Osteopathy in Russia has now formed as an independent direction of scientific knowledge and has all three characteristic levels – general philosophical, general scientific and specific scientific, as well as its own methodology. The following had been done in osteopathy as in a scientific direction of medicine: 1) its own conceptual apparatus was created; 2) a methodology had been developed that allows the use of evidence-based medicine approaches and mathematical processing of the results obtained; 3) scientific knowledge has a systematic, ordered nature; 4) the object, subject and content of osteopathy as a scientific direction were determined; 5) experimental and clinical evidence of the effectiveness of osteopathic treatment for various diseases and health disorders had been obtained. When conducting clinical studies in osteopathy, a wide range of methods for examining patients is used to obtain reliable information about the condition of organs and tissues, as well as about the body as a whole. Still it is necessary to develop the scientific component of osteopathy more actively, conduct multicenter clinical research to study clinical effectiveness, develop methodological and organizational foundations for providing osteopathic care to various groups of the population with somatic dysfunctions at all stages (prevention, diagnosis, treatment and medical rehabilitation) in order of preservation of human health, prevention of common non-communicable diseases, medical rehabilitation of patients after serious illnesses.

Introduction. Scoliotic disease in children is a very common pathology, and adolescent idiopathic scoliosis predominates among it. For planning treatment and assessing its results, functional disorders that accompany scoliotic deformity, including somatic dysfunctions (SD) identified by osteopaths, may be of interest. Regional biomechanical disorders in patients with scoliosis have been studied previously. The most frequently detected diabetes in children with scoliosis was diabetes in the axial regions of the body. According to a number of authors, in some cases, practicing osteopaths underestimate other components of somatic dysfunction, «getting carried away» in treatment only with biomechanical disorders, and this can affect the effectiveness of treatment. This issue undoubtedly requires study and analysis.

The aim – to study the features of the neurodynamic and hydrodynamic (rhythmogenic) components of somatic dysfunctions of the axial regions of the body in children with scoliosis of various localizations.

Materials and methods. A cross-sectional continuous study was conducted on the basis of the State Budgetary Educational Institution Rehabilitation and Educational Center № 76 of the Department of Labor and Social Protection of the City of Moscow from January to December 2022. 100 children were examined, aged from 12 to 18 years (median 15 years, mean age 15,2+1,5 years), of which 64 were girls and 36 boys. Inclusion criteria: juvenile scoliosis of I–III degree (according to the Cobb method), incomplete skeletal growth according to the Risser test, body mass index no more than 25, absence of pathology of the cardiovascular and respiratory systems in the stage of decompensation, absence of diseases of the nervous system. All patients underwent X-ray examination of the spine in frontal and lateral projections to verify the diagnosis. The Cobb angle was measured and the presence of one or more scoliotic curves was determined. To study the conduction of the respiratory rhythmic impulse (RII) and, to some extent, the active mobility of the main axial regions (thoracic, lumbar and pelvic) in a standing position, the patient took the deepest breath possible with the part on which his palm is located. To assess the neurodynamic component of SD in the above axial regions, a special test was carried out for the coordination of conjugal movements when walking – a test for assessing motor synergies of the pelvis, shoulder girdle and neck. The severity of violations was assessed in points from 1 to 3.

Results. The results of a study of active conjugate movements (synergies) in a walking test for the purpose of analyzing the neurodynamic component of DS showed that there are no statistically significant correlations of signs for all localizations of scoliosis. However, it is clear that with cervicothoracic/upper thoracic localization of scoliosis, violations of counterrotation of the eyes and head were most often detected. Disturbances of counterrotation of the head and shoulders were least often detected in lumbar scoliosis, disturbances of counterrotation of the shoulder and pelvic girdles – in cervicothoracic / upper thoracic localization of scoliosis. Impaired performance of DRI and active mobility was most often detected in the region of localization of scoliotic deformity. Impaired mobility of the pelvic region was detected in more than half of the subjects, and most often in children with scoliosis in the lumbar region, but there were no statistically significant differences between the groups. The severity of mobility impairments was assessed in points from 0 to 3, and then the sum of points was calculated for all examined regions for each subject. The correlation between the severity of scoliosis and the total score of impaired mobility of the axial regions is r=0,38, p<0,05.

Conclusion. The test proposed by the authors for assessing the neurodynamic and rhythmogenic components of regional somatic dysfunction not only showed its informative value, but also made it possible to identify individual patterns of the combination of organic and functional disorders in patients with scoliosis. At the same time, the data obtained are not enough to recommend the use of these diagnostic tests to develop a treatment strategy for patients. Further research should be aimed at studying the active mobility of the axial regions over time during treatment.

Introduction. Pelvic organ prolapse is a major medical and social problem. Up to 53 % of women note certain manifestations of prolapse, almost half of them are women of working age. There are still many unresolved issues in the treatment of pelvic organ prolapse and prolapse. Conservative therapy for pelvic organ prolapses is poorly effective. The only clinically proven way to combat the disease, widely used in world medical practice, is surgical treatment. However, the possibilities of surgical correction of genital prolapse are limited by the high frequency of relapses, which occur in 36 % of operated women, as well as complications when using mesh prostheses (17–31 %). Therefore, exploring nonsurgical treatments aimed at preventing disease progression is a critical challenge for clinicians.

The aim was to study the effect of osteopathic correction, used in the complex treatment of pelvic organ prolapse, on the course of this disease.

Materials and methods. The study included 36 women aged 25 to 45 years with the first stage of genital prolapse. All patients underwent standardized osteopathic diagnostics with the formation of a unified osteopathic conclusion at the beginning and at the end of the study. The subjects of the main group, as part of complextreatment, received osteopathic correction in the number of 3 sessions with an interval of 2–3 weeks; patients in the control group who performed physical therapy exercises (PT) were dynamically monitored.

Results. In patients with genital prolapse, somatic dysfunctions are most often diagnosed at the global (psychoviscerosomatic disorder) and regional levels (pelvic, lumbar and thoracic regions), which are dominant. The inclusion of osteopathic correction in the complex treatment of genital prolapse in women is significantly more significant than the isolated performance of physical therapy exercises and helps to reduce the frequency of detection of somatic dysfunctions at the global and regional level (p>0,05), and is also significantly more significant (p>0,05) promotes: reducing the severity of genital prolapse, reducing the severity of urogenital symptoms, improving the quality of life of patients.

Conclusion. As part of the complex treatment of patients with genital prolapse, osteopathic correction in combination with physical therapy exercises helps to reduce the degree of pelvic organ prolapse, reduce the severity of urogenital symptoms and improve the quality of life of women.

Introduction. In everyday practice, the activity of a dentist is exposed to many negative factors that affect his health. Forced, often asymmetric posture, monotonous movements that are accompanied by static-dynamic tension of the back muscles, shoulder girdle and upper limbs lead to diseases of the musculoskeletal system.

The aim is to identify the features of joints mobility of the upper limbs in dentists of different specialties (surgeons, therapists, orthopedists).

Materials and methods. 91 people were examined – dentists of working age (27–63 years) of different specialization, right-handed: 21 orthopedists, 47 therapists, 23 surgeons. Active mobility was measured in the joints of the upper limbs – shoulder, elbow and wrist.

Results. In the examined group of dentists, the joints of the left hand were statistically significantly more mobile than the right (according to most indicators p<0,05). A history of upper limb injuries reduced mobility in the right wrist joint (p=0,013). Since the mobility of most of the joints on the right and left differed, a comparison was made between the groups separately on the right and left hands. In orthopedists, the shoulder joints are more mobile when performing a horizontal abduction than in therapists and surgeons (p=0,043). For the rest of the indicators, there were no differences between the groups. Comparison of joint mobility of the right and left groups in each group showed that orthopedists were the most symmetrical, slightly worse indicators in dental surgeons. Pronounced asymmetry of the mobility of the joints of the hands was observed in dentists-therapists (for most indicators p<0,05).

Conclusion. Most of the joints of the left hand had greater mobility than the right at dentists. Injuries to the upper limbs in history had a negligible impact on the joints mobility. When comparing the groups, it turned out that the mobility of the joints of the upper limbs in dentists of different specialties practically does not differ. However, when comparing the joints mobility of the right and left hands in each group, it turned out that the main indicators of orthopedists and surgeons were symmetrical. Pronounced asymmetry in the joint mobility of the right and left hands was observed in dentists-therapists, which may be due to the peculiarities of their work.

Introduction. In the general methodology of osteopathy over the past 10–15 years there have been significant changes associated with the transition from a purely local paradigm to a comprehensive assessment of osteopathic status. According to approved clinical guidelines, it is customary to distinguish somatic dysfunctions at three levels: global, regional and local. In this case, somatic dysfunction can be characterized from the perspective of biomechanical, hydrodynamic and neurodynamic disorders. The introduction of a new paradigm undoubtedly requires a number of studies that could confirm the validity of such a hierarchical division of somatic dysfunctions. One of the criteria for determining regional somatic dysfunctions is a significant limitation of mobility of the entire region. This suggests that the volume of active movements in regional and local somatic dysfunctions should differ. However, no one has previously studied this hypothesis, which predetermined the purpose of this study.

The aim was to objectify biomechanical disorders in areas of regional somatic dysfunction in patients with dorsopathy of the cervical spine.

Materials and methods. A comparative blind study was conducted from June 2020 to December 2021 on the basis of the Polyclinic № 1 of the Administration of the President of the RF and the specialized osteopathic clinic «Mokhov Institute of Osteopathy». We observed 58 patients aged 18 to 45 years with dorsopathy of the cervical spine, 24 men and 34 women. All patients had their osteopathic status assessed, the range of active movements in the cervical spine was measured, and the level of pain was measured. Based on the results of osteopathic diagnostics, the patients were divided into two groups: the main group – with regional biomechanical disorders in the neck region and the comparison group – with local somatic dysfunctions of individual spinal motion segments at the level of the cervical spine (C_I–VII). There were 31 people in the main group (18 women and 13 men), and 19 people in the comparison group (10 women and 9 men). Assessment of osteopathic status and severity of pain syndrome was carried out by one specialist, and angularometry by another, who did not know which group the examined patient belonged to.

Results. For patients with dorsopathy of the cervical spine, the most typical somatic dysfunctions are at the regional level: neck (structural component), thoracic (structural component), lumbar (structural component), pelvis (structural and visceral components), dura mater. The vast majority of the examined patients (84 %) had a combination of 2 or more regional biomechanical disorders. Patients with local and regional disorders did not differ in the severity of pain syndrome (p>0,05). This preliminary allows us to conclude that the severity of the pain syndrome does not allow us to judge the level of manifestation of somatic dysfunctions (local / regional). As a result of the study, statistically significant differences (p≤0,05) were identified between groups in the range of motion in the cervical region in the sagittal plane, which confirms the initial hypothesis about a more pronounced limitation of range of motion in patients with regional somatic dysfunctions of the neck region compared to local ones.

Conclusion. The presence of regional biomechanical disorders at the neck level in patients with dorsopathy of the cervical spine is accompanied by a more significant limitation in the range of active movements in the sagittal plane compared to patients with local disorders at this level. At the same time, the severity of the pain syndrome does not depend on the level of manifestation of somatic dysfunctions.

Introduction. The perceptual skills of an osteopath, high tactile sensitivity and a systematic approach suggest that when carrying out osteopathic correction, not only a local effect on the musculoskeletal structures occurs, but the interaction of two biological systems as well.

The aim was to study the differences in the characteristics of the bioelectrical activity of the osteopath′s brain in a state of quiet wakefulness and when working with patients, simulating treatment (working with a ball, a soft toy).

Materials and methods. The study involved 7 osteopaths, 3 men and 4 women with experience from 3 to 20 years. Based on the assessment of the bioelectrical activity of the brain of osteopaths using the method of mathematical analysis of the multivariable structural function of the first order (SF1) of a multichannel EEG, features of the interaction of biopotentials in the process of working with patients and when simulating treatment were identified. For each osteopath, integral parameters of the multichannel EEG were calculated, characterizing its spatial (p_S) and temporal (p_T) ordering in various states (quiet wakefulness, working with patients, imitation of treatment).

Results. In a series of observations, it was found that a number of osteopaths practice a predominantly stable strategy of working with overlapping clouds of overlapping p_S and p_T parameters in various states, which may indicate a resonant interaction with the patient. In a number of cases, a strategy of «following the patient» was observed, with different configurations of clouds of p_S and p_T parameters in a calm state and during treatment of the patient, which may indicate «tuning» to the patient. The strategy of an osteopath with less experience in the profession was distinguished by signs of emotional stress in the bioelectrical activity of the brain and increased spatial ordering of the EEG, regardless of the patient.

Conclusion. Analysis of the overlap of clouds of p_S and p_T parameters at rest and in various stages of work with the patient showed that osteopaths practice two main dynamic styles of work: «Attraction», a stable strategy with an overlay of clouds of p_S and p_T parameters, and «Following», clouds of p_S parameters and p_T have different configurations at rest and during patient treatment. In a number of cases, flexible approaches were observed with a change in the dynamic style of the same doctor when working with different patients.

Aims – to study the dynamics of postural balance indicators in the process of total reconstruction of dentition occlusion.

Materials and methods. The prospective study included 48 patients receiving dental orthopedic treatment for pathology of hard dental tissues and partial absence of teeth. Monitoring of postural status was carried out according to stabilometric studies and photometry of the direction and angular values of deviations of the general center of gravity of the body, the centers of gravity of body regions and the lines of their boundaries.

Results. Before treatment, the examined patients were characterized by a ventral shift in the general center of gravity (5,07±0,62º) and the center of gravity of the cervical spine (5,50±0,75º), a shift in the center of gravity of the lumbosacral spine to the right (5,92±0,59º), significant inclination of the biauricular (7,09±0,57º), biacromial (8,31±0,84º), superior bicondylar (8,73±0,75º) lines in the frontal plane and clavioscapular (8,08±1,03º), bispinal (8,50±0,69º) lines – in the sagittal plane, as well as a pronounced decrease relative to the known norms of the statokinesiogram area indicators (273,06±82,62 mm² in test with eyes closed), the average position of the center of pressure in the frontal (–1,43±2,01 mm in the test with eyes closed) and sagittal (–36,94±7,39 mm and –28,17±4,48 mm in tests with open and closed eyes, respectively) axes. As the occlusal balance is restored using orthopedic dental methods, normalization of the values of all of the listed parameters has been recorded, with the exception of the angle of inclination of the upper bicondylar line.

Conclusions. The angles of inclination of the pelvis and head in the frontal and sagittal planes, the asymmetry of the belt of the upper limbs and the range of fluctuations in the center of pressure of the feet along the sagittal and frontal axes are informative indicators of postural compensation for changes in the position of the lower jaw and disturbances in the occlusal balance of the dentition. To correct the corresponding posturological disorders, it is advisable to organize an interdisciplinary approach in the management of orthopedic dental patients with chiropractors, rehabilitation therapists, kinesiologists, and osteopaths.

The article is devoted to the short leg phenomenon. Data on its prevalence in the population are presented. Much attention is paid to the differential diagnosis of false functional shortening and true anatomic shortening of the lower limb. The pathogenesis of pain syndrome and degenerative-dystrophic processes, postural disorders associated with unequal leg length are discussed in detail. The questions of correction of postural imbalance depending on its causes are discussed: lift therapy, osteopathic correction, gymnastics. The data of actual researches and own clinical observations are given.

The problem of ensuring an adequate level of quality of medical care still remains one of the most important and pressing in the modern healthcare system. The main goal of both the healthcare system as a whole and its individual structural elements (down to a specific medical worker) is to provide high-quality medical care aimed at achieving the optimal possible indicators of public health and a high level of population satisfaction. At the same time, the quality of medical care is one of the key concepts, which reflects the observance of human rights in the field of healthcare, guaranteed by the Constitution of the Russian Federation. Today, state regulation of osteopathy covers almost all the main aspects of providing medical care to the population of the Russian Federation in the «Osteopathy» profile. At the same time, medical care in the «Osteopathy» profile differs from other areas and has a number of features, which means that issues of assessing the quality of osteopathic care should be considered with these features in mind. The purpose of this review is to highlight a number of issues related to the quality of medical care in the field of osteopathy based on an analysis of current regulatory legal acts.