Introduction. The incidence of falls in people living in social institutions of long-term care and undergoing medical and social rehabilitation in a hospital setting significantly exceeds that in comparison with people living at home. The identification of factors that increase the risks of falls and the inclusion of measures for their timely correction in the individual rehabilitation program for older people in long-term care social institutions is an important aspect of geriatric care.

The aim of the study was to assess the prevalence of the risk of falls and factors affecting the risk of falls in people over 60 years old living in a long-term care social institution.

Materials and methods. The study was conducted on the basis of the boarding house for the elderly and disabled № 1 (St. Petersburg). 153 people aged 60–99 years were examined. The average age was 80±0,79 years. An assessment of the risk of falls (Morse scale), geriatric status, as well as the fear of falls on the scales of assessment of the fear of falls and the falls efficacy scale was carried out.

Results. Among the indicators characterizing the domain of physical functioning, a statistically significant relationship between the high risk of falls and the level of basic functional activity was noted. The risks of falls did not depend on the presence/absence of frailty. There is a statistically significant relationship between the domain of mental functioning and the risks of falls. Fear of falling was present in more than half of the subjects and was associated with a higher risk of depression.

Conclusion. The main parameters associated with a high risk of falls in people in a long-term care facility were the level of basic functional activity, cognitive impairment according to the MMSE scale, and the presence of fear of falls. The fear of falls is an important factor influencing the psycho-emotional, cognitive and functional status of older age groups in long-term social institutions. These parameters must be taken into account in a comprehensive assessment of the patient′s condition for the personalized development of rehabilitation programs. 

Introduction. The main direction of conservative treatment of patients with dorsopathies remains drug therapy, but most clinicians agree that even the «best» drug therapy does not always help to achieve the desired results, and in addition is not without a number of known problems — allergic reactions, side effects, polypragmasy, impossibility of use due to the presence of comorbid pathology. Therefore, in recent years there has been an increase in interest in various non-medicamentous methods of treatment of dorsopathies: massage, physical therapy, physiotherapy, manual therapy and osteopathy, reflexotherapy. Previous work has demonstrated the clinical effectiveness of both reflexotherapy and osteopathic correction in the treatment of patients with dorsopathies. Both osteopathy and reflexology are disciplines that actively position a holistic approach to the human body and subsequent treatment. But at the same time, the question of coincidence or inconsistency of the results of diagnostic protocols of the two «fundamental» non-medicinal approaches has not been studied before. All of the above predetermined the purpose of this study.

The aim of the study: to compare the results of osteopathic and reflexotherapeutic diagnostics in patients with dorsopathy of the cervical spine.

Materials and methods. The cross-blind study was conducted on the basis of the medical clinic LLC «Mokhov Institute of Osteopathy» (Saint-Petersburg) in the period from September 2018 to December 2022. 110 patients (68 women and 42 men) with dorsopathy of the cervical spine were under observation. All patients underwent a one-stage assessment of osteopathic status and electropuncture diagnosis according to the method of I. Nakatani, and the level of pain syndrome was measured. All measurements were performed by different specialists, which allowed «blinding» the results obtained.

Results. Somatic dysfunctions (SD) of the global level were revealed in 19 (17 %) people and were represented mainly by the disorder of cranial rhythmic impulse production and psychovisceral-somatic disorder. SD of the regional level were revealed in the majority of the examined patients (98 people, 89 %). The most typical were dysfunctions of the following regions: neck (structural component), thoracic (structural component), pelvis (structural and visceral components), dura mater. Local SD were diagnosed in all examined patients (110 patients, 100 %). Among local SD the most frequently revealed were dysfunctions of separate vertebralmotor segments, separate joints of the skull, sacrum, knee joint, ankle joint. Pain syndrome of moderate severity was characteristic for the examined patients. Electropuncture diagnostics according to the methods of I. Nakatani allowed to estimate the state of acupuncture meridians in the so-called representative points. According to the data obtained for the examined patients the most typical were hypofunction of lung meridian and hyperfunction of heart, bladder and kidney meridians. In accordance with the set goal we evaluated the conjugation between the results of osteopathic and reflexotherapeutic diagnostics. A medium association was found between: Lung SD and hypofunction of the corresponding meridian (conjugation coefficient 0,58), small intestine SD and hypofunction of the corresponding meridian (conjugation coefficient 0,52). A high strength association was found between: pericardial ligament SD and hypofunction of the corresponding meridian (contiguity coefficient 0,78), liver SD and hypofunction of the corresponding meridian (contiguity coefficient 0,74), kidney SD and hypofunction of the corresponding meridian (contiguity coefficient 0,8).

Conclusion. Patients with cervical dorsopathy are primarily characterised by SD of regional and local levels. The connections between separate SD (both local independent and in the «structure» of regional biomechanical disorders) and hypofunction of corresponding meridians revealed in the course of this work potentially allow us to speak about comparability of separate results of osteopathic and reflexotherapeutic diagnostics. At the same time, it is interesting that the manual findings are comparable only with hypofunction of meridians.

Introduction. One of the main indicators reflecting the functional state of the athlete′s organism and limiting his professional achievements in such sports as volleyball, basketball, handball, etc., is jumping ability. Sharp accelerations and jolts of the lower limbs during jumping and landing can contribute to the formation of reversible structural and functional changes in volleyball athletes, both in the region of the lower limbs and in the overlying regions, including the pelvis. Somatic dysfunctions (SD) of the pelvic region can contribute to the formation of lower limb length disparity (LLLD) and activation of myofascial trigger points with the appearance of myofascial pain syndrome, decreased strength of the corresponding muscles, limiting the functional state of the athlete. In the conditions of toughening of anti-doping legislation, the requirements to injury prevention and improvement of functional capabilities of volleyball athletes using non-medicamentous methods of influence are increasing.

The aim of the study: to substantiate the inclusion of osteopathic correction in the support of training and playing processes of volleyball athletes.

Materials and methods. A randomised controlled prospective study involved 45 female volleyball athletes of a professional volleyball team. Inclusion criteria: age 16–25 years; high level of sportsmanship; satisfactory general health at the time of the first examination and throughout the study programme. Inclusion criteria: conditions and diseases that are absolute contraindications to osteopathic correction; contraindications to functional tests; presence of anatomical LLLD. According to the inclusion and non-inclusion criteria, 32 subjects were selected and divided using the randomisation envelope method into main and control groups of 16 subjects each. At the beginning of the study, the osteopathic status, clinical parameters (severity of LLLD, pain according to verbal rating scale) and jump height were assessed. Osteopathic correction was performed only in the main group and only 1 time at the beginning of the study. In both groups, standard treatment was applied as indicated. After that, dynamic studies in both groups (1 week, 2 weeks, 2 weeks, 3 weeks, 1 month, 2 months, 3 months) with evaluation of osteopathic status, clinical parameters and jump height were performed.

Results. No global level SD was found in the study group. Various regional level SDs were identified in volleyball athletes, the most frequently identified for this group were SDs of the regions pelvic somatic component (100 per 100 subjects), lumbar somatic component (94 per 100 subjects), thoracic somatic component (87 per 100), lumbar visceral component (65 per 100) and pelvic visceral component (59 per 100). Also characteristic for this group were SDs of the local level, which were chronic in nature (muscular-fascial formations and joints of the upper and lower extremities). Inclusion of osteopathic correction in athletes of the main group led to a decrease in the frequency of detection of regional and local level SD (p<0,05) compared to athletes of the control group. All clinical parameters and jump height in the main group improved significantly (p<0,05) and remained at the achieved level for about 2 months.

Conclusion. The obtained data demonstrate the positive influence of osteopathic correction on the functional state of volleyball athletes, and the most important indicator for them — jumping ability. We can recommend the use of osteopathic correction every 2 months in the accompaniment of professional athletes-volleyball players. 

Introduction. According to WHO data from 15 to 20 % of patients seeking gastroenterological care suffer from irritable bowel syndrome. The peak incidence is at the age of 30–40 years and is a frequent cause of disability due to the development of pain syndrome with localisation in the abdomen and changes in stool frequency in the absence of organic pathology. Low effectiveness of treatment of this disease is associated not only with multifactorial formation of gastrointestinal tract dysfunction and the lack of a single standard of therapy, but also with low adherence of patients to treatment due to polypragmasy and the need for long-term use of medications against the background of stressors, urbanisation, low motor activity and changes in diet and diet quality. All this puts before clinicians the task of searching for and including new non-medication methods of treatment of patients with this nosology, which predetermined the purpose of this study.

The aim of the study was to investigate the effect of including osteopathic correction in the complex treatment of patients with irritable bowel syndrome on the course of this disease.

Materials and methods. A prospective randomised controlled study, conducted between January 2022 and March 2023 at the outpatient clinic of FBUZ MSCh № 32 FMBA of Russia in Zarechny, Sverdlovsk region, included 64 patients of both sexes with an established diagnosis of irritable bowel syndrome. All participants of the study were divided into two comparable groups - main and control groups of 32 people each. Patients of the main group along with standard drug therapy received osteopathic correction, patients of the control group received only drug therapy according to clinical recommendations in gastroenterology. At the end of the treatment course the osteopathic status and the degree of pain syndrome severity were evaluated in patients of both groups.

Results. In patients with irritable bowel syndrome the most frequently diagnosed were somatic dysfunctions of global and regional level. Somatic dysfunctions of the global (psychovisceral dysfunction — 23,4 %, rhythmogenic cranial dysfunction — 17,2 %, global biomechanical dysfunction — 6,3 %) and regional levels (lumbar region: visceral component — 35 %, somatic component — 29,7 % and thoracic region: somatic component — 37,4 %) were determined as dominant. The inclusion of osteopathic correction in the complex treatment of patients with irritable bowel syndrome resulted in a statistically significant (p<0,05) decrease in the severity of pain syndrome with localisation in the abdomen.

Conclusion. As part of the complex treatment of patients with irritable bowel syndrome, osteopathic correction in combination with the use of standard drug therapy contributes to a significantly more significant reduction in the severity of pain syndrome compared to the use of pharmacological treatment alone in this category of patients. 

Introduction. Panic disorder (PD) is most common in people of the most working age (25 to 64 years). The prevalence of this condition among the population varies from 2 to 5 %. Benzodiazepines and antidepressants, 

which are included in most international and national clinical guidelines, have proven clinical efficacy in the treatment of panic disorder. However, the treatment regimens offered to date are far from always helpful in achieving the desired outcome. This necessitates the search for alternative treatment schemes, including the use of non-medication methods.

The aim of the study: to substantiate the possibility of using osteopathic correction in the complex therapy of patients with panic disorders.

Materials and methods. A controlled randomised study was conducted from December 2020 to December 2021 on the basis of the medical clinic «Anatomy of Health» (Bataysk). There were 32 female patients under observation, aged 25 to 55 years with a previous diagnosis of panic disorder. Depending on the applied treatment, all observed patients were divided into 2 groups using the method of simple randomisation: main group (16 patients) and control group (16 patients). All patients received conventional psychopharmacotherapy and psychotherapy selected according to an individual scheme. In addition to the described therapy scheme, the patients of the main group received three sessions of osteopathic correction lasting about 60 minutes each. The interval between the sessions was from 14 to 21 days. All patients were assessed for osteopathic status, the frequency and severity of panic attacks were investigated using the Panic Disorder Severity Rating Scale.

Results. The average age of the examined patients was 38,1±8,7 years. All the patients had comorbid pathology: dorsopathies of nasal localisation (25 people, 80 %), pathology of gastrointestinal tract (17 people, 54 %), cephalgia (12 people, 38 %). Somatic dysfunctions (SD) of global level were less characteristic for the examined patients and were revealed in 7 people [3 (19 %) in the main group and 4 (25 %) in the control group]. All patients had a combination of global rhythmogenic disorder (impaired cranial rhythmic impulse production) and global neurodynamic disorder (psychoviscerosomatic). The patients were found to have regional level SD, with a combination of 2 or more regional biomechanical disorders, and the following regions were characterised by dysfunctions: thoracic [structural and visceral components — 32 (100 %) and 32 (100 %) respectively], pelvis [visceral component — 19 (59 %)], and head [13 (41 %)]. If before the treatment the patients of both groups did not differ statistically significantly in the frequency of detected SDs, after the treatment a statistically significant (p<0,05) decrease in the frequency of detection of regional biomechanical disorders of the thoracic region (structural and visceral component) and pelvis (visceral component) in the patients of the main group was obtained. For the rest of the indicators the differences were not significant. Most of the patients had mild (17 patients, 53 %) and moderate (8 patients, 25 %) panic attacks. The average number of points according to the questionnaire was 10,1±2,5. According to these indicators the groups did not differ statistically significantly. After completion of the course of complex treatment in the patients of the main group in comparison with the control group there is a statistically significant (p<0,05) higher number of people with borderline values and mild panic attack severity, this corresponds to a statistically significant (p<0,05) lower number of scores on the self-questionnaire.

Conclusion. The patients with PD are primarily characterised by SD of the thoracic region (structural and visceral components) and pelvis (visceral component). Inclusion of osteopathic correction in the complex therapy of PD patients allows to achieve statistically significant more significant positive dynamics of indicators characterising the severity of the disease (decrease in the number of patients with severe form and increase in mild and borderline forms of the disease). It is reasonable to recommend to profile specialists to refer patients with PD for consultation to an osteopathic doctor with the purpose of potential inclusion of OC in treatment programmes for this group of patients. 

Introduction. In modern medicine, great attention has been paid to the study of patients with panic attacks (PAs) for a long time. One of the areas of scientific research is the study of the patients′ personality traits, as well as social, genetic and physiological factors causing the development of panic disorder. But peculiarities of pain syndrome in patients with PAs remain understudied. As a result, treatment and rehabilitation of patients with PAs remain insufficiently effective.

The aim: to research the role of pain syndrome in the clinical presentation of panic attacks.

Materials and methods. The studies involved 197 participants aged 38,65±10,91 including 41 men (20,8 %) and 156 women (79,2 %). They were divided into two groups based on the presence or the absence of PAs with the first group representing 147 people with panic attacks and the second group — 50 people without panic attacks. In all patients, pain syndrome (headache, chest pain, neck pain, and pain in the lumbosacral region) was assessed according to a 10-point Visual Analogue Scale (VAS). To study the dependence of pain syndrome characteristics on the severity of the disease course, patients with PAs from the first group were divided into 3 groups according to PA frequency in a four-week period: group of 31 people with infrequent PAs (less than four panic attacks), group of 48 people with mid-frequent PAs (at least four panic attacks), and a group of 68 people with frequent PAs (at least four panic attacks per week).

Results. According to our research, pain syndrome of different localization and intensity is more common in patients with PAs than in those without PAs, and was detected in 93,2 % of patients with PAs. Patients with PAs more frequently reported multisite pain, differently from those without PAs predominantly presenting complaints of pain in one body region. The intensity of headache, chest or neck pain is significantly higher in patients with PAs than in patients without PAs (р<0,05). In the majority of patients with PAs (75,9 %), pain syndrome preceded developing of PAs.

Conclusion. Pain syndrome can serve as a predisposing factor for the development of panic attacks and be the reason for the aggravation of the disease course, which is why pain syndrome in patients with PAs should undoubtedly be corrected. Taking into consideration the fact that a medication burden on such patients is high, the correction should primarily be performed using non-drug treatment options, including osteopathic methods.

Introduction. The main instrument of diagnosis and treatment for an osteopathic physician is the hands. In the process of professional retraining in the speciality of osteopathy, doctors master various types of palpation and hundreds of osteopathic correction techniques, which require various strictly dosed pressure forces on tissues.

The goal of the study is to research the development of pressure force dosing skill in primary retraining trainees in osteopathy during training.

Materials and methods. The cohort prospective study was conducted during 2022–2024. The object of the study was the students of the professional retraining cycle in the speciality «Osteopathy» at the Institute of Osteopathy (Saint-Petersburg) — 15 people aged 32–65 years (median — 51 years), 8 men and 7 women. The survey was conducted 4 times: at the end of the 2nd course, in the first and second half of the 3rd course and in the 4th course. Also during 2023, a cohort one-time survey of 16 doctors working in various specialities in the Lipetsk State Institution of Health Care № 4 «Lipetsk-Med» was conducted. This control group included doctors with work experience of at least 3 years, there were 10 men and 6 women aged 30 to 60 years (median 49 years), and according to these indicators, as well as work experience, there were no statistically significant differences from the main group of osteopathy trainees (p>0,05). The subjects pressed their hand on the electronic scales and achieved weights of 30; 250; 800 g. They pressed the scales once with open eyes and saw the result, then tried to repeat it three times with closed eyes. The arithmetic mean was calculated from the three values and then the target weight was subtracted from it and the deviation from it was obtained in absolute numbers (g) and in %.

Results. The survey of the cadets of primary retraining in the speciality «Osteopathy» at the end of the 2nd year of training, and doctors from the control group, showed that the future osteopaths demonstrated statistically significantly (p<0,05) smaller error (p<0,05) when trying to reproduce the weight of 30 g (from 0 to 220 g, median 50 g) and 250 g (from –190 to 350 g, median 41 g) from the doctors of the control group (respectively from 20 to 200 g, median 90 g and from –70 to 260 g, median 75 g). At the same time, physicians of both groups were more often mistaken in the larger direction. Calculating the % deviations from the target weight showed that for both groups of physicians, the minimum weight of 30 g was the most difficult to reproduce and the maximum weight of 800 g was the easiest. The relative values of deviations from the target weight were statistically significantly lower in the group of future osteopaths (p<0,05). In the process of training doctors on the course of professional retraining in osteopathy, the absolute values of deviations from the target weight systematically decreased, for the weights of 30 g (p=0,001) and 800 g (p=0,041) these changes were statistically significant. The most pronounced dynamics was observed for the improvement of the 30 g weight set. Men were more accurate in 800 g weight set, women were more accurate in 250 g weight set. The dynamics of the skill of dosing the 30 g pressure force showed similar results regardless of gender. In the experimental group, 9 people had been using manual therapy techniques in their medical practice for 3 to 17 years before the training. Calculation of correlations between the number of years of chiropractic practice and absolute deviations from the target weight showed low values of correlation coefficients in all courses of training (p>0,05).

Conclusion. The skill of dosed pressure is better developed in the trainees of the 2nd year of the professional retraining course in osteopathy than in doctors who are not trained in osteopathy. In the process of osteopathic training, the skill of dosed pressure improves. Its development was independent of years of chiropractic practice, and little influenced by gender. The most pronounced progress occurred on the small (p=0,001) and large scales (p=0,041) in the 4th year of training.

The review discusses the pathogenetic mechanisms of primary osteoarthritis (OA) formation. The recommendations of the Association of Rheumatologists of Russia on the main principles of rehabilitation for OA are presented, including drug and non-drug methods of pain syndrome correction, improvement of motor activity and quality of life of patients. Particular attention is paid to the mechanisms of osteopathic correction for OA, which are aimed at restoring the impaired biomechanics of the patient’s body, eliminating persistent muscle hypertonicity, peripheral sensitization, and aimed at regulating antinociceptive mechanisms. An important advantage of manual treatment is the possibility of its use before, during or after other types of treatment and the ability to enhance their therapeutic potential.

More than 140 mln people experience the sensation of tinnitus. At the same time, it should be understood that tinnitus is not an independent nosological unit and may be a manifestation of many diseases that may or may not be directly related to the hearing organ. Currently, there is no effective drug for the treatment of tinnitus. The therapeutic process involves specialists of different specialities: neurologists, otoneurologists, surdologists, otolaryngologists, physiotherapists, psychologists and psychotherapists, chiropractors, orthodontists and gnathologists. This is due to the variety and combination of pathologies that cause tinnitus. A clinical case is described to study the possibility of using osteopathic correction in combination with cognitive-behavioural therapy in the treatment of a patient with tinnitus.