

15. Younis F., Sultan J., Dix S., Hughes P. J. The range of the Oxford Shoulder Score in the asymptomatic population: a marker for post-operative improvement. Ann. R. Coll. Surg. Engl. 2011; 93 (8): 629–633. https://doi.org/10.1308/ 003588411X13165261994193

16. Амирджанова В. Н., Горячев Д. В., Коршунов Н. И., Ребров А. П., Сороцкая В. Н. Популяционные показатели качества жизни по опроснику SF-36 (результаты многоцентрового исследования качества жизни «МИРАЖ»). Науч.-практич. ревматол. 2008; 46 (1): 36–48. [Amirdjanova V. N., Goryachev D. V., Korshunov N. I., Rebrov A. P., Sorotskaya V. N. SF-36 questionnaire population quality of life indices Objective. Rheumatol. Sci. Pract. 2008; 46 (1): 36–48 (in russ.)]. https://doi.org/10.14412/ 1995-4484-2008-852

17. Новик А. А., Ионова Т. И., Кайнд П. Концепция исследования качества жизни в медицине. СПб.: ЭЛБИ; 1999; 160 с. [Novik A. A., Ionova T. I., Kind P. The concept of studying the quality of life in medicine. St. Petersburg: ELBI; 1999; 160 p. (in russ.)].

18. Инструкция по обработке данных, полученных с помощью опросника SF-36. Ссылка активна на 01.11.2022. [Instruction for processing the data obtained by the SF-36 questionnaire. Accessed November 01, 2022 (in russ.)]. https://therapy.irkutsk.ru/doc/sf36a.pdf

19. Мохов Д. Е., Белаш В. О., Кузьмина Ю. О., Лебедев Д. С., Мирошниченко Д. Б., Трегубова Е. С., Ширяева Е. Е., Юшманов И. Г. Остеопатическая диагностика соматических дисфункций : Клинические рекомендации. СПб.: Невский ракурс; 2015; 90 с. [Mokhov D. E., Belash V. O., Kuzmina Yu. 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: Nevskiy rakurs; 2015; 90 p. (in russ.)].

20. Мохов Д. Е., Белаш В. О. Методология клинического остеопатического обследования: Учеб. пособие. СПб.: Изд-во СЗГМУ им. И. И. Мечникова; 2019; 80 с. [Mokhov D. E., Belash V. O. Methodology of clinical osteopathic examination: Studyguide. St. Petersburg: Izd-vo SZGMU im. I. I. Mechnikova; 2019; 80 p. (in russ.)].

21. Гайнуллин И. Р. Клинико-функциональная оценка эффективности остеопатической манипулятивной терапии плечелопаточного болевого синдрома: Автореф. дис. канд. мед. наук. Казань; 2014. [Gainullin I. R. Clinical and functional evaluation of the effectiveness of osteopathic manipulative therapy for shoulder pain syndrome: Abstract Dis. Cand. Sci. (Med.). Kazan; 2014 (in russ.)].

22. Федеральные клинические рекомендации по диагностике и лечению остеоартроза. М: Общероссийская общественная организация «Ассоциация ревматологов России»; 2013; 19 с. [Federal clinical guidelines for the diagnosis and treatment of osteoarthritis. M: All-Russian public organization «Association of Rheumatologists of Russia»; 2013; 19 p. (in russ.)].

23. Степнев С. Г. Вертебральные, невральные и миофасциальные нарушения у больных с брахиалгией: Автореф. дис. канд. мед. наук. Казань; 2013. [Stepnev S. G. Vertebral, neural and myofascial disorders in patients with brachialgia: Abstract Dis. Cand. Sci. (Med.). Kazan; 2013 (in russ.)].

24. Мохов Д. Е., Трегубова Е. С., Белаш В. О., Юшманов И. Г. Современный взгляд на методологию остеопатии. Мануал. тер. 2014; 4 (56): 59–65. [Mokhov D. E., Tregubova E. S., Belash V. O., Yushmanov I. G. A modern view of the osteopathy methodology. Manual Ther. J. 2014; 4 (56): 59–65 (in russ.)].

25. Потехина Ю. П., Трегубова Е. С., Мохов Д. Е. Феномен соматической дисфункции и механизмы действия остеопатического лечения. Мед. вестн. Северного Кавказа. 2020; 15 (1): 145–152. [Potekhina Yu. P., Tregubova E. S., Mokhov D. E. The phenomenon of somatic dysfunction and the mechanisms of osteopathic treatment. Med. News North Caucasus. 2020; 15 (1): 145–152 (in russ.)]. https://doi.org/10.14300/mnnc.2020.15036

26. Potekhina Yu. P., Tregubova E. S., Mokhov D. E. Osteopathy is a new medical specialty. Assessment of clinical effectiveness of osteopathic manipulative therapy in various diseases (review). Med. News North Caucasus. 2018; 13 (3): 560–565. https://doi.org/10.14300/mnnc.2018.13105