Introduction. The specific object of osteopathic physician’s work is somatic dysfunction (SD). It is generally accepted, based on the basic concepts of anatomy and physiology, to distinguish three components in SD: biomechanical, hydrodynamic and neurodynamic. These disturbances in the body can be defined at different levels — local, regional and global. However, there are very few studies aimed at objectifying SD, revealing the pathophysiological mechanisms of their formation, and substantiating the separation of disorders at different levels. Recently, the notion of «non-infectious epidemic» in relation to dorsopathies and related pain syndromes has been heard. At the same time, despite the variety of diagnostic methods, a multitude of existing drugs and conventional medicine techniques, as well as advances in the field of spinal neurosurgery, many issues of treatment and rehabilitation of patients with neurological manifestations of degenerative spinal diseases remain unresolved.

The aim of the study: to compare local temperature indices in areas of local and regional SD in patients with cervical dorsopathy.

Materials and methods. In the cross-sectional study, 462 patients diagnosed with cervical spine dorsopathy were examined. All patients were assessed for osteopathic status based on clinical guidelines. Local temperature was also measured using a portable infrared thermometer along the posterior surface of the neck with calculation of mean values and thermoasymmetry.

Results. The vast majority of the examined patients — 408 (88 per 100 examined) were diagnosed with regional biomechanical disorders: regions of the thoracic and pelvis, structural and visceral components; regions of the dura mater, neck, structural component. SDs of local level were detected in all examined patients. The most frequently identified dysfunctions were: spinal motor segments (SMS) of the cervical, thoracic and lumbar spine, visceral, individual sutures of the skull, joints of the lower extremities. Patients with regional biomechanical disturbance at the neck level are characterized by statistically significantly (p<0,05) lower average temperature values in this area compared to patients with local dysfunctions and without dysfunctions of this area. From the physiological point of view it is more important not just average temperature indices in this or that area, but the presence of functionally significant (>0,4 °C) thermoasymmetry. It turned out that in patients with regional SD (neck region, structural component) the values of thermoasymmetry are statistically significantly higher (p<0,05) compared to patients without SD or with local SD at the neck level.

Conclusion. According to the results of local infrared thermometry in the area of regional biomechanical disturbance at the neck level, patients with dorsopathy have a decrease in local temperature, as well as the presence of functionally significant (>0,4 °С) thermoasymmetry in comparison with patients in whom at this level either local level SDs were diagnosed or no dysfunction was detected at all. The obtained data allow us to speak about the validity of differentiation of dysfunctions of different levels, as well as objectify the hydrodynamic component of SD.

Introduction. Along with the increasing incidence of cholelithiasis, despite the success of its surgical treatment, there is a significant increase in the number of patients with the so-called postcholecystectomy syndrome (PCES). It is caused by the fact that cholecystectomy disturbs the process of bile secretion and does not compensate complex pathophysiological disorders occurring at cholelithiasis. The arsenal of effective means of medication and non-medication correction is relatively small that makes clinicians look for new methods of PCES therapy. Earlier studies have shown rather high clinical effectiveness of osteopathic correction in the complex treatment of patients with gastroenterological profile, which allows us to assume that osteopathic correction can be effective in the treatment of patients with PCES.

The aim of the study: to substantiate the possibility of using osteopathic correction to eliminate the manifestations of postcholecystectomy syndrome.

Materials and methods. The prospective controlled randomised study was conducted from January to July 2023 on the basis of the surgical department of the Kirishi Clinical Interdistrict Hospital of the Leningrad Region. Twenty-two patients aged 35 to 65 years were examined. All patients underwent surgical treatment of cholelithiasis and subsequently developed postcholecystectomy syndrome. According to the exclusion criteria, 2 patients dropped out of the study. Depending on the conducted treatment the patients were divided into 2 groups of 10 people each — main and control — using the method of randomisation envelopes. Patients of both main and control groups received complex conventional conservative treatment, but patients of the main group additionally received osteopathic correction. A total of 6 sessions with an interval of one month were conducted. The duration of each session was 60 minutes, the approach to each patient was individual. All patients before the beginning and after the completion of the course of treatment were assessed for osteopathic status, the severity of pain syndrome, ultrasonic diagnostics with evaluation of the biliary tract, biochemical blood analysis with evaluation of the level of total bilirubin.

Results. The most frequently detected somatic dysfunctions (SD) in the observed patients were: lumbar region (both structural and visceral components — 100 %), neck region, visceral component (40 %), pelvic region, visceral component (30 %), dura mater region (30 %). In the same way, all patients were diagnosed with SD of local level. Among local dysfunctions it is worth mentioning: SD of spinal-motor segments of the thoracic spine (50 %), cervical spine (30 %), joints of the lower limbs (40 %), separate joints of the skull (10 %). On the background of the conducted treatment only in the patients of the main group a statistically significant (p<0,05) decrease in the frequency of detecting SD was obtained: lumbar region, visceral and structural component, pelvic region, visceral component. After treatment both in the main group and in the control group a significant (p<0,05) decrease in the level of pain syndrome was registered, but in the patients of the main group these changes were more pronounced (p<0,05). A significant (p<0,05) decrease in the level of total bilirubin was registered in the patients of the main group who received osteopathic correction after the completion of the course of therapy. The values of this index in the patients of the control group remained practically unchanged. Before treatment, patients with PCES had insignificant increase in the size of the choledochus according to ultrasound diagnostics and did not differ from each other by this indicator. On the background of treatment only patients of the main group had statistically significant (p<0,05) positive dynamics in the form of choledochus size reduction.

Conclusion. Application of osteopathic correction in the framework of complex treatment of patients with postcholecystectomy syndrome allows to achieve pain relief, reduce the diameter of the choledochus and reduce the level of total bilirubin. The obtained data allow us to recommend consultation of an osteopathic physician to patients with postcholecystectomy syndrome in order to decide on the inclusion of osteopathic correction in the programme of complex treatment.

Introduction. Modern methods of therapy of chronic venous insufficiency in general and varicose veins in particular often do not take into account the trigger factor of venous outflow disturbance development and are mainly aimed at reducing symptomatic manifestations of the disease. As a consequence — low efficiency of conservative therapy and increase in the number of operative treatments, decrease in the quality of life in patients with varicose veins, which should not escape the attention of clinicians. At the same time, it can be assumed that osteopathic approach in work with patients suffering from varicose veins, can not only influence the cause that led to the violation of venous blood outflow from the lower extremities, but also improve the quality of life of this group of patients. One of the modern works on the correction of venous insufficiency using osteopathic correction was carried out on patients with degree C2-3 according to the international classification of СЕАР, but this study did not include patients with already existing reflux in the superficial veins.

The aim of the study: to evaluate the clinical efficacy of osteopathic correction in the complex therapy of patients with varicose veins of the lower limbs with the presence of pathological reflux on the superficial veins.

Materials and methods. The prospective controlled randomized study was conducted in the period from March 2022 to December 2022 based on the Sverdlovsk Regional Hospital № 2 (Ekaterinburg). There were 44 female patients aged 30 to 60 years with the diagnosis of «varicose veins of the lower limbs», with the presence of pathological reflux in the superficial veins of the lower limbs according to ultrasound diagnostics. According to the exclusion criteria, 4 people dropped out. Depending on the applied treatment scheme, all observed patients were divided into equal 2 groups of 20 people each — main and control — using randomization envelopes. Patients of both main and control groups received complex conservative treatment in accordance with the approved clinical recommendations: compression therapy, drug therapy. Patients of the main group additionally received 2 sessions of osteopathic correction with an interval of 14 days. All patients were assessed for osteopathic status, quality of life, pain syndrome severity and ultrasonic diagnostics with measurement of the diameter of superficial veins of the lower limbs. Assessment and measurements were performed before treatment and 1 month after the start of treatment.

Results. Dysfunctions of the following regions were most characteristic for patients with varicose veins of the lower limbs: lumbar, structural [in 6 (30 %) patients of both main and control groups] and visceral components [in 12 (60 %) and 10 (50 %) patients, respectively]; pelvis, structural [in 7 (35 %) and 6 (30 %) patients, respectively] and visceral components [in 13 (65 %) and 12 (60 %) patients of the main and control groups, respectively]. After treatment, only in the patients of the main group a statistically significant (p<0,05) decrease in the frequency of detection of regional biomechanical disorders of the pelvic and lumbar region (structural and visceral component) was obtained. For the other SDs the differences were not significant. The examined patients were characterized by pain syndrome of moderate severity and a decrease in the level of quality of life. Only the conducted complex treatment with the use of osteopathic correction led to a significant (p<0,05) decrease in the intensity of pain syndrome and improvement of the quality-of-life indicators, while in the patients of the control group these indicators practically did not change. Ultrasound diagnostics showed no significant changes in the diameter of superficial veins of the lower limbs in the observed patients in any of the groups.

Conclusion. The use of osteopathic correction within the complex therapy of patients with varicose veins of the lower extremities allows to achieve a statistically more significant decrease in the intensity of pain syndrome and improve the quality of life compared to conventional compression and drug therapy. It is reasonable to continue the study on a larger sample of patients.

Introduction. Currently, the problem of infertility treatment has acquired not only medical, socio-demographic, but also economic importance. Overcoming infertility is currently carried out by modern high-tech methods of treatment — reproductive technologies (HRT), in which some or all stages of conception and early development of embryos are carried out outside the woman’s body. The standard variant of HRT is in vitro fertilization (IVF) — a medical technology of fertilization of women's eggs in vitro with the husband‘s (donors) sperm with subsequent transfer of the obtained embryos into the uterine cavity of the mother. However, the percentage of effectiveness of IVF programs is from 35 to 40 % and is due to the presence of high quality embryos in most cases uterine factor, which poses a challenge to clinicians to find and include new, primarily non-medicamentous, ways to treat patients with uterine form of infertility, which predetermined the purpose of this study.

The aim of the study: study of the influence of including osteopathic correction in the complex treatment of patients with uterine form of primary female infertility under IVF protocol on the percentage of pregnancy and childbirth.

Materials and methods. In a prospective randomized study conducted in the period from January 2020 to March 2024 based on the Medical Clinics LLC «Mokhov Institute of Osteopathy» (Saint-Petersburg), 70 people with a diagnosis of female infertility, primary, uterine form, who had 3 or more unsuccessful IVF attempts were included. All the participants of the study were divided into two groups — the main group and the control group of 35 people each. Patients of the main group along with standard drug therapy were given osteopathic correction, patients of the control group received only drug therapy according to the order № 107n from 30.08.2012 «On the procedure for the use of assisted reproductive technologies, contraindications and restrictions to their use». At the end of the treatment course, the osteopathic status, uterine blood flow parameters and the number of pregnancies and births were evaluated in the patients of the studied groups.

Results. Patients with uterine form of primary female infertility were most often diagnosed with somatic dysfunctions of global and regional level. Somatic dysfunctions of the global (psychovisceral-somatic disorder — 28,6 %), and regional level (the dura mater region — 30 %, lumbar region visceral component — 15 %, pelvic region visceral component 18 %, thoracic region visceral component — 8,4 %) were determined as dominant. As a result of inclusion of osteopathic correction in the complex treatment of patients with infertility, the frequency of pregnancy resulting in childbirth statistically significantly increased.

Conclusion. As part of the complex treatment of patients with uterine form of primary female infertility osteopathic correction in combination with the use of standard medical therapy as part of the IVF protocol contributes to a statistically significant increase in the number of pregnancies and born children compared to the use of an isolated standard IVF protocol in this category of patients.

Introduction. Chronic tonsillitis does not always lend itself well to standard treatment, so it requires interdisciplinary cooperation with the search for new methods of diagnosis and treatment, one such method may be osteopathic correction. Changes in the structure of connective tissue in chronic inflammation contribute to the development of biomechanical disorders in the form of limitation of tissue mobility and increase in their density, which, in turn, may be prerequisites for the formation of somatic dysfunctions (SDs). There are no data on the peculiarities of osteopathic status in patients with chronic tonsillitis in the available literature, which predetermined the purpose of this study.

The aim of the study: to study the features of osteopathic status in patients with chronic tonsillitis and its dynamics after a course of complex therapy including osteopathic correction.

Materials and methods. The prospective randomized controlled study, conducted on the basis of the Department of Osteopathy with a course of functional and integrative medicine and the Department of Otorhinolaryngology of I.I. Mechnikov NWSMU in the period from 06.2022 to 04.2024, included 93 patients with the diagnosis of «Chronic tonsillitis» who visited a doctor about the recurrence of the disease. All patients were divided into two groups, main (n=44) and control (n=49), depending on the treatment performed, using the randomisation envelope method. All patients were examined by osteopathic examination with the formation of an osteopathic report before treatment, as well as 30 and 90 days after the start of treatment. Patients of both groups received otorhinolaryngological treatment in the form of washing of the palatine tonsils (five washing procedures with antiseptic solution, the interval between the procedures was 2 days). Patients of the main group additionally received osteopathic correction of the identified somatic dysfunctions, which included five procedures: three procedures with an interval of 14 days. The total duration of the course was 1 month. Osteopathic correction was performed to each patient individually, based on the results of osteopathic diagnostics and a completed osteopathic report.

Results. Regional (neck region, visceral and structural components; thoracic region, structural and visceral components; head region) level dysfunctions were the most characteristic for patients with chronic tonsillitis. Global SDs were dominant in 23 % of patients and regional SDs in 77 %. After the complex (including otorhinolaryngological treatment and osteopathic correction) treatment in the patients of the main group, the frequency of detection of regional and local SDs statistically significantly decreased, global level SDs were not detected (p<0,05 by the McNemar criterion). With regard to the frequency of detection of global, regional and local SDs in patients of the control group receiving only otorhinolaryngological treatment, there was no statistically significant dynamics (p>0,05 by the McNemar criterion).

Conclusion. According to the results of the study, the peculiarities of osteopathic status in chronic tonsillitis were shown. The inclusion of osteopathic correction in the complex treatment of patients contributes to a statistically significant decrease in the frequency of detection of somatic dysfunctions of different levels compared to conventional conservative treatment. It is necessary to continue the study and analyse the relationship between the identified somatic dysfunctions and the presence of objective and subjective symptoms of the disease.

Introduction. The importance of staff development cannot be overemphasized. This process plays a crucial role in the personal and career growth of individuals and the overall success of organizations. Consequently, one of the most important factors in modern organizations is continuous professional training and development of specialists, and there is a need to develop not only specific employees, but also the entire team. This is fully characteristic for the sphere of medicine and for dentistry. A significant competitive advantage for any dental clinic is a highly qualified and systematically developing staff. Changing patient behavior and increased expectations, the emergence of new medical technologies, equipment and treatment methods on the market require more and more developed professional and supraprofessional competencies of medical staff.

The aim of the study is to identify problem areas for further development of a program to improve the personnel development system of private dental clinics.

Materials and methods. The object of the study was private dental clinics in Saint-Petersburg (four network brands in the form of limited liability companies). The research methodology consists of a set of methods of sociological analysis, including interviewing, questionnaires, direct observation, as well as special methods: Porter’s five forces analysis, expert focus groups, ranking by the method of pairwise comparisons. The research was conducted in the period from January 2023 to May 2024.

Results. The research revealed key HR-trends in the dental services market: growing competition not only for talented doctors and paramedical staff, but also for non-medical staff, demand for well-coordinated teams/ shifts with complementary competencies, attention of clinic owners and managers to the creation of a favorable internal environment of the clinic, and the need for professional clinic managers. The typologization of dental clinic staff by their readiness for development is proposed, and two risk groups among the staff are identified. Dental clinics were analyzed according to Porters five forces model, as a result of which the weightiest «forces» — pressure of suppliers and pressure of competitors — were identified. The results of interviewing chief physicians and surveying the staff of dental clinics were obtained. All the above formed the basis for the formed catalog of problems typical for private dental clinics in the current period.

Conclusion. The results of the conducted research necessitated the development of a model project of personnel development in the field of private dentistry, which will be presented by the authors in subsequent publications. The authors assume that the development of such a project will not only allow to create an effective integrated system of personnel development but will also become a precedent for the introduction of the project approach in private dental clinics in St. Petersburg, and in the future — in clinics in the regions of Russia.

Introduction. In the genesis of somatic dysfunctions formation the leading role is given to adaptation reactions on the part of the organism as a whole and connective tissue in particular. It should be noted that the main cells of connective tissue — fibroblasts play an important role in the formation of its structural and functional characteristics. At the cellular level, adaptation changes affect not only morphometric indicators, but, due to changes in the synthetic function of cells, also biochemical indicators. There is an opinion that in childhood the adaptation activity of fibroblasts in response to external influences proceeds differently, which can be studied by changes in the concentration of collagen, elastin and glycosaminoglycans in the intercellular matrix.

The aim of the study: to study changes in the functional activity of the main cells of connective tissue in the process of modelled compression effect on fibroblast culture obtained during surgical intervention in preschool children and adults.

Materials and methods. Under experimental conditions (in vitro), compression conditions were modelled with respect to fibroblast culture taken from patients during surgical intervention. The study took into account the data of 40 studies of connective tissue, formed in vitro, taken from patients after surgical interventions for the period from 2022 to 2023. The whole study material was divided into two groups of 20 samples from adult and paediatric patients after surgical intervention. Inclusion criteria for the main group: material taken after surgical intervention — excision of the foreskin for social indications in children aged 3-7 years. Inclusion criteria for the control group: material taken after surgical intervention — blepharoplasty in patients aged 27-35 years.

Results. The fibroblast response to the impact is formed within 24-48 hours. The main stage of functional activity recovery after removal of the external factor (compression) occurs during the first 72 hours. Fibroblasts adapt morphologically (changing their shape) and change their local habitat (intercellular substance) in response to changes in environmental conditions due to changes in the ratio of elastin, collagen and glycosaminoglycans. The initial indices of the functional activity of fibroblasts in children are lower compared to adults when comparing the indices of elastin and collagen, and higher when comparing the indices characterising the number of soluble CD44 receptors synthesised by fibroblasts. In the process of adaptation of the main cells of connective tissue in children, stimulation of production of elastin, collagen and glycosaminoglycans by fibroblasts at the initial level is expressed. After the fibroblast culture was placed in high-pressure conditions for 24 hours, collagen and elastin synthesis was almost completely inhibited. Subsequent cultivation under normal conditions leads to gradual restoration of elastin production to control figures and moderate restoration of collagen and glycosaminoglycans synthesis, which is one third of the initial figures.

Conclusion. In the course of the experiment it was found that fibroblasts cultivation under conditions of increased pressure leads to a decrease in their functional activity, increase in proliferative activity and cell viability with preservation of their immunophenotype. Restoration of collagen, elastin and soluble CD44 level to the initial level of expression occurs, as a rule, in 72 hours. At the same time, the restoration of the synthetic activity of fibroblasts of children occurs in a shorter time range compared to that of adult fibroblasts. The obtained data allow us to explain the fact that a significant part of clinical effects are observed not immediately, but 72 hours after osteopathic correction. It can be recommended to eliminate the compression factor in the body as one of the possible etiological factors in the formation of somatic dysfunctions in the process of osteopathic correction.

Introduction. At an osteopathic doctor’s appointment, musculoskeletal neck pain is the most common reason for consultation, reaching 60 %. Osteopathic doctors use a wide range of manual techniques to diagnose and correct somatic musculoskeletal dysfunction, including articulation and muscle-energy techniques (MET). Both types of techniques can increase cervical spine mobility, decrease neck muscle tone, and alter the viscoelastic properties of soft tissue, including in asymptomatic individuals. No studies on the effect of MET and articulation techniques on neck muscle tone according to surface electromyography (SEMG) were found. Comparison of the effect of different osteopathic techniques on the bioelectrical activity of neck muscles in one group of subjects was also not conducted.

The aim of the study: to compare the effect of muscle-energetic and articulation osteopathic techniques on the bioelectrical activity of neck muscles in young people with no complaints of neck pain.

Materials and methods. From December 2023 to March 2024, a study was conducted at the Department of Osteopathy of I. I. Mechnikov NWSMU (Saint-Petersburg) with 30 participants aged 22 to 44 years (median 27 years), including 17 women and 13 men. At the time of examination, they actively did not present complaints of musculoskeletal pain. Inclusion criteria were the presence of diseases and/or conditions that were absolute contraindications to osteopathic correction, a history of neck trauma; the presence of metal structures in the spine; taking medications affecting muscle tone at the time of the study; and neuromuscular diseases. Each participant in the study was treated twice: in the first stage of MET on the neck and in the second stage at least one month of articulation on the neck. Before and immediately after osteopathic treatment, the tone of the sternocleidomastoid muscles (SCMM) was palpatory examined and the average amplitude of their electrical activity A av. (pV) at rest was recorded using SEMG, which was performed on the Kolibri wireless electrophysiologic signal monitoring complex («Neurotech», Russia). Recordings were made synchronously from the right and left sides of the body, then the asymmetry of electrical activity was calculated as the modulus of the difference A av. between the left and right sides.

Results. During palpatory examination before the exposure at both stages, the tone of the SCMM was most often evaluated as normal or elevated. After application of both MET and articulation, the number of persons with hypertonus statistically significantly decreased and increased with normotonus (p=0,02), while the groups before and after application of these techniques did not differ from each other (p>0,05). The average amplitude of the electrical activity of the SCMM after both MET and articulations was statistically significantly decreased, indicating a decrease in muscle tone. There was no statistically significant difference in this index before and after osteopathic techniques at the first and second stages (p>0,05). After MET, there was a tendency to decrease the asymmetry of the average electrical activity between the left and right SCMM, but these changes were not statistically significant (p=0,11). After articulation, the asymmetry of average electrical activity between the left and right SCMM decreased statistically significantly (p=0,032).

Conclusion. A single application of osteopathic techniques of MET and articulation equally reduces muscle tone and, accordingly, the electrical activity of the sternocleidomastoid muscles. At the same time, articulations additionally reduce the asymmetry of electrical activity of these muscles, i. e. they normalize muscle tone more harmoniously. To objectify for the doctor and the patient such an important result of osteopathic correction as a decrease in muscle tone and reduction of its asymmetry, the method of surface EMG is recommended. If the method of electrode application and examination is followed, this method gives reliable and repeatable results, which is the basis for its use as an objective method of proving the effectiveness of osteopathic techniques.

Introduction. The frequency of diseases of large joints is steadily increasing. In 2019, in the Russian Federation, among the population over working age, osteoarthritis was diagnosed in 420,000 patients for the first time in their lives. At the same time, the understanding of the mechanisms of development of pathologies of large joints among physicians is deepening. Thus, the International Classification of Diseases-11 rejects the term «osteoarthritis» (ICD-11) in favour of the term «arthritis», emphasising the inflammatory nature of this disease. Total knee arthroplasty, recognised as the gold standard for the treatment of gonarthritis, is used at late stages of the disease when other treatments are ineffective. In Russia, 50,000 total knee arthroplasty surgeries were performed in 2020. Each patient requires rehabilitation and preoperative preparation to achieve the best possible functional results of gonatritis treatment. Orthopaedic traumatologists see a reserve for improving the quality of treatment of patients with stage III-IV gonarthritis in the improvement of perioperative support and in increasing the preand postoperative awareness of patients. Non-medicamentous treatment methods used in the preoperative period can be considered as prerehabilitation, increasing the rehabilitation potential of the patient after total knee arthroplasty.

The aim of the review: to systematise information on the use of non-medicamentous methods in conservative treatment and preoperative preparation of patients with gonarthritis and to evaluate the possibility of their use in the prerehabilitation of patients.

The aim of this review was to systematize the functions of the diaphragm and their disorders occurring during artificial lung ventilation, as well as to evaluate the possibilities of their osteopathic correction. The diaphragm is not only the main respiratory muscle, but also takes part in the functioning of cardiovascular, digestive and other systems of the body, including the central nervous system. Consequently, dysfunctions of the diaphragm negatively affect the condition of the entire body. They can be formed for various reasons, including in patients who are on artificial lung ventilation for a long time. Instrumental diagnosis of diaphragm dysfunction has not been developed, but osteopathic physicians have techniques for both diagnosis and correction of diaphragm dysfunction. There are relatively few publications proving the positive effect of osteopathic correction on external respiratory function. Osteopathic treatment of the diaphragm has potential benefit in reducing the time patients spend on ventilator and their rehabilitation afterwards. No such studies were found in the available literature, but they are highly relevant and may open new perspectives for the application of osteopathic correction.

Delay of speech and motor development in children is an urgent medical and social problem affecting various aspects of life of a child and his family. Early detection and correction of these disorders are important for further development of a child. In this regard, methods of manual therapy and osteopathy are considered as one of the promising approaches to solving this problem. The aim of the paper is to analyze the current scientific data, highlighting the possibilities of applying manual therapy and osteopathy in the correction of delayed speech and motor development in children. Within the framework of this review, we analyzed the results of studies, as well as descriptions of clinical cases published in refereed medical journals mainly for the last 5-10 years. It was found that the use of manual therapy and osteopathy methods in delayed speech and motor development in children contributes to normalization of muscle tone, improvement of blood circulation and lymph flow. The positive influence of these methods on the formation of movement coordination skills, fine motor skills, as well as the improvement of articulation and speech quality has been revealed. Their effectiveness in the complex rehabilitation of children with various nervous system disorders accompanied by delayed speech and motor development has been shown. Thus, the data testify to the prospective application of these therapeutic methods in the complex treatment of delayed speech and motor development in children.