Comparison of osteopathic and reflexotherapeutic diagnostic results in patients with cervical dorsopathy

Introduction. The main direction of conservative treatment of patients with dorsopathies remains drug therapy, but most clinicians agree that even the «best» drug therapy does not always help to achieve the desired results, and in addition is not without a number of known problems — allergic reactions, side effects, polypragmasy, impossibility of use due to the presence of comorbid pathology. Therefore, in recent years there has been an increase in interest in various non-medicamentous methods of treatment of dorsopathies: massage, physical therapy, physiotherapy, manual therapy and osteopathy, reflexotherapy. Previous work has demonstrated the clinical effectiveness of both reflexotherapy and osteopathic correction in the treatment of patients with dorsopathies. Both osteopathy and reflexology are disciplines that actively position a holistic approach to the human body and subsequent treatment. But at the same time, the question of coincidence or inconsistency of the results of diagnostic protocols of the two «fundamental» non-medicinal approaches has not been studied before. All of the above predetermined the purpose of this study.

The aim of the study: to compare the results of osteopathic and reflexotherapeutic diagnostics in patients with dorsopathy of the cervical spine.

Materials and methods. The cross-blind study was conducted on the basis of the medical clinic LLC «Mokhov Institute of Osteopathy» (Saint-Petersburg) in the period from September 2018 to December 2022. 110 patients (68 women and 42 men) with dorsopathy of the cervical spine were under observation. All patients underwent a one-stage assessment of osteopathic status and electropuncture diagnosis according to the method of I. Nakatani, and the level of pain syndrome was measured. All measurements were performed by different specialists, which allowed «blinding» the results obtained.

Results. Somatic dysfunctions (SD) of the global level were revealed in 19 (17 %) people and were represented mainly by the disorder of cranial rhythmic impulse production and psychovisceral-somatic disorder. SD of the regional level were revealed in the majority of the examined patients (98 people, 89 %). The most typical were dysfunctions of the following regions: neck (structural component), thoracic (structural component), pelvis (structural and visceral components), dura mater. Local SD were diagnosed in all examined patients (110 patients, 100 %). Among local SD the most frequently revealed were dysfunctions of separate vertebralmotor segments, separate joints of the skull, sacrum, knee joint, ankle joint. Pain syndrome of moderate severity was characteristic for the examined patients. Electropuncture diagnostics according to the methods of I. Nakatani allowed to estimate the state of acupuncture meridians in the so-called representative points. According to the data obtained for the examined patients the most typical were hypofunction of lung meridian and hyperfunction of heart, bladder and kidney meridians. In accordance with the set goal we evaluated the conjugation between the results of osteopathic and reflexotherapeutic diagnostics. A medium association was found between: Lung SD and hypofunction of the corresponding meridian (conjugation coefficient 0,58), small intestine SD and hypofunction of the corresponding meridian (conjugation coefficient 0,52). A high strength association was found between: pericardial ligament SD and hypofunction of the corresponding meridian (contiguity coefficient 0,78), liver SD and hypofunction of the corresponding meridian (contiguity coefficient 0,74), kidney SD and hypofunction of the corresponding meridian (contiguity coefficient 0,8).

Conclusion. Patients with cervical dorsopathy are primarily characterised by SD of regional and local levels. The connections between separate SD (both local independent and in the «structure» of regional biomechanical disorders) and hypofunction of corresponding meridians revealed in the course of this work potentially allow us to speak about comparability of separate results of osteopathic and reflexotherapeutic diagnostics. At the same time, it is interesting that the manual findings are comparable only with hypofunction of meridians.

1. Vasilev A. Yu., Vitko N. K. Computed tomography in the diagnosis of degenerative changes of the spine. М.: Vidar; 2000; 120 p. (in russ.)].

2. Büttner-Janz K., Hahn S., Schikora K., Link H. D. Basic principles of successful implantation of the SB Charité model LINK inter-vertebral disk endoprosthesis. Der. Orthopade. 2002; 31 (5): 441–453. https://doi.org/10.1007/s00132-001-0297-2

3. Belash V. O., Agasarov L. G. Refl exology in the treatment of patients with dorsopathy. Russ. Osteopath. J. 2020; 4: 117–130. https://doi.org/10.32885/2220-0975-2020-4-117-130 (in russ.)].

4. Lalayan T. V., Andreev V. V., Barantsevich E. R. Introduction to practical vertebro-neurology: Textbook for doctors. St. Petersburg: RITs PSPbGMU; 2018; 74 p. (in russ.)].

5. Isaikin A. I., Akarachkova E. S., Isaikina O. Yu., Kondrashov A. A., Kir′yanov M. A. Spinal pain: Clinical recommendations. St. Petersburg: Skifi ya-print; M.: Profmedpress; 2021; 80 p. (in russ.)].

6. Shtok V. N. Pharmacotherapy in neurology: Practical Guide. М.: Med. inform. agentstvo; 2010; 536 p. (in russ.)].

7. Kamchatnov P. R., Chugunov A. V., Shurygin S. N. Local use of non-steroid anti-infl ammatory drugs inpatients with dorsopathy. Consilium medicum. 2019; 21 (2): 90–94. https://doi.org/10.26442/20751753.2019.2.190313 (in russ.)].

8. Agasarov L. G., Kuzmina I. V., Chigarev A. A., Maryanovskii A. A. Clinic, pathogenesis and correction of manifestations of dorsopathies. Bull. New Med. Tecnol. (Electron. Journ.). 2015; 1. https://doi.org/10.12737/10416 (in russ.)].

9. Kozlova N., Belash V. Osteopathic aspects of vertebroneurology. Russ. Osteopath. J. 2017; 1–2: 105–117. https:// doi.org/10.32885/2220-0975-2017-1-2-105-117 (in russ.)].

10. Belyaev A. F., Shiryaeva E. E., Kuznetsova G. V. Non-medicamentous therapy as a basis of regenerative medicine . Pacifi c Med. J. 2008; 3: 88–92 (in russ.)].

11. 1. Novoseltsev S. V., Kosmirov V. I. Effect of osteopathic therapy for discogenic lumbar spine pain syndromes on serum levels of proinfl ammatory cytokines TNFΑ and IL-1Β. Russ. Osteopath. J. 2011; 1–2: 5–11 (in russ.)].

12. Novoseltsev S. V., Malinovskii E. L., Smirnov V. V., Savvova M. V., Lebedeva V. V. Clinical and diagnostic comparisons of the effectiveness of osteopathic treatment of herniated and protruded intervertebral discs in the lumbar spine. Russ. Osteopath. J. 2011; 1–2: 44–51 (in russ.)].

13. Belash V. O., Mokhov D. E., Tregubova E. S. The use of the osteopathic correction for the combined treatment and rehabilitation of the patients presenting with the vertebral artery syndrome. Probl. Balneol. Physiother. Exercise Ther. 2018; 95 (6): 34–43. https://doi.org/10.17116/kurort20189506134 (in russ.)].

14. Franke H., Franke J. D., Fryer G. Osteopathic manipulative treatment for nonspecifi c low back pain: a systematic review and meta-analysis. BMC Musculoskelet. Disord. 2014; 15 (1): 286. https://doi.org/10.1186/1471-2474-15-286

15. 5. Dal Farra F., Risio R. G., Vismara L., Bergna A. Effectiveness of osteopathic interventions in chronic non-specifi c low back pain: a systematic review and meta-analysis. Complem. Ther. Med. 2021; 56: 102616. https://doi.org/10.1016/j.ctim.2020.102616

16. Licciardone J. C., Kearns C. M., Minotti D. E. Outcomes of osteopathic manual treatment for chronic low back pain according to baseline pain severity: Results from the osteopathic trial. Manual. Ther. 2013; 18 (6): 533–540. https://doi.org/10.1016/j.math.2013.05.006

17. Licciardone J. C., Gatchel R. J., Aryal S. Recovery from chronic low back pain after osteopathic manipulative treatment: A randomized controlled trial. J. Amer. Osteopath. Ass. 2016; 116 (3): 144–155. https://doi.org/10.7556/jaoa.2016.031

18. 8. Mokhov D. E., Belash V. O., Aptekar I. A., Nenashkina E. N., Potekhina Yu. P., Tregubova E. S., Belyaev A. F. Somatic dysfunction: Clinical Guidelines 2023. Russ. Osteopath. J. 2023; 2: 8–90. https://doi.org/10.32885/2220-0975-2023-28-90 (in russ.)].

19. Matamalas A., Ramirez M., Mojal S., Garcia De Frutos A., Molina A., Salo G. et al. The visual analog scale and a fi ve-item verbal rating scale are not interchangeable for back pain assessment in lumbar spine disorders. Spine (Phila Pa 1976). 2010; 35 (21): 1115–1119. https://doi.org/10.1097/BRS.0b013e3181e7b315

20. 0. Breivik H., Borchgrevink P. C., Allen S. M., Rosseland L. A., Romundstad L., Breivik Hals E. K. et al. Assessment of Pain. Brit. J. Anaesthesia. 2008; 101 (1): 17–24. https://doi.org/10.1093/bja/aen103

21. Giusti R. Glossary of osteopathic terminology. Bethesda: AACOM; 2016; 86 p.

22. Mokhov D. E., Potekhina Yu.P., Tregubova E. S., Gurichev A. A. Osteopathy — a new direction of medicine (modern concept of Osteopathy). Russ. Osteopath. J. 2022; 2: 8–26. https://doi.org/10.32885/2220-0975-2022-2-8-26 (in russ.)].

23. Tarasova A. V., Potekhina Yu. P., Belash V. O., Klassen D. Ya. The application of infrared thermography for the objectifi cation of somatic dysfunctions and osteopathic correction results. Manual Ther. J. 2019; 4 (76): 35–41 (in russ.)].

24. Belash V. O., Maslov D. A. Objectifi cation of regional biomechanical disorders in patients with dorsopathy of the cervical spine. Russ. Osteopath. J. 2024; 2: 70–81. https://doi.org/10.32885/2220-0975-2024-2-70-81 (in russ.)].

25. 5. Raenko O. P., Vinogradova D. A., Potekhina Yu. P., Milutka Yu. A. The effect of myofascial techniques on the electrical activity of the neck muscles. Russ. Osteopath. J. 2024; 1: 78–91. https://doi.org/10.32885/2220-0975-2024-1-78-91 (in russ.)].

26. 6. Potekhina Yu. P., Timanin Е. М., Kantinov А. Е. Viscoelastic properties of tissues and changes in them after osteopathic correction. Russ. Osteopath. J. 2018; 1–2: 38–45. https://doi.org/10.32885/2220-0975-2018-1-2-38-45 (in russ.)].

27. Timanin E. M., Potekhina Yu. P., Mokhov D. E. Investigation of viscoelastic characteristics of neck and upper thoracic muscles by vibration viscoelastometry. Med. Equipment. 2019; 317 (5): 25–28 (in russ.)].

28. Agasarov L. G. Technologies of restorative treatment in dorsopathies: Textbook. М.: University textbook; 2010: 96 p. (in russ.)].

29. Methodical recommendations of the Ministry of Health of the Russian Federation №2002/34 from 12.12.2002 «Electropuncture diagnostics by the method of I. Nakatani». M.; 2003: 27 p. (in russ.)].

30. Potekhina Yu.P., Milutka Yu.A., Tregubova E. S., Yanushanets O. I. The study of the osteopathic diagnostics results′ coincidence frequency. Russ. Osteopath. J. 2020; 1–2: 7–17. https://doi.org/10.32885/2220-0975-2020-1-2-7-17 (in russ.)].