Introduction. Dorsopathy and associated pain and neurological syndromes are among the most common diseases of the musculoskeletal system and connective tissue throughout the world. The characteristic features of these states are high prevalence (at the level of a pandemic), often resistance to treatment, as well as persistent disability, often leading to disability of the patient. The frequency of back pain syndromes (dorsopathies) in the population is very high (58–84 %), and the socio-economic losses are enormous. Thus, the search for new methods and schemes of therapy, as well as the prevention of dorsopathies, is still relevant and actual. Osteopathy in the Russian Federation is a young and dynamically developing medical specialty. Somatic dysfunctions are the main object of osteopathic infl uence. So the analysis of the somatic dysfunctions prevalence both in practically healthy people and suffering from various diseases is of great interest. The analysis of the osteopathic status in patients with dorsopathy will potentially help to expand the understanding of the etiopathogenesis of the disease, to develop relevant prevention and treatment regimens. All this predetermined the purpose of the present study.
The aim of the study was to make the most common somatic dysfunctions map based on the data of the assessment of the osteopathic status of patients with dorsopathy at the cervical level.
Materials and methods. A cross-sectional study was conducted at the Mokhov Institute of Osteopathy LLC medical clinic (St. Petersburg) from September 2018 to September 2022. The 462 patients with a dorsopathy diagnosis aged from 18 to 44 years were under observation. All patients underwent an assessment of osteopathic status in accordance with the clinical guidelines.
Results. There were detected somatic dysfunctions of all three levels of manifestation in the examined patients with dorsopathy. The dysfunctions of the regional (thoracic region, structural and visceral components; pelvic region, structural and visceral components, neck region, structural component) and local (visceral dysfunctions, dysfunctions of individual PDS at different levels, skull sutures) levels were the most characteristic. The analysis of the dominant dysfunctions structure showed that in 16 % of patients the dominant ones were global, in 72 % — regional, and in 12 % — local somatic dysfunctions.
Conclusion. In the work, it was possible to analyze the structure of somatic dysfunctions in young patients with dorsopathy at the cervical level. It is advisable to continue the study in order to identify possible relationships between the diagnosed somatic dysfunctions and other objective and subjective manifestations of dorsopathy.

Introduction. The realization of the whole variety of spine motor activity cannot be explained from the standpoint of the gravitational concept only. A reliable explanation of spine functioning is possible in the frame of tensegrity model. However, evidence for all components of the spine tensegrity model has not yet been provided. There is no description of the most stable spine zone and its center localization. In spine tensegrity model the stability center also plays the role of compression center.
The purpose of the work — to determine the localization of spine zone, with the least angular variability for vertebrae, that is, the most stable spine zone.
Materials and methods. Digital spine radiographs of 141 patients aged from 21 to 88 years (57 male and 84 female) applied for dorsopathies were randomly selected. The inclusion criteria in the study cohort were the availability of digital radiographs for all spine parts made simultaneously in accordance with required radiography standards. The exclusion criteria were gross violations of spinal statics in the scoliosis form of the III–IV degree due to congenital anomalies in vertebral development. On the basis of the available spine radiographs, general digital radiological images were formed models of entire spine in sagittal projection for each patient. Then for each of 141 general images the occipital vertical and anteroposterior axes of the rC_III rL_V (rL_VI) vertebrae were drawn. The perpendicular was restored from intersection point of each r axis with the occipital vertical, and the angle between occipital vertical and the perpendicular was measured. The measured angles characterized the angular position of each vertebra relative to occipital vertical.
Results. When studying the average values of anteroposterior axis angles r and their average deviations, it was found that minimal variations in angular position of vertebrae was located at zone of T_XI and T_XII vertebrae. A study of variation range of anteroposterior axis angles r showed that the minimum values were determined for the vertebrae T_XI, T_XII and L_I . It was found that apex of physiological thoracic kyphosis as well as apex of lumbar lordosis was never detected at the level of T_XI and T_XII vertebrae.
Conclusion. The study showed that there was a zone in the spine, with minimal changes of vertebra angular positions throughout life. The center of the zone was located at the junction of T_XI and T_XII vertebrae. This zone has a special anatomical structure, refl ecting the mechanisms of spine self-stabilization, ensuring the stability of physiological curvature in thoracolumbar junction. The presence of such a zone proves the functioning of a spine tensegrity model, with the center of stability located between T_XI and T_XII vertebrae.

Background. Visual Analog Scale Foot and Ankle (VAS FA) is a valid tool for the assessment of functional status in foot and ancle-related patients.
Aim — validation of Russian-language version of Visual Analog Scale Foot and Ankle (VAS FA).
Materials and methods. Reliability, validity and sensitivity of Russian-language version of the VAS FA were assessed in 60 foot and ancle-related patients. The reliability was checked by assessing the internal consistency (calculating Cronbach′s alpha). The reproducibility was checked by a test-retest analysis. The criterion validity was evaluated by correlation analysis with SF-36, FFI and AOFAS scores. The sensitivity was studied by comparing VAS FA score dynamics after conservative treatment with minimal important change VAS FA.
Results. Evaluating the internal consistency yielded a very high Cronbach′s alpha (0,92). The test-retest analysis demonstrated a signifi cant correlation (0,95) between the results of primary and secondary testing. Assessing the criterion validity showed a high relationship to the scores of SF-36 (0,77), FFI (0,86) and AOFAS (0,81). In patients who noted an improvement after conservative treatment the positive change of the VAS FA score exceeded 2–2,3 times the minimal important change VAS FA.
Conclusion. Russian-language version of VAS FA is a reliable, valid and sensitive tool to evaluate the functional status in foot and ancle-related patients and it can be used in Russian-speaking patients.

Introduction. Gastroesophageal refl ux disease (GERD) is a chronic relapsing disease characterized by regularly repeated refl ux of gastric and, in some cases, duodenal contents into the esophagus. The urgency of the GERD problem is due to the widespread prevalence of this disease, a signifi cant decrease in the life quality and working capacity of patients, and it leads to signifi cant material losses and increases the risk of complications with long-term use of proton pump inhibitors. There is evidence of the effectiveness of osteopathic correction as a non-drug method as part of the complex treatment of non-erosive GERD. However, taking into considertion the potential risk of complications (osteoporosis and fractures, vitamin B12 and iron defi ciency, dementia, hypomagnesemia, impaired renal function, infectious complications, neoplasms, cardiovascular complications) caused by the use of the drugs′ treatment of GERD, it is in demand to search for evidence of the effectiveness of osteopathic correction as monotherapy for non-erosive GERD.
The aim of the study was to investigate the possibility of using osteopathic correction as a monotherapy for the treatment of patients with non-erosive GERD.
Materials and methods. The study involved 26 patients with non-erosive form of GERD. The age of patients was from 22 to 50 years old. Using the method of randomization envelopes, the two groups were formed (control and main). There were 13 patients (4 females and 9 males) in each group. All the study participants were prescribed a correction of the diet and regime of work and rest. Participants in the control group received basic drug therapy according to the Guidelines of the Russian Gastroenterological Association for the diagnosis and treatment of GERD. The dosage and duration were selected individually depending on the clinical manifestations and their duration. Participants of the main group received a course of osteopathic correction (2 sessions with an interval of 12–14 days). All participants underwent an esophagogastroduodenoscopy (EGD) examination at the start of the study. Before and after the treatment in both groups, the severity of GERD symptoms was assessed using the GerdQ questionnaire, as well as osteopathic status was estimated. In addition, we studied the relationship between the structure of dominant somatic dysfunctions (SD) and some indicators of the state of the esophagus and stomach, measured as part of an EGD examination: the cardia of the esophagus and stomach (closes, closes incompletely), transcardial migration of the stomach folds during calm breathing (yes, no), Hiss angle (acute, smoothed), the arch of the stomach during calm breathing (shifts, shifts to a limited extent), the shape of the arch of the stomach (normal, fl attened), the contents of the stomach (usual, with an admixture of bile).
Results. The use of an osteopathic correction course for patients with a non-erosive form of GERD is accompanied by a statistically signifi cant (p<0,05) decrease in the severity of symptoms of the disease, assessed by the GerdQ questionnaire. The achieved indicators (the severity of symptoms of the disease, assessed using the GerdQ questionnaire) do not statistically signifi cantly differ from those achieved using standard drug therapy. The course of osteopathic correction is accompanied by a statistically signifi cant (p<0,05) decrease in the severity of biomechanical disorders of the thoracic region. A signifi cant correlation was established between the presence of dominant SD in the thoracic region and the presence of some features of the esophagus and stomach state (incomplete closure of the cardia of the esophagus and stomach, transcardial migration of the stomach folds during quiet breathing, a fl attened Hiss angle, a limited displacement of the gastric fornix during quiet breathing, a fl attened shape of the gastric fornix).
Conclusion. The obtained results allow to consider the possibility of using osteopathic correction as a monotherapy for patients with non-erosive GERD. However, it is recommended to continue research in this direction on a larger sample size and using instrumental methods of examination in dynamics.

The article traces the history of the origin, formation of osteopathy and its official recognition in the world, including Russia. There are highlighted the specific features of osteopathy, making possible to consider it as an independent direction of modern official medicine, as well as to review the differences between osteopathy and manual therapy. The advantages of the osteopathic method of care include close psychological contact with the patient, the preservation of manipulative medical techniques, the rejection of polypragmasy, an individual holistic approach to the treatment of each patient, adherence to the ideas of early diagnosis and preventive medicine, the presence of a philosophical theoretical component of the worldview of an osteopathic doctor. The most important therapeutic principle of osteopathy is revealed. This is careful and gentle correction of osteopathic dysfunctions. It is based on the reserve capabilities of the body for selfhealing, inherent in it initially, and is aimed at harmonizing life processes. It gives the right to consider the technologies used in osteopathy as a nature-like. The inclusion of an osteopathy course in the basic training of a doctor could contribute to the education of clinical thinking of any specialist, holistic perception of a person and his health problems. Despite the official acceptance of osteopathy in the Russian Federation in 2015, it is still perceived by a fairly large part of the medical community not as a full-fl edged scientific discipline and an independent medical specialty, but as an alternative method of healing, one of many whose effectiveness and safety have not been proven. This article is aimed, among other items, to overcome the lack of information in scientific journals and mass media on fundamental research in osteopathy and the specifics of osteopathic care.

Introduction. Previously, the authors conducted a series of studies of changes in the bioelectric activity (BEA) of the brain of patients while an osteopath was working with them. Data on the specific response of the brain to osteopathic effects allow us to explain many mechanisms of the therapeutic effect of osteopathy. It is of interest to study the nature of changes in the BEA of an osteopath′s brain during prolonged tactile contact with objects of influence.
Aim: the identification of changes in the BEA of the osteopath′s brain that occur in the process of performing osteopathic listening of the patient relative to the period of quiet wakefulness; the reproducibility of the interaction patterns of the osteopath′s cerebral cortex biopotentials during working with different patients; the comparison of the nature of changes in the BEA of the osteopath′s brain during osteopathic listening of the patient and during imitation of listening (palpation of an inanimate object).
Materials and methods. The study involved 2 osteopaths (the article′s authors) having more than 5 years of experience in osteopathy. Measurements were carried out twice with each of them. The authors of the article themselves and the clinic′s assistant acted as patients. A soccer ball was used for an experiment with simulated listening. The BEA of the osteopaths′ brain was recorded by the method of multiparametric computer EEG.
Results. Changes in the BEA of the osteopath′s brain during imitation of listening (palpation of an inanimate object) are characterized by the greatest increase in EEG correlations in the leads C4, P4. Changes in the BEA of the osteopath′s brain when performing diagnostic listening of the patient′s cranial rhythmic impulse relative to the period of calm wakefulness are characterized by a longitudinal direction of brain activity and an increase in interhemispheric interaction of biopotentials. During the end of the audition immediately after working with the patient, the individual differences of each of the subjects related to the style of working with patients and the nature of the mobility of nervous processes became more pronounced.
Conclusion. Changes in the BEA of the osteopath′s brain during imitation of listening allow us to talk about the activity of the secondary somatosensory cortex, i.e., the work of ascending mechanisms of the nervous system, orientation reaction, and cognitive attention. Changes in the BEA of the brain of an osteopath during diagnostic listening may indicate the predominance of descending mechanisms of the nervous system, the work of the executive control system, perceptual attention of the doctor.

An analysis of the models of medical rehabilitation of domestic healthcare at the turn of the 20th-21st centuries is presented. The analysis of the concepts of the development of medical rehabilitation in the Russian Federation was carried out from the standpoint of the existing legal framework and the real situation in practical medicine. The main tendencies and trends in the improvement of medical rehabilitation in the near future are described. The regular connection between medical rehabilitation and sanatorium-and-spa treatment is indicated as a characteristic feature and originality of the national healthcare system in the paradigm of preventive medicine.

The described clinical case shows positive results of osteopathic correction in the complex treatment of syndrome of pain dysfunction of the temporomandibular joint (DTMDJ). Diagnosis and treatment of this syndrome attract attention because of the ambiguity of the etiology, pathogenesis and lack of effectiveness the treatment algorithm to achieve a stable result. In order to increase the adaptive capabilities of the body to the changes occurring in the stomatognathic system in the treatment of DTMDJ, we have developed and put into practice an interdisciplinary principle of diagnosis and treatment, which consists in an objective assessment of the clinical manifestations of somatic dysfunctions and their elimination before the start of dental intervention, which is carried out with adequate osteopathic support, leveling the increased load on the adaptation mechanisms. The dental intervention itself is carried out with adequate osteopathic support, leveling the increased load on the adaptation mechanisms. Interdisciplinary interaction allows you to optimize the approach to dental treatment. 

Introduction. According to the classification of the USA National Institutes of Health (NIH), chronic abacterial prostatitis/chronic pelvic pain syndrome (CPPS) is characterized by a symptom complex of pelvic pain, urinary disorders and sexual dysfunction in the absence of uropathogens and infl ammation signs. This is a heterogeneous syndrome. There is no universal therapy for it; and there is a low effectiveness of drug treatment. Among publications about this problem, the articles devoted to the results of the non-drug methods of CPPS treatment have become increasingly common, and it makes possible to summarize these works within the framework of a systematic review.
The aim: to study according to the literature data the results of the non-drug treatment methods, including osteopathic correction, in patients with CPPS.
Materials and methods. A literary search was performed on Russian and foreign databases of scientific medical literature (PubMed, De bruiter, The International Journal of Osteopathic Medicine, Journal of Bodywork and Movement Therapies, Journal of Osteopathic Medicine, CyberLeninka, Russian Osteopathic Journal, etc.). The main search was carried out from 2017 to 2022. According to the keywords chronic prostatitis, chronic pelvic pain syndrome, treatment, the 252 studies have been found since 2017, including 15 meta-analyses, 17 randomized controlled trials (RCTs). There was a high level of evidence in 47 studies, including 8 meta-analyses and 11 RCTs. To search for articles describing the results of manual therapy and osteopathic correction of CPPS in men, the time range was expanded from 2010 to 2022. There were found 6 articles, including 2 RCTs.
Results. The complexity of the CPPS pathogenesis in men causes difficulties in treatment. Currently, preference is given to non-drug methods, among which acupuncture has shown the best results in terms of pain relief, reducing the lower urinary tract symptoms, improving the patients′ life quality, and full absence of side effects. In addition, good results were obtained with the use of low-frequency extracorporeal shock wave therapy, pelvic fl oor physiotherapy, local cryotherapy. There is a minimum of side effects for all these treatment methods. According to the studies of Russian and foreign specialists, there has been shown the greater effectiveness of osteopathic treatment of chronic prostatitis/CPPS in comparison with individual drug treatment, gymnastics, physiotherapy, prostate massage, general therapeutic massage. Adverse events are not described. Only acupuncture and osteopathic correction showed long-term (several years) preservation of the achieved positive results among the considered treatment methods.
Conclusion. Among all the found studies of the osteopathic correction (OC) or manual therapy results, there were small samples of involved patients, and different criteria of the treatment results assessment were used. There were often no comparison groups, as a result only 2 RCTs could potentially be included in the meta-analysis. Judging by the described results, OC can affect several links in the pathogenesis of CPPS in men. Therefore it is expedient to conduct studies on large patients groups with mandatory random formation of control groups for better evidence.

Background. The aim of this study is to evaluate the effects of an osteopathic treatment on the main symptoms of Fibromyalgia: pain, quality of sleep, anxiety, depression, deterioration in the quality of life.
Methods. This open, prospective and observational pilot study included 13 patients, all of them submitted to an osteopathic treatment. The study took place in the «Centre d′Évluation et de Traitement de la Douleur» (Centre of Evaluation and Treatment of Pain) at the «Saint-Antoine» Hospital in Paris. The osteopathic treatment has been adapted to each patient without pre-established procedure of treatment. Six sessions with three weeks intervals (± seven days). The intensity as well as the impression of alteration of the symptoms has been evaluated before the first and after the last session of treatment with the following auto evaluation forms: QCD, QIF, PSQI, HAD and PGIC.
Results. In all 13 patients (women: 92%, middle-aged 51 years), the Quality of Life (QIF) improved with 34% namely from 73,9±10,2 to 48,7±17,6 (p<0.0001). The Sleep score (PSQI) decreased with 25 % i. e. 13,3±3,3 to 10±3,4 (p=0003) as well as Pain that decreased with 38 %, that is from 58,5±15,7 to 36,2±16,1 (p=0,005). Anxiety decreases with 25 %, namely from 10,5±4,2 to 7,9±4,5 (p=0,004).There was no significative diminishing of Depression.
Conclusion. The results of this cohort are encouraging even if the high standard deviations seem to be the mirror of important interindividual differences. A controlled, randomized trial with more patients is necessary to confirm these data.