The aim is to present for osteopaths the modern ideas about somatic dysfunctions as potentially reversible structural and functional disorders in the human body, and about its diagnostics and the correction possibilities.

A specific subject of osteopathic influence is a group of palpable phenomena, which are called somatic dysfunctions. Somatic dysfunctions are included in the International Classification of Diseases, Injuries and Conditions Affecting Health, 10th Revision (ICD-10). Somatic dysfunction (SD) is a potentially reversible structural and functional disorder in tissues and organs, manifested by palpation-determined limitations of various types of movements and mobility. Reversibility is one of the main characteristics of SD, associated with the ability to obtain the effect of changing/eliminating the identified disorders in response to various methods of osteopathic correction. Impaired mobility, that is, SD, can have several components that can be combined with each other and have different degrees of severity — biomechanical, hydrodynamic (rhythmogenic) and neurodynamic. SD can manifest itself at the global, regional and local levels, and can have an acute or chronic character. The leading role in the pathogenesis of SD formation belongs to the connective tissue. Based on anamnestic data, physical examination, as well as using the algorithm of palpation diagnostic techniques, osteopaths determine the relative position of the body structures and their symmetry, as well as the qualitative state of the tissues. In addition to the generally accepted formulation of the diagnosis, an osteopathic conclusion includes the indication of biomechanical, rhythmogenic and neurodynamic disorders at the global, regional and local levels, as well as the dominant SD, the correction of which will be the logical ultimate goal of the osteopathic session. In accordance with the current regulatory framework, the osteopathic physician at the appointment fills out the form «Primary examination by an osteopathic physician» or the form «Examination by an osteopathic physician (observation in dynamics)». These medical documents are an insert in the Registration Form № 025/u, approved by the order of the Ministry of Health of Russia dated December 15, 2014 № 834n. The restoration of mobility is the goal of osteopathic treatment techniques applying and leads to the normalization of the functional state of tissues. The practice of osteopathy is to release the elements of the musculoskeletal system, internal organs, to restore the proper functioning of all body systems, including the nervous, circulatory and lymphatic systems. In the absence of contraindications (absolute or relative), the treatment regimen is determined individually in accordance with the issued osteopathic conclusion, including the defining of the number, nature (type) of techniques and the sequence of their use in a given session. The effectiveness of osteopathic correction of SD has been proven for various diseases and conditions, a list of which is also presented in the Recommendations.

Conclusion. The implementation of the Clinical Recommendations can contribute to the timely diagnosis and improve the quality of medical care for patients with SD.

Introduction. Many studies have noted negative trends in the state of students′ health in higher education institutions. Consequently, there is a need to monitor the students′ physical health in order to improve the health preserving and strengthening technologies. The concept of somatic dysfunction (SD) is close to the category of pre-disease. It is a borderline condition, in which the functional reserves of the body are depleted, and it cannot be called healthy, but the detectable by routine diagnostic tools organic changes are not determined in such a person. There was not possible to find works in which the level of physical health and osteopathic status were compared.

The aim of the study is to research the physical health level and osteopathic status of the III–IV courses students.

Materials and methods. The cross-sectional study from March to November 2022 involved the 82 III–IV year students from different Universities in Yekaterinburg. 50 of them were women and 32 were men. Inclusion criteria: age 19–21 years, no complaints, no acute diseases, chronic diseases in persistent remission, no pregnancy. So the examined can be called relatively healthy people. Each person was examined once. Students filled out a questionnaire developed by the authors, where they noted the presence of chronic diseases, and the motor activity level. Then they underwent an osteopathic examination according to an approved protocol with a description of the osteopathic status and identification of the dominant somatic dysfunction. After that, there was conducted Introduction. Many studies have noted negative trends in the state of students′ health in higher education institutions. Consequently, there is a need to monitor the students′ physical health in order to improve the health preserving and strengthening technologies. The concept of somatic dysfunction (SD) is close to the category of pre-disease. It is a borderline condition, in which the functional reserves of the body are depleted, and it cannot be called healthy, but the detectable by routine diagnostic tools organic changes are not determined in such a person. There was not possible to find works in which the level of physical health and osteopathic status were compared. The aim of the study is to research the physical health level and osteopathic status of the III–IV courses students.

Materials and methods. The cross-sectional study from March to November 2022 involved the 82 III–IV year students from different Universities in Yekaterinburg. 50 of them were women and 32 were men. Inclusion criteria: age 19–21 years, no complaints, no acute diseases, chronic diseases in persistent remission, no pregnancy. So the examined can be called relatively healthy people. Each person was examined once. Students filled out a questionnaire developed by the authors, where they noted the presence of chronic diseases, and the motor activity level. Then they underwent an osteopathic examination according to an approved protocol with a description of the osteopathic status and identification of the dominant somatic dysfunction. After that, there was conducted the examination with using the G. L. Apanasenko′s express system for assessing the health level. It consists of a number of indicators that are ranked and each rank is assigned by a corresponding score. The overall health score is determined by the sum of points and allows to distribute all the persons into 5 levels of health.

Results. The study of the physical health level among the students showed that there was no high level of health in this group, the level above average was detected in 19,5 % of the examined, the average level was detected in 35,4 %, below average — 28 %, low — 17,1 %. The average level of health in men is higher than in women. Among the examined the 43,9 % had one diagnosis of a chronic disease in the stage of persistent remission. When comparing the examined patients with and without chronic diseases diagnoses, it turned out that the bulk of the studied indicators in these subgroups did not differ (p>0,05). Osteopathic examination showed that 13 people had no SD at all (15,8 %). 18 people (22 %) had one regional biomechanical SD, and one person had global neurodynamic SD. When comparing the subgroups without SD and/or with regional/global SD with the rest of the subjects (in whom only local SD was detected), it turned out that these three subgroups differed statistically significantly in terms of the main indicators of the health level. In the subgroup without SD, there were observed the best indicators of physical health. In the examined subgroups with local and regional/global SD, the resting heart rate and the heart rate recovery time after 20 squats were statistically significantly higher, and the sum of points and the overall assessment of the health level were less (p<0,0001). At the same time, these subgroups did not differ statistically significantly in terms of physical activity. Conclusion. The study showed that the presence of chronic diseases in the stage of persistent remission in young people does not affect the level of health. The presence of local and especially regional SD is associated with decreased health indicators, and a decreased adaptation to physical activity.><0,0001). At the same time, these subgroups did not differ statistically significantly in terms of physical activity.

Conclusion. The study showed that the presence of chronic diseases in the stage of persistent remission in young people does not affect the level of health. The presence of local and especially regional SD is associated with decreased health indicators, and a decreased adaptation to physical activity.

Introduction. The cervical spine from osteopathy point of view, taking into account spine functional division, includes vertebrae of the cervical-thoracic junction, and the approach requires additional coordination. The X-ray examination experience with the entire spine integrity suggests that both cervical vertebrae and vertebrae of cervical-thoracic junction are the place of the greatest age-related changes. The study of gender difference in cervical spine vertebra positions and its age-related dynamics requires additional attention. The purpose of the work: on the basis of digital radiographs to develop an integral indicator for assessing the position of the vertebrae of the middle cervical spine; research objectives: to quantify vertebra positions from CIII–VI; to propose a characteristic of transition smoothness from vertebral CIII–VI group to the vertebral CVII–TIII group; to study the male/female features of age trend in cervical spine shape.

Materials and methods. Radiographs of all spine parts in sagittal plane were examined for 141 patients with dorsopathies (57 males and 84 females). The cohort of patients is divided into 4 groups: I (n=31) — 21–44 years (average age 33,1 years); II (n=39) — 45–59 years (average age 52,6 years); III (n=50) — 60–74 years (average age 66,8 years); IV (n=21) — 75–88 years (average age 81,1 years). A single digital X-ray spine image in sagittal plane was obtained for each patient. On the combined digital radiograph, the occipital vertical was drawn along all spine parts, starting from the external tubercle of occipital bone, and anteroposterior axes for CIII–TIII vertebrae (r axes) were drawn. The angles between the occipital vertical and the perpendiculars restored to the axes at the points of their intersection with the occipital vertical were measured. Statistical processing of the data obtained was carried out.

Results. The St integral indicator has been developed to quantify the vertebra position of middle cervical spine. It was calculated by formula St = (rCIII+rCIV+rCV +rCVI)/4. Using St the type boundaries are determined, and four displacement types for the cervical vertebra group (from CIII–VI) are identified: I — low start; II — medium start; III — high start; IV — ultra-high start. An age-related trend of changes in CIII–VI vertebra position was detected. The correlation between the position indicator St of the middle cervical vertebrae and indicator ArCT for the vertebrae of cervical-thoracic junction CVII–TIII was proved. Gender differences depending on age were revealed in transition smoothness between these spine parts.

Conclusion. Some arguments have been obtained confirming the validity of attributing the vertebra group of cervical-thoracic junction from CVII to TIII to the functional unity of cervical spine. Quantitative smoothness assessment of transition from the middle cervical spine to the vertebra group of cervical-thoracic junction can be carried out by calculating the difference between the ArCT and St indicators. The difference demonstrates age-related shape features of the spine part for males and females.

Introduction. Connective tissue dysplasia (СTD) is a group of polymorphic pathological conditions caused by hereditary or congenital defects in collagen synthesis and accompanied by a violation of the functions of the musculoskeletal system and internal organs, which is considered as a factor in the development of pathology of the maxillofacial region in children: dystrophic forms of periodontal diseases; anomalies of shape, size, teething; pathology of the temporomandibularthe mandibular joint. There are difficulties in determining the pathogenetic relationship between CTD and individual nosological forms of dental diseases, which is important for determining the prognosis of their course and the choice of methods of rehabilitation of children. It is important to improve the methodology of preventive examinations in relation to the early detection of phenotypic signs of CTD, including in the maxillofacial region. Substantiation of the connection of CTD with dental diseases will make it possible to develop examination and medical examination schemes, increase the effectiveness of comprehensive prevention of dental diseases and rehabilitation of adolescents with combined pathology.

The aim is to study the incidence of CTD in adolescents and its relationship with dental diseases in order to develop a scheme of examinations and medical examinations, increase the effectiveness of comprehensive prevention of dental diseases and rehabilitation of adolescents with combined pathology.

Materials and methods. A survey of 140 male adolescents aged 15–18 years, students of schools in Smolensk was conducted. When examining the somatic status, generally accepted markers of CTD were taken into account: bone (asthenic type of constitution, scoliotic deformity of the spine, hallux valgus, chest deformities), skin (increased skin extensibility of more than 3 cm), articular (hypermobility of joints) and visceral (changes from the cardiovascular system — prolapses of the heart valves, abnormally located chords; changes from the respiratory organs — polycystic lung disease, trachiobronchial dyskinesia; changes from the urinary system — nephroptosis, kidney doubling; changes from the gastrointestinal tract — visceroptosis, gallbladder anomaly; changes from the blood system — thrombocytopathy, hemoglobinopathy). When examining the dental status, the following generally accepted markers of CTD were taken into account: malocclusion (prognathia, deep bite, their combination), narrowing of the dentition, anomalies of the position of individual teeth, anomalies of soft tissue attachment, gum recession, chronic gingivitis. The diagnosis of CTD and the health group was established by a pediatrician on the basis of clinical recommendations and the order of the Ministry of Health of the Russian Federation № 621 dated 30.12.2003 «On a comprehensive assessment of the health status of children». Factor analysis was used to form a set of signs combining signs of CTD and dental diseases.

Results. Of the phenotypic signs of СTD, bone and joint changes were diagnosed in 79,3 % (95 % CI 72,6– 86) of adolescents. In second place in frequency 35 % (95 % CI 27,1–42,9) were signs of СTD of the cardiovascular system and the organ of vision (myopia). 40 % (95 % CI 31,9–48,1) of the examined adolescents were diagnosed with chronic gingivitis, gum recession. Deep bite and prognathia were more common than other malocclusions: in 40,7 % (95 % CI 32,6–48,9) and 17,1 % (95 % CI 10,9–23,4), respectively. The use of factor analysis allowed us to identify four most informative factors (the first of them is the most significant) to characterize the relationship between the signs of CTD and its dental manifestations.

Conclusion. The incidence of CTD in males in the age group of 15–18 years is 43 %. The most informative prognostic factor was the relationship of tracheobronchial dyskinesia with prognathia, deep bite, narrowing of the jaws, generalized gingivitis. The interrelation of signs of СTD of the cardiovascular system and bone-joint changes with gum recession, chronic gingivitis, prognathia and deep bite was also revealed.

Introduction. Currently, there is a trend towards an increase in the number of elderly people all over the world. The increase in life expectancy is caused by medical and scientific progress and by the quality of the social security service. However disability, illness, weakening of family and social ties, decreased capacity in almost all areas, make the lives of elderly people bleak. Therefore, the search of new developments for improving the life quality of this people category remains actual. Osteopathic treatment can be one of the non-drug, sanogenic methods.

The aim of the study is to investigate the impact of general osteopathic treatment in life quality of elderly people.

Materials and methods. The study was conducted at the Clinic of the Eurasian Institute of Osteopathic Medicine from January to May 2021. There were examined 30 people over the age of 60. The studied patients were divided into 2 groups of 15 people. The main group received general osteopathic treatment for 3 weeks with a frequency of once every 7 days. The control group received a complex of physical therapy for 3 weeks, for 30 minutes daily. All patients of both groups underwent an osteopathic examination before and after the study with the formation of an osteopathic conclusion, the life quality indicators were evaluated, and saturation was measured.

Results. During the general osteopathic treatment in the elderly patients of the main group, there was detected a decrease in the number of regional and local somatic dysfunctions. Reliably significant changes were found in the life quality indicators according to the SF-36 questionnaire, as well as in the saturation of arterial blood hemoglobin by oxygen (according to the results of pulse oximetry). Among patients of the control group, there were detected significantly less significant changes in these indicators.

Conclusion. General osteopathic treatment can improve individual indicators of the life quality of elderly people, reduce the number of somatic dysfunctions, and increase blood oxygenation.

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.

Introduction. The main tool of the osteopathic physician, which carries out most of the diagnostic and therapeutic actions, is the hands. To conduct scientifi c research in osteopathy, it is necessary to understand the nature of the impact and its quantitative characteristics, in particular, the pressure force of the physician′s hands on the patient′s body. In the available literature, it was possible to fi nd single instrumental studies of the pressure force of the osteopath′s hands during performing cranial techniques. Similar studies about the performance of other techniques could not be found in the available literature.

Aims: to measure by an instrumental method the pressure force of the osteopath hands during various osteopathic techniques (cranial, visceral, structural).

Materials and methods. The study was conducted on the basis of the Mokhov Institute of Osteopathy Clinic in January 2023. The study involved 6 lecturers of the Institute of Osteopathy (St. Petersburg), their experience as an osteopath is at least 5 years; the age is from 33 to 53 years. As patients, the residents of the Osteopathy Department of Mechnikov North-West Medical State University were involved. There were 2 men and 4 women, aged from 24 to 26 years, with a normosthenic constitution and a body mass index from 19,5 to 24. The following devices were used to measure the pressure strength of the osteopathic physician′s hands: Fsr402 resistive pressure sensors (Arduino Italy) and A402 (Tekscan USA), FlexiForce Prototyping Kit with FlexiForce MicroView software (Tekscan USA), and a device for determining skin elasticity and human skin scars (strain gauge attached to a caliper, Patent RU 2763 843 C1). Each physician demonstrated several osteopathic techniques on one patient. During the execution of each technique, three measurements were made, and the arithmetic mean was calculated. Structural, visceral and cranial techniques of osteopathic correction were performed.

Results. The Friedman test showed a statistically signifi cant difference in pressure strength for different techniques (p<0,01). The greatest pressure force was measured during the mobilization of the descending colon (3,6±0,3 Newton); the minimum force was measured during the mobilization of the thoracic spine in the extension (1,5±0,3 Newton). When performing each technique, there was a range (the difference between the minimum and maximum values) between physicians from 0,95 Newton for performing a frontal bone lift to 1,8 Newton for mobilizing the sigmoid colon. Conclusion. The pilot study showed that during performing different techniques, the pressure strength of the osteopathic physician′s hands differed signifi cantly. It is advisable to continue the study on a more representative sample.> <0,01). The greatest pressure force was measured during the mobilization of the descending colon (3,6±0,3 Newton); the minimum force was measured during the mobilization of the thoracic spine in the extension (1,5±0,3 Newton). When performing each technique, there was a range (the difference between the minimum and maximum values) between physicians from 0,95 Newton for performing a frontal bone lift to 1,8 Newton for mobilizing the sigmoid colon.

Conclusion. The pilot study showed that during performing different techniques, the pressure strength of the osteopathic physician′s hands differed signifi cantly. It is advisable to continue the study on a more representative sample.

Introduction. Attention deficit hyperactivity disorder (ADHD) is diagnosed in childhood and is the most common mental disorder in children — about 5–7 % among school-age children. None of the treatment methods, as clinical observations showed, is completely effective for the treatment of ADHD. In most cases, the main method of treatment is pharmacotherapy. But despite the proven short-term effectiveness, pharmacotherapy may have limitations: partial response or no response, side effects, questionable long-term benefits, poor adherence to the treatment regimen, negative attitude of parents. Limitations of existing pharmacological treatment methods emphasize the need to develop effective non-pharmacological interventions that improve short- and long-term results in regard to neuropsychological deficiency symptoms and disorders of other general activity fields. Currently, there are publications noting the positive clinical effect of osteopathic correction on the children′s health state in various mental sphere disorders. But only a few studies are aimed at studying the effect of osteopathic correction in ADHD. At the same time, there are no publications about the osteopathic correction use in the ADHD treatment without pharmacotherapy.

The aim of the study is to investigate the possibility of osteopathic correction using for the treatment of children with attention deficit hyperactivity disorder.

Materials and methods. The study was conducted on the basis of the medical organization «Health′ Clinic» Tver from March 2021 to February 2022. Inclusion criteria: children age 7–10 years; established ADHD diagnosis; absence of diseases and conditions that are an absolute contraindication for osteopathic correction; parental consent to osteopathic examination and correction. Criteria for non-inclusion: age of children younger than 7 and older than 10 years; not confirmation of the diagnosis according to the «ADHD Assessment Scale — ICD-10 criteria»; the presence of diseases and conditions that are an absolute contraindication for osteopathic correction. Exclusion criteria: failure to attend repeated examinations. The total number of children was 38 people. The patients were distributed by randomization envelopes into 2 groups of 19 people each. The main group: the osteopathic correction and the behavioral psychotherapy were used. The comparison group: the drug hopanthenic acid and the behavioral psychotherapy were used. Before and after the treatment, osteopathic status was assessed in both groups, and the severity of ADHD was assessed according to the ADHD assessment scale (ICD-10 criteria), and an attention test was conducted in the form of a Bourdon correction test.

Results. At the beginning of the study, the patients were characterized by regional biomechanical disorders of the head region — in 100 % of participants in both groups, as well as the neck (structural component) — in 63 % of participants in both groups, and the dura mater — in 89 % of participants in the comparison group and 79 % of the main group. After the course of treatment, a significant (p<0,05) positive dynamics was observed in the main group according to the three above indicators, and there was no significant dynamics in the comparison group. After the treatment, the statistically significant (p<0,05) positive dynamics was observed in both groups with respect to the severity of ADHD and the main characteristics of attention: the indicators of the ADHD assessment scale (ICD-10 criteria) decreased, the accuracy coefficients and concentration of attention increased, and the fatigue index decreased. At the same time, in the main group, the fatigue index decrease was statistically significant (p<0,05) more pronounced than in the comparison group.

Conclusion. The obtained results allow us to recommend osteopathic correction in the treatment of children with ADHD, especially in the cases where, for some reasons, there are restrictions on the medications use.