Introduction. The strengthening of thoracic kyphosis and forward head posture is one of the urgent problems of modern man. Such changes are most often detected for elderly and senile people. However, today these features are also detected for young people. Digital radiography can objectively assess the position of the cervical and thoracic vertebrae. However, the criteria for reliably registering the position of the vertebrae of the cervicalthoracic junction have not yet been developed.

The aim of the study — to develop a method for assessing the position of the vertebrae of the cervical-thoracic junction according to digital radiographs; to develop a typology of the vertebra positions of the cervical-thoracic junction; to study the frequency of vertebral position types for the cervical-thoracic junction for different age groups.

Materials and methods. Spine X-ray images in the sagittal plane for 141 adult patients with dorsopathies were studied. The selection of patients was random and there were four age groups: 32 persons aged 21 to 45, 32 persons aged 46 to 59, 50 persons aged 60 to 74 and 21 persons aged 75 to 88 year-old. The study was conducted on PC screen, without the patient′s presence. A single digital X-ray image of the spine for each patient in the sagittal plane was obtained. On the combined digital radiograph, the occipital vertical was drawn along all parts of the spine, starting from the external hillock of the occipital bone downwards, and the anteroposterior C_V–T_V axes of the vertebrae (r axes) were applied. At the points of intersection of the axes with the occipital vertical, the perpendiculars to the axis were restored, and the angles between the perpendiculars and the vertical — the angles of the anteroposterior axes of the vertebrae (r angles) — were measured. Statistical analysis was performed using the MS Offi ce Excel 2007 and Statistica 12 software packages.

Results. It was found that the values of the anteroposterior axe angles r of CVII–TIII vertebrae can serve as criteria for determining the spatial position of the cervical-thoracic junction vertebrae. There are 4 types of the shape of the cervical-thoracic junction. Type I is a straightened kyphosis («giraffe neck»); type II is physiological («harmonious»); type III — enhanced kyphosis («bear withers»); type IV–hyperkyphosis («buffalo hump»). Types III and IV are accompanied by a forward displacement of the head. Straightened cervical-thoracic junction kyphosis — type I — was diagnosed in 21 (15 %) people, 52 (37 %) patients were assigned to type II, another 48 (34 %) patients had type III, and 20 (14 %) patients had type IV cervical-thoracic junction kyphosis. In young patients aged 21 to 45, as well as in middle-aged patients aged 46 to 59, the most common type was the harmonious type II of cervical-thoracic junction, in elderly patients aged 60 to 74 — type III and close to it in frequency was type III. In elderly patients aged 75 to 88, the IV type of the position of the vertebrae of the cervical-thoracic junction prevailed in frequency.

Conclusion. The proposed diagnostic method allows to register the type of the vertebra positions in cervicalthoracic junction for each patient. Four position types of the cervical-thoracic junction vertebrae were determined: straightened kyphosis «giraffe neck», physiological kyphosis «harmonious», enhanced kyphosis «bear withers» and hyperkyphosis «buffalo hump». Increased kyphosis and hyperkyphosis are accompanied by a forward head posture.

Introduction. Perception is a holistic reflection of objects and phenomena. A person has all the channels of perception — auditory, visual, kinesthetic. Only the expression degree of each channel in the overall structure of perception is different. Psychologists studied the specific weight of perception channels in its overall structure in a single-stage «slice». There is no reliable data on changes in perception in one group of subjects over a long period of time. Osteopathic researches have examined the development of touch during learning process. At the same time, there have not been studied the dynamics of perception as a whole system.

The goal of the study is to research the changes of the perception channels among students of the cycle of professional retraining in the specialty «Osteopathy» in the process of 4-year education and to compare it with the perception channels characteristics of teachers of the cycle.

Materials and methods. From 2018 to 2021 a cohort, prospective study was conducted. The study involved persons enrolled in a long (3,5 years) cycle of professional retraining in the specialty «Osteopathy» from I to IV courses — 63 people (35 men, 28 women, age from 26 to 52 years, median 36,5 years), and also teachers of osteopathy with at least 5 years of work experience — 20 people (14 men, 6 women, age from 31 to 55 years, median 48 years). An annual survey was conducted based on the questionnaire of S. A. Efremtseva «Diagnostics of the dominant perceptual modality», which consists of 48 questions aimed at identifying the predominant (dominant) channels of perception in three directions: auditory, visual or kinesthetic. The maximum score for each of the three modality channels is 16, the minimum is 0. The survey was anonymous. In the questionnaire, the participants provided only data on their gender, age, study group number, and the date of the study.

Results. The general structure of the students′ perception underwent changes during their learning. The specific weight of the kinesthetic channel in the general structure of listeners′ perception grew annually and doubled in the IV year in comparison with the beginning of training. At the same time, the specific weight of other channels of perception decreased steadily. The expression of all channels of listeners′ perception in absolute numbers also increased (p<0,005). The kinesthetic channel showed the most stable positive dynamics. Its expression began to grow already in the second year of the learning (p<0,001), while the expression of the auditory and visual channels had a statistically significant difference only when comparing 3rd and 4th years of the learning (p<0,005). The perception channels among the teachers of osteopathy were characterized by high absolute indices with similar values for individual channels. In half of the subjects, the kinesthetic channel prevailed in the structure of perception, and in the second half the polymodal channel prevailed with a high rate of kinesthetics. The expression of all perception channels of the osteopathic school students during the learning process gradually approached to that of the osteopathy teachers. At the 4th year of the learning, students did not statistically significantly differ from teachers by the absolute values of perception channels indicators.

Conclusion. The students of the osteopathic school showed a regular increase in the expression of all perception channels during their learning (p<0,005). The expression of the kinesthetic channel grew most rapidly. The largest increasing across all channels occurred in the 4th year of the learning. During the first three years of the learning, the listeners, in terms of the perception channels expression, gradually approached the teachers who had high indicators by all channels. At the 4th year, the students did not differ statistically significantly from the teachers. Therefore, the primary training in osteopathy should last at least 3,5–4 years for the high perception index formation of perception of an osteopathic physician.

Introduction. Myofascial pain syndrome (MFPS) is one of the most common pathologies of the musculoskeletal system that causes chronic pain. This type of pain reaches its peak in middle-aged people; women get sick 2,5 times more often than men. The disease leads to significant disability; it is not only a medical but also a social problem. Atthe same time, a number of authors still note the low clinical efficacy of the applied therapy regimens. In this situation there is in demand the further study of the MFPS pathogenesis, in particular, the clinical and electroneurophysiological characteristics of this pathology, in order to search for new, including pathogenetically proved, treatment methods.

The aim of the research was to study the relationship between the indicators of the blinking reflex and somatosensory evoked potentials in patients with active and latent forms of MFPS.

Materials and methods. In order to study the neurophysiological aspects of MFPS, a comprehensive clinical and electroneurophysiological examination was carried out in 92 patients of working age, including 78 women and 14 men, whose average age was 48,1±9,3) years, suffering from MFPS of the scapular area. The patients were subdivided into subgroups depending on the prevalence and severity of pain manifestations: the first subgroup — with an active form (58 people, 63 %), the second subgroup — with a latent form of MFPS (34 people, 37 %). The control group was formed from conditionally healthy volunteers in the amount of 35 people, comparable to the main group by age and sex.

Results. The comparing of the study results, taking into account polysynaptic reflex excitability and the data of somatosensory evoked potentials, revealed the significant positive correlations of the indicators. The obtained results allowed to assess the excitability of spinal cord motor neurons as well as suprasegmental structures in MFPS, involved in the implementation of pain syndrome.

Conclusion. The use of clinical electroneurophysiology methods makes it possible to assess the functional state of the CNS structures involved in the analysis of nociceptive afferentation. In the active form of MFPS, an increase in the excitability of stem and thalamic structures was mainly determined, which could potentially indicate the activation of adaptive processes on the one hand, and on the other hand, the predisposition of neuronal networks to a state of arousal. In the latent form of MFPS, a multidirectional change in reflex excitability was observed.

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.

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.

Introduction. Glaucoma is a chronic eye disease characterized by a constant or periodic increase in intraocular pressure, a decrease of visual fields and visual acuity, and by a special form of optic nerve atrophy with excavation in the disc area. The reflection of this slowly fl owing atrophy is a disturbance in the visual field and a complete irreversible loss of visual function. The prevalence of the disease increases with increasing age. The main methods of treatment are medical and surgical. Non-penetrating operations are recognized as the safest methods of surgical treatment of glaucoma. The most common complications of such operations include: detachment of the choroid, small anterior chamber syndrome, hyphema, cicatricial changes in the filtration cushion. Based on the analysis of literature data, it can be assumed that the inclusion of osteopathic correction in the complex therapy of patients with operated glaucoma can increase the effectiveness of therapy.

The aim of the research was to study the clinical efficacy of osteopathic correction in the complex treatment of patients operated on primary open-angle glaucoma.

Materials and methods. The study involved 20 patients (20 eyes) aged 70 to 75 years with developed and advanced stages of primary open-angle glaucoma, who underwent surgical treatment. The main (10 people) and control (10 people) groups were formed by simple randomization. Participants in the main group received standard medical therapy and osteopathic correction, while participants in the control group received only medical therapy. Changes in the following clinical parameters were evaluated: visual acuity, visual fi eld, intraocular pressure, thickness of the retinal nerve fiber layer, and severity of pain syndrome. Indicators were recorded at the beginning of the study (2 weeks after surgery) and at the end of the study (2–3 months after surgery).

Results. Patients receiving osteopathic correction as part of the complex therapy after surgery of primary openangle glaucoma are characterized by a statistically significant (p<0,05) decrease in the severity of pain syndrome, an increase in the magnitude of the visual field and of the thickness of the retinal nerve fiber layer.

Conclusion. The obtained results suggest the effectiveness of the inclusion of osteopathic correction in the complex treatment of patients with operated on primary open-angle glaucoma. It is recommended to continue the study with a larger sample size.

Introduction. The method of kinesio taping (Kenzo Kase, 1973) is actively gaining popularity among various medical specialists. This is due to the safety of the method and its proven effectiveness in certain pathological conditions and functional disorders. There are isolated publications showing the effectiveness of kinesio taping to reduce the manifestations of algomenorrhea.

The aim of the study is to evaluate the effectiveness of using the kinesio taping method for relieving pain in adolescent girls with functional algomenorrhea in a children′s rehabilitation hospital.

Materials and methods. The material for the study was the results of observation of 38 girls aged 13 to 17 years, who were on inpatient treatment in the St. Petersburg Children′s rehabilitation center of orthopedics and traumatology «Ogonyok» and turned to the medical staff for help with painful mēnsēs in order to receive pharmacological correction (taking antispasmodics and/or NSAIDs), as well as with a request to change the rehabilitation program (cancellation of physical therapy or physiotherapy procedures for the period of pain). Based on the experience of Seyda Toprak Celenay and María Isabel Tomás-Rodríguez, in order to influence the severity of algomenorrhea syndrome in patients, kinesio taping of the suprapubic region was performed with a 5 cm wide cotton tape with a light tension in the range of 10–15 %. The intensity of the pain syndrome before and after kinesio taping was evaluated by the patient himself using a modified facial pain Scale [The Faces Pain Scale-Revised (FPS-R) according to Von Baeyer C. L. et al., 2001], and an instrumental assessment of the intensity of pain sensations was additionally performed using a dynamometer-algometer «MEGEON 04300».

Results. The method of kinesio taping allows you to exclude (in 58 % of patients) or reduce (in 16% of patients) the use of pharmacological drugs. The inverse relationship between the subjective assessment of the intensity of pain syndrome by patients and the reduction of pain syndrome was established: that is, the greater the intensity of pain, the less likely the analgesic effect from the use of kinesio tape. The decrease in the pain syndrome of the girls was noted in the period of 1–12 hours (on average 3 hours 51 minutes) from the moment of applying the kinesio tape. Unfortunately, in the remaining 26 % of cases, the kinesiotaping method was not effective.

Conclusion. The kinesiotaping method is justified for use in patients with algomenorrhea and often allows you to exclude or reduce the intake of pharmacological drugs.

The article attempts to systematize the scales, tests and questionnaires that are used in the practice of an osteopathic physician from the standpoint of the «patient′s model». The purpose of the scales using in the practice of an osteopathic physician is to objectify the patient′s diagnosis, assess the dynamics of her/his condition, the therapy results, the ability to demonstrate the treatment results to the patient and the professional community, and maintain continuity in the treatment process. The scales allow an osteopath to assess not only the dynamics of somatic dysfunctions (SD) during the treatment, but also to shift from a qualitative to a quantitative assessment of the patient′s clinical condition. In this case, it becomes possible to draw parallels, to determine the cause-and effect relationship between SD and the patient′s clinical condition.

The survival rate of children who require intensive care for life-threatening diseases or injuries has recently increased significantly. In pediatric intensive care, a decrease in mortality is accompanied by an increase in morbidity. This trend has led to a shift in focus of attention from reducing mortality to optimizing outcomes in critically ill patients. A broader approach and focus on outcome in critically ill survivors has been greatly facilitated by the development of a concept that integrates post-intensive care (PIC) diseases into Post Intensive Care Syndrome (PICS). The concept of PIC syndrome implies the occurrence of disorders in patients after IC in three main areas: mental health, cognitive functions and physical health, and also takes into account the state of the family of surviving patients, in particular, parents, who often have a deterioration in mental health. Diagnosis and treatment of this condition involves the work of a multidisciplinary team, in which it is desirable to include an osteopathic doctor in order to more effectively and timely diagnose and correct reversible functional disorders.

Introduction. Although its neurophysiological effects have not been fully elucidated, current evidence suggests the clinical effectiveness of spinal manipulation. Different studies suggest that manual therapy induces changes in the autonomic nervous system (ANS). Recent studies showed that mobilization produced a sympatheticexcitatory effect. However, studies using thrust manipulation appeared to be less consistent in their results.

Objectives. The main objective of this review was to evaluate whether spinal manipulation induces effects on the ANS. Another objective was to correlate the changes in the measured variables with the activation or inhibition of the sympathetic or parasympathetic nervous system and with the level of spinal manipulation.

Materials and methods. We performed a literature search in the following databases: PubMed, PEDro, CINAHL and OVID, using the keywords «Manipulation, spinal» and «Autonomic Nervous System». The PEDro scale was used to assess the methodological quality.

Results. Nine studies met the inclusion criteria. Six trials measured cardiovascular function indicators (blood pressure, heart rate, Heart Rate Variability). Three other trials measured the pupil reaction. In most studies, cervical or upper thoracic region was manipulated.

Conclusions. Our review does not provide definitive evidence of the effects of spinal manipulation on the ANS. However, most studies observed the existence of autonomic effects by modifying parameters such as blood pressure or Heart Rate Variability after manipulation. Increased parasympathetic activation probably occurs after cervical and lumbar treatment and increased sympathetic activation after dorsal treatment.