Introduction. The new coronavirus infection (COVID-19) pandemic has affected the lives of many people. Any infectious and infl ammatory process in the lungs can lead to adverse consequences for the whole organism. The pathological process affecting the respiratory structures of the lungs, bronchi leads to disruption of various links of the external respiration system; therefore, timely effective rehabilitation for such patients can improve the quality of life, reduce the period of temporary disability, and most importantly, restore the function of external respiration.
The aim was to prove the effectiveness of the osteopathic methods application in the rehabilitation of patients after coronavirus pneumonia.
Materials and methods. On the basis of the Primorsky Institute of Vertebroneurology and Manual Medicine (Vladivostok) the rehabilitation of patients with coronavirus pneumonia was carried out using osteopathic methods. 63 patients after suffering from coronavirus pneumonia were randomly divided into 2 groups comparable in terms of clinical and functional characteristics. The fi rst group (main) consisted of 34 people (average age 65.5±1.5 years), of which 44.1 % were men and 55.9 % were women. Group 2 (control) included 28 patients (mean age 64.1±1.6 years), of which 32.1 % were men and 67.9 % were women. To assess the function of external respiration, spirometry was performed and the main indicators of the vital capacity of the lungs were assessed (vital capacity — VC, and FVC — forced vital capacity). To measure the saturation of hemoglobin in arterial blood with oxygen (SpO₂), pulse oximetry was performed. Rehabilitation included in the main group osteopathic correction (2 procedures), breathing exercises (4 procedures) and chest massage (4 procedures); in the control group there were breathing exercises (4 procedures) and chest massage (4 procedures). The rehabilitation course lasted 14 days. For the statistical analysis of the obtained data the Statistica-10 software package was used.
Results. The studies revealed a pronounced change in the function of external respiration in patients who had undergone coronavirus pneumonia. According to the results of spirometry, more than 90 % of patients showed a statistically signifi cant (p=0.006) decrease in VC compared to the physiological norm — both in the main group (VC down to 80.7 %) and in the control group (VC down to 87.6 %), as well as a signifi cant (p=0.0001) decrease in FVC to 77.7 % in the main group and to 79.1 % in the control group. After rehabilitation, patients in the main group showed a statistically signifi cant improvement in the function of external respiration, manifested in an increase in VC by 12.3 % (p<0.0001), FVC by 12.1 %. In patients in the control group (without osteopathic correction), after the rehabilitation, the main indicators of the function of external respiration also improved, but the changes were not statistically signifi cant. As a result of rehabilitation, the patients of the main group showed a statistically signifi cant SpO₂ increasing (from 96.6±0.2 to 97.5±0.2 %, p=0.0013); in the control group, there was also a positive dynamics of these indicators, but the changes were not statistically signifi cant.
Conclusion. The results of the study allow to conclude that the inclusion of osteopathic correction methods in the rehabilitation of patients after coronavirus pneumonia has a positive effect on their state, improves the external respiration function indicators — VC and FVC, and also increases the SpO₂. The obtained results allow to recommend the inclusion of osteopathic methods in the rehabilitation programs for patients who have undergone coronavirus infection.

Introduction. Scoliosis is a symptom of scoliotic disease, which is a polyetiological disease characterized by a certain symptom complex of morphological and functional changes in the spine, chest and internal organs. The greatest detectability of the disease occurs at the age of 8–13, during the period of the intensive skeleton growth, and during this period the most dangerous feature of scoliosis manifests itself — its steady and rapid progression in every 3–4th child. Despite the successful development of orthopedics, the treatment of scoliotic disease still remains a rather difficult problem. Osteopathic correction can potentially complement existing treatment schemes and increase their effectiveness.
The aim of the study is to substantiate the possibility of osteopathic correction in the treatment of pediatric patients with grade I idiopathic scoliosis.
Materials and methods. A prospective randomized controlled trial enrolled 50 patients aged 4 to 11 years with grade I idiopathic scoliosis. The study participants were divided into two groups by simple randomization. The control group participants received standard orthopedic treatment, and the main group participants received osteopathic correction. The osteopathic status and the degree of spinal curvature were assessed at the beginning and at the end of the study.
Results. Osteopathic correction of pediatric patients with grade I idiopathic scoliosis is accompanied by a decrease in the number of regional and local somatic dysfunctions and the frequency of detection of regional biomechanical disorders (p<0,05). The decrease of these indicators is more pronounced than in patients receiving standard orthopedic treatment (p<0,05). At the end of the treatment, there was a decrease in the Cobb angle in patients receiving osteopathic correction (from 7,3±0,8 to 4,2±0,8 degrees; M±m, p<0,05), and an increase of this indicator in patients who received standard therapy (from 7,0±0,7 to 9,1±1,4 degrees; M±m, p<0,05).
Conclusion. The obtained results make it possible to consider the possibility of recommending of osteopathic correction for childhood patients with grade I idiopathic scoliosis.

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, finger-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.

Introduction. The syndrome of undifferentiated connective tissue dysplasia (UCTD) combines a group of diseases that is heterogeneous in origin and polymorphic in clinical manifestations. UCTD is characterized by joint hypermobility and pain in the joints and back. In the last decade, osteopathic methods for the diagnosis and correction of dorsalgia and joint mobility disorders, including UCTD, have become widespread. However, the results of osteopathic correction in children and adolescents with undifferentiated dysplasia have not yet been fully investigated.
The aim of the study was to research the results of osteopathic correction in children and adolescents with the syndrome of undifferentiated connective tissue dysplasia.
Materials and methods. The study involved 48 children and adolescents aged 10 to 18 years. A study group and a control group were formed by the simple randomization method. Each group consisted of 24 participants: 5 boys and 19 girls in the main group; 7 boys and 17 girls in the control. The participants of the main group received osteopathic correction. The participants in the control group received drug therapy and lifestyle correction. In both groups, osteopathic status, intensity of pain syndrome, functioning of the autonomic nervous system (the predominance of sympathetic or parasympathetic influences on the cardiovascular system), the level of depression and anxiety were assessed before and after the treatment.
Results. Osteopathic correction in children and adolescents with UCTD was accompanied by a statistically significant (p<0,05) decrease in the detection frequency of regional somatic dysfunctions of the head, neck, thoracic region, and pelvis. There was also a statistically significant (p<0,05) decrease in the intensity of pain syndrome, normalization of the functioning of the autonomic nervous system, which manifested in the achievement of a state of autonomic balance, assessed by the Kerdo index, a decrease in the level of depression and anxiety. Standard treatment, including drug therapy and lifestyle correction, was accompanied by the normalization of the functioning of the autonomic nervous system and a decrease in the level of depression. However, osteopathic correction led to statistically significantly more pronounced results for these indicators compared to the results of standard treatment.
Conclusion. The obtained results make it possible to consider the possibility of including osteopathic correction in the complex treatment of children and adolescents suffering from undifferentiated connective tissue dysplasia, since it have a positive effect on the course of the main disease. It is advisable to conduct a study on a larger sample of patients with subsequent follow-up assessment.

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 C_0-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.

Introduction. Pathology of the temporomandibular joints (TMJ) is widespread even among young people, and the frequency of its occurrence increases with the age of patients. In this case, there is violated one of the main characteristics of the joints — mobility, which is measured by the mouth opening width (MOW). There is not enough information in the literature on the age and sex characteristics of the TMJ mobility in individuals without pathology of this joint.
The aim of the study is to research the mobility of the TMJ in different age groups in men and women without pathology of this joint.
Materials and methods. There were examined 714 patients who applied for dental care, aged 20 to 79 years (504 women and 210 men), without pathology of the TMJ. The range of motion in the TMJ was measured using a caliper with thin lips during the opening of the mouth in a neutral head position. The subjects were divided into age groups: 20–29, 30–39, 40–49, 50–59, 60–69 and 70–79 years old.
Results. It was found that the most common MOW value was 4,9 cm (range from 4,5 to 5,2 cm). A distribution of relative frequencies corresponding to the normal Gaussian distribution was observed for this indicator. The mobility of the TMJ changed little with age. Analysis of the distribution of temporomandibular joint mobility by age groups of patients with a step of 10 years showed the similarity of the average MOW values in all groups of subjects, except for the group of 20–29 years. Their average values (4,75 cm) were lower than those of the other groups (4,9 cm, p<0,05). It was found that men have a higher mobility of the TMJ compared to women in all age groups (on average by 0,28 cm, p<0,05).
Conclusion. Mouth opening widths of 4,6 to 5,2 cm (average 4,9 cm) can be considered as normal. TMJ mobility is not related to age. Consequently, a decrease in the mobility of the TMJ in persons of older age groups cannot be considered as normal age-related changes. TMJ mobility depends on sex. Men have higher TMJ mobility than women in all age groups. Thus, the TMJ differ from other joints not only in their complexity (two joints always work together), but also in age and sex patterns of mobility.

Introduction. Motivational factors are determinants of well-being and quality of life in professional activity. Motivation of medical workers is mainly determined by such factors as the possibility of self-realization, achievement of respect and interest in the content of work.
The aim to assess the motives of professional activity of future osteopathic physicians.
Materials and methods. A questionnaire was administered to 62 physicians of various specialties during their first year of study according to the Educational Program for Additional Professional Education of Professional Retraining for 3 504 hours in the specialty «Osteopathy» at the Institute of Osteopathy (Moscow). The average age of those surveyed was about 37,8±7,4 years, of whom 27 individuals were male and 35 — female. And they were split into two age groups: 38 people under 40 years old and 24 people over 40 years old. All surveyed people were also divided into two groups according to their medical specialty: therapists (42 people) and surgeons (20 people). We also formed two groups based on the place of residence: those from Moscow and St. Petersburg (33 people) and those arriving from other regions (29 people). Motivational interviewing was performed using a software psychodiagnostic complex APC Multipsychometer. The «Motivational Profile» psychological questionnaire was used to assess professionally significant motives of professional activity. The assessed indicators were: money, career, relationships with management, relationships with colleagues, intrinsic (inner) motivation, recognition, success, responsibility and interesting work. Mathematical processing of the obtained research materials was carried out on a PC using Statistica 6.0 application software packages. In psychophysiology, it is generally accepted to translate «raw» grades (scores) into standard «sten» (sn) grades using tables. Linear conversion of «raw» scores into standardized scales (stens) was carried out using Statistica 6.0 and Excel.
Results. The highest values of the indicators were noted on the scales of interesting work and intrinsic motivation (over 7 sn). Success and responsibility scales also showed high values (6,3–6,8 sn). The career and relations with management values (4,3 sn) were below the average alongside with the relations with colleagues scales (3,6 sn). The results of factor analysis showed that in 68,4 % cases the linear combination of initial attributes of surveyed doctors was determined by 3 main factors: responsibility (35,2 %), attitude to recognition and career (17 %) and the level of relationships with colleagues (16,2 %). Responsibility for professional performance was more pronounced for men (19,3 %; p<0,03) than for women. For women, however, the motif of relations with colleagues had greater value by 28,1 % (p<0,03). In the age group up to 40 years old, the values of the career indicator were greater by 33,3 % (p<0,05), compared to those aged 41 and over, where the expression of the management relation motif was 25,6 % greater (p<0,05). The correlation of expression of professional motives with the region of doctors′ residence has been revealed. The money motive was 20,4 % higher for those living in peripheral regions of Russia (Altai, Siberia, Ural, South of Russia) in comparison with those living in Moscow and St. Petersburg. It was also found that doctors with up to 20 years of medical experience had a greater importance of motives regarding career and responsibility (43,3 %; p<0,05) than those with more than 20 years of experience (36,2 %; p<0,05). The importance of money as a motive was 24 % greater (p<0,05) if the duration of work experience was 20 years or more. The comparative characteristic of the indicators of motives in connection with the medical specialty (therapeutic, surgical) before admission to study did not reveal any significant differences.
Conclusion. There has been established leading role of internal motivation and high responsibility factors, not related to monetary reward. The indicators varied depending on the gender, length of service and the region of residence of the doctors.

Introduction. In the vast majority of sports, joint mobility is a necessary basis for effective technical self-improvement. Insufficient mobility of joints sharply complicates and slows down the process of motor skills mastering, and some of it (mainly the key components of an effective technique for performing competitive exercises) cannot be mastered.
Aim of the study is to reveal the features of the active and passive mobility of extremities joints in skiers and skaters athletes.
Materials and methods. The study involved 46 athletes, including 27 skiers and 19 skaters. The inclusion criteria for the study were: age 18–24 years; lack of complaints from the musculoskeletal system; experience of constant sports activities for at least 2 years; absence of competitive practice during the research period. The protocol for the study of the joint mobility included 5 types of active and passive movements, the values of which were expressed in angular degrees: flexion and extension in the wrist joint, flexion in the knee joint, plantar flexion and dorsal extension in the ankle joint. The range of motion (both active and passive) in the joints was measured in both limbs using a goniometer.
Results. In all the examined joints of all studied subjects, the volume of passive movements statistically significantly exceeded the volume of active ones (p<0,05). Among athletes-skiers, the greatest differences were observed in the ankle joint during dorsal extension (29,4 %), and the smallest — in the knee joint (14,1 %). In the group of skaters, the smallest difference between passive and active mobility was recorded in the ankle joints — with plantar flexion (8,1 %). The maximum differences in passive and active performance of movements were found in the wrist joint — in flexion (29,4 %). Correlation analysis according to Spearman showed strong and moderate negative associations between active mobility and differences in active and passive movements.
Conclusion. The amount of passive mobility in the joints always exceeds the amplitude of active movements. This creates the prerequisites for the development of active mobility at the expense of the reserve. This reserve in each joint has its own value and decreases with increased load on the joint, therefore, for different sports, the indicators of the reserve of mobility in the same joints differ due to the movements stereotyped for each sport. The maximum difference in active and passive movements is in the joints with the least load in the training process of athletes of a certain specialization. A decrease in the reserve of mobility increases the risk of injury and disrupts the athlete′s work capacity. Accordingly, the knee joints are the most vulnerable in skiers, and the ankle joints in skaters.

Recently, there has been a significant improvement in the methods of diagnosis and treatment of myofascial pain syndrome. The continuing high frequency of occurrence of this pathological condition against the background of numerous scientific studies in the field of its diagnosis, treatment and prevention testifies to the significant scientific and practical relevance of this problem at the present time, and the predominant use of pharmacotherapy, which often entails side effects, significant financial costs against the background of its comparatively low effectiveness, actualizes the use of non-drug methods of influence.

The article provides an overview of instrumental methods and technical means allowing to evaluate some of the proven effects of osteopathic correction, such as an increase in the range of motion in the joints, normalization of muscle tone, postural balance and walking, anti-inflammatory effect and improvement of blood circulation in patients with amputation defects of the lower extremities. The article provides an overview of instrumental methods and technical means used for diagnostic purposes in the rehabilitation of patients with amputation defects of the lower extremities. The possibility of it to verify some of the osteopathic correction effects, such as an increase in the range of motion in the joints, normalization of muscle tone, postural balance and walking, anti-inflammatory effect, and improvement of blood circulation, has been evaluated.
Purpose — to present instrumental methods applicable to assess the results of osteopathic correction in the rehabilitation process of patients with amputation defects of the lower extremities.

The use of the disjunction by dentists, to solve the problem of narrow palate, allows to maintain flexible tissues and permeable sutures. The opening of the palatal suture by means of the dental disjunction confers greater freedom of movement to the upper jaw and the palatine but given the close relationship of this bones with the vomer, the ethmoid and even the spheno-basilar synchondrosis, it is hypothesized that osteopathy could contribute not only to accelerate the process of disjunction, but also to avoid the recurrences of it. The maneuvers proposed here take into consideration the cranial structures that are in direct relation with the bony palate.
The aim is to analyze whether the osteopathic maneuver of the balancing of the spheno-basilar synchondrosis and the front-ethmoidal separation influence the angle of the sella turcica, the joint angle and the distance between the central fossae in children with narrow palate who use a disjunction.
A controlled, randomized, longitudinal and double-blind clinical trial was conducted; with experimental group and control group and two external evaluators. Measurements have been made prior to treatment, and after 45. It was shown that the two osteopathic maneuvers used were sufficient to cause significant increases in the angle of the sella turcica and the joint, and the distance between fossa and fossa of the first permanent molars. Osteopathic interventions were performed before placing the circuit breaker, 15 days and 35 days later.