Introduction. Panic attacks (PAs), not infrequently occurring against the background of apparent health, are fairly common in general medical practice and can accompany many mental, somatic, and neurological diseases. Unfortunately, in current studies of characteristics of patients with PAs insufficient attention is paid to the body as a source of physical suffering. A number of studies have confirmed the effectiveness of osteopathic treatment techniques aimed at eliminating the body′s somatic dysfunctions (SDs) as well as reducing the severity and frequency of PAs up to their complete disappearance. Also, it is obvious that there is a certain connection between panic attacks and structural and functional disorders of the body. However, criteria for risk-prediction of PAs development in healthy people and patients with PAs have not been developed.
The aim of the study: to develop criteria for risk-prediction of PAs development in healthy people and patients with PAs using osteopathic techniques based on the analysis of structural and functional disorders.
Materials and methods. The study involved 123 participants aged 39,4±10,9, including 21 men (17,1 %) and 102 women (82,9 %). All patients were divided into two groups with the first group representing 73 people with panic attacks and the second group — 50 people without panic attacks. All the patients were examined using osteopathic techniques in accordance with clinical practice guidelines.
Results. Patients with PAs have a noticeably greater number of somatic dysfunctions compared to healthy people, statistically significantly differing from them (p>0,001). Despite the diversity of SDs of the body, the following SDs are more often observed in patients with PAs: local somatic dysfunctions of the upper thoracic vertebrae, upper ribs, the sphenobasilar synchondrosis (SBS) patterns, and/or SDs of cranial sutures. A combination of these dysfunctions increases the risk of panic attack development. It can be assumed that not only an external provoking factor is needed for PA development, but also the body′s proneness to it, which is expressed as a certain combination of the SDs disrupting the normal functioning of the body, and may indicated a somatopsychiatric disorder.
Conclusion. Osteopathic techniques make it possible to predict the risk of developing PAs on the basis of the identified combinations of SDs of the first and second thoracic vertebrae, the first and second ribs, SBS patterns, and/or cranial sutures, to complement generally approved methods of diagnosing panic disorder and aid in the differential diagnosis of complex clinical cases.

Introduction. High physical and emotional stress adversely affects physicians′ health. Static, often prolonged, working postures create suboptimal load on the musculoskeletal system, particularly the cervical spine. Extended neck flexion (e. g., over operating tables, computer work) and excessive psychoemotional tension contribute to cervicalgia. Medical professionals themselves rarely seek medical care, compounded by time constraints limiting rehabilitation opportunities. Given surgeons′ unique demands, providing effective treatment with minimal procedures is crucial. These factors defined the study′s purpose.
The aim of the study: to compare clinical efficacy of osteopathic correction and massage in cervicalgia therapy for surgical specialists experiencing prolonged occupational overload.
Materials and methods. The prospective controlled randomized study was conducted from March 2024 to December 2024 on the basis of the Perm Regional Clinical Hospital. 36 operating surgeons aged 35–55 years were under observation. Depending on the applied method of treatment the patients were divided into two equal groups of 18 people each — the main and control groups using randomization envelopes. Patients of the main group received osteopathic correction (2 sessions with an interval of 14 days). Patients of the control group received a course of medical massage (10 sessions lasting 60 minutes each). All patients were assessed for osteopathic status, level of pain syndrome, limitation of life activity due to neck pain, volume of active movements in the cervical spine before treatment and 7 days after its completion.
Results. In the patients of the main group a statistically significant (p<0,05) decrease in the frequency of detection of the following somatic dysfunctions of the regional level was obtained: thoracic region, visceral component, pelvic region, structural and visceral components. According to these indicators after the completion of treatment, the groups became statistically significantly different (p<0,05). In patients of the control group there was a statistically significant (p<0,05) decrease in the frequency of detection of only somatic dysfunctions of the thoracic region, structural component. Statistically significant (p<0,05) decrease in the degree of pain syndrome severity and limitation of vital activity both in patients of the main and control groups was noted on the background of the conducted treatment, but in the main group the positive changes were significantly more pronounced (p<0,05). Both patients in the main group who received osteopathic correction and patients in the control group who received medical massage showed a statistically significant (p<0,01) increase in the volume of active movements in the cervical spine. There were no significant differences between the studied groups in this indicator after treatment completion.
Conclusion. Osteopathic correction demonstrated superior pain reduction and functional improvement vs. massage in surgeons with occupational overload. Both methods comparably improved cervical spine. Osteopathy is recommended for this cohort, particularly when massage is contraindicated. Further research is warranted.

Introduction. Celiac disease is an immune-mediated disease caused by gluten consumption in genetically predisposed individuals. The main site of damage in celiac disease is the duodenum, where atrophic changes in the villous portion of the mucosa develop. Mucosal damage and inflammation can affect intestinal contractile motility through disruption of complex hormonal and neuro-immune regulation. It is known that osteopathic correction can influence the motor and evacuatory activity of the gastrointestinal tract.
The aim of the study: to evaluate the results of osteopathic treatment on stomach and duodenal motility in patients with celiac disease.
Materials and methods. In accordance with the inclusion criteria, 131 patients with diagnosed celiac disease associated with gallbladder dysfunction who received medical care in the gastroenterology department and at the clinical base of the Department of Osteopathy I. I. Mechnikov North-Western State Medical University (LLC «Mokhov Institute of Osteopathy») from 2016 to 2022 were included in the study. All subjects were distributed into 3 groups by the method of simple randomization. The main group included patients who received combined therapy (osteopathic correction and ursodeoxycholic acid preparations) — 50 people. Ursodeoxycholic acid preparations were used for treatment of gallbladder dysfunction. The control group consisted of patients who received only ursodeoxycholic acid preparations — 35 people. The comparison group included patients who received only osteopathic correction — 46 people. Osteopathic examination was performed according to the approved clinical recommendations. Osteopathic correction of the identified somatic dysfunctions was carried out to the patients of the main group and the comparison group once every 10 days for 3 months, the average course of osteopathic treatment amounted to 6 sessions. Peripheral electrogastroenterography was performed using a gastroenteromonitor device GEM-01 «Gastroscan-GEM» (NPP «Istok-System», Fryazino), by means of which electrical potentials of the gastrointestinal tract sections were recorded from the skin surface of the subject. Analysis of the frequency spectrum of electrical waves reflecting the electrical activity of smooth muscle cells made it possible to judge about the motor activity and motor-evacuatory function of these gastrointestinal tract sections.
Results. Based on the obtained parameters of myoelectric activity evaluated by tone (Pi/Ps), rhythmicity (Kritm) and propulsivity (Pi/Pi+1stomach/duodenum), functional features were determined in patients with celiac disease, which were confirmed by a decrease in relative electrical power and rhythmicity coefficient, indicating anthroduodenal dyscoordination during food stimulation. Integral changes in myoelectric activity tone, rhythmicity and propulsivity indicated impaired postprandial motility of the stomach and duodenum, which was confi rmed by corresponding changes in the values of bioelectric activity indices after food stimulation. After the therapy (3 months after the beginning of the study) the overwhelming majority of patients of the main group and the comparison group had a normal variant of myoelectric activity response of the stomach (80 and 76,1 %, respectively) and duodenum (58 and 65,2 % respectively).
Conclusion. The use of osteopathic correction improves the functioning of the stomach and duodenum compared to drug treatment, affecting the coordinated functioning of the gastroduodenal area. The use of osteopathic correction contributes to the optimization of gastroduodenal motility.

Introduction. The course of pregnancy against the background of chronic pyelonephritis is associated with a high risk of complications both on the part of the expectant mother and the fetus. The peculiarities of intrauterine development of the child in pregnancy complicated by chronic pyelonephritis (delayed intrauterine development and chronic fetal hypoxia against the background of placental insufficiency due to infectious process, gestosis, anemia, etc.), as well as the non-physiological course of the birth act have a negative impact on the adaptation of newborn children in the postnatal period, leading to neonatal morbidity and early childhood disability. The complicated course of pregnancy and labor in women suffering from chronic pyelonephritis, which has a negative impact on the development of the fetus and the health of the newborn child, necessitates the search and inclusion in the dispensary monitoring of this contingent of women of new non-medicamentous ways to reduce perinatal risks in order to preserve the health of mother and child.
The aim of the study: evaluate the effect of osteopathic correction on the outcome of pregnancy and childbirth in women with chronic pyelonephritis.
Materials and methods. In a prospective controlled randomized study conducted from January 2018 to January 2025g on the basis of the medical clinic LLC «Institute of Osteopathy Mokhov» were included 180 pregnant women with chronic pyelonephritis without renal failure at the age of 25–45 years. A comparison group of 60 healthy pregnant women was also formed. All pregnant women with chronic pyelonephritis, depending on the correction method used, were divided by simple randomization using a random number generator into three groups: the main group (60 people) and two control groups of 60 people each. Patients of the main group received standard drug therapy according to the approved clinical recommendations and osteopathic correction of somatic dysfunctions (3 procedures with an interval of 10–14 days). Patients in the first control group received standard drug therapy. Patients of the second control group, along with drug therapy, used physical exercises 2 times a week for 1,5 months, as prescribed by a physician of therapeutic physical training (LPK). Healthy pregnant women were dynamically monitored. In all women, the term and method of delivery, the body weight of the newborn child, and Apgar scale scores at 1 and 5 minutes after birth were assessed (using data extracted from medical records).
Results. Osteopathic correction in the complex therapy of chronic pyelonephritis in pregnant women in comparison with isolated standard drug therapy and with the use of exercises of physical therapy in combination with standard drug therapy statistically significantly (p<0,01) promotes timely delivery of premature newborns with normal body weight without signs of asphyxia, and also statistically significantly (p<0,05) reduces the frequency of operative delivery, including emergency delivery, which is comparable with the corresponding indicators in healthy pregnant women.
Conclusion. The course of pregnancy in the background of chronic pyelonephritis is associated with a high risk of developing perinatal pathology. The inclusion of osteopathic correction in the complex treatment of chronic pyelonephritis allows to statistically significantly reduce the frequency of operative delivery, including emergency delivery, and also leads to timely delivery of full-term newborns with normal body weight without signs of asphyxia.

Introduction. Within modern osteopathic methodology, somatic dysfunctions (SD) may manifest at different levels: local, regional, and global. While the global level can be conditionally viewed as a combination of regional SDs (polyregionality), identifying regional and local SDs undoubtedly requires objective validation. Previous studies have identified impaired peripheral circulation in spinal osteochondrosis complicated by pain syndrome and described cerebral hemodynamics in patients with occupational dorsopathies. However, no studies assessing cerebral hemodynamics in young adults with cervical spine dorsopathy based on SD manifestation levels were found in available literature, thus defining this study′s aim.
The aim of the study: to prove differences in hemodynamics at different levels of SD in young patients with cervical dorsopathy.
Materials and methods. A cross-sectional study was conducted at the osteopathy department clinic of I. I. Mechnikov North-Western State Medical University from September 2018 to September 2022. The study included 631 patients diagnosed with dorsopathy. After applying inclusion/non-inclusion/exclusion criteria, 169 patients were excluded. Thus, a group of 462 patients was formed. All observed patients underwent ultrasound duplex scanning of extracranial sections of the head vessels, and osteopathic status was assessed in accordance with the approved clinical guidelines.
Results. In young patients with cervical spine dorsopathy, blood fl ow indices in the main arteries of the head do not differ from the age norms. Signs of cerebral venous dyscirculation were detected in 259 (56 %) examined patients. In patients with regional SD at the neck level in comparison with patients with local dysfunction at this level or without any dysfunction at all statistically significantly (p<0,05) more often venous dyshemia is detected, and there is a decrease in the average blood flow velocity along the right vertebral artery. No significant differences were registered in other cerebral hemodynamic parameters.
Conclusion. This study revealed specific hemodynamic features in areas of regional SD at the cervical level. The findings further validate distinguishing between local and regional SD levels and partially objectify their hydrodynamic component.

Introduction. Delayed psychomotor development (DPD) is a group of disorders united by clinical symptoms of lagging speech and mental development. The exact diagnosis is established at 3–5 years of age, when impairments begin to affect the child′s mental development, thinking skills, and understanding of abstract concepts. According to epidemiological studies, the prevalence of DPD in preschool children ranges from 8 to 10 %, depending on the socioeconomic conditions of their region of residence. Timely comprehensive multidisciplinary intervention can correct these impairments; however, it is often associated with high pharmacological burden and the need for daily visits to healthcare facilities over extended periods to undergo medical procedures, which carries certain risks given the high morbidity rates among preschoolers. The search for new non-pharmacological correction methods within the combined treatment of children with DPD–aimed at reducing drug burden on the developing organism and optimizing treatment protocols by decreasing the frequency of clinic visits–defined the purpose of this study.
The aim of the study: to evaluate the effect of incorporating osteopathic correction into combined treatment for preschool children with DPD on neuropsychological and speech therapy development indicators.
Materials and methods. A prospective randomized study was conducted at Children′s Polyclinic № 3 (Groznyy) from January 2023 to October 2023, involving 50 children diagnosed with DPD. Participants were divided into two comparable groups: a main group and a control group (25 children each). Patients in the main group received standard drug therapy, psychological-speech therapy correction, and osteopathic correction. Control group patients received only drug therapy and psychological-speech therapy correction. Upon treatment completion, osteopathic status, neuropsychological, and speech therapy indicators were assessed.
Results. Preschool children with DPD most frequently exhibited regional and local-level somatic dysfunctions. Dominant regional somatic dysfunctions included: Head region (64 %), Visceral component of the neck region (20 %), Meninges region (12 %). Incorporating osteopathic correction into combined treatment significantly increased the speech development coefficient from 14,6±1,5 to 44,4±0,9 (p<0,05), achieving normal speech development levels compared to the control group, where speech development remained low.
Conclusion. Within combined DPD treatment for preschoolers, osteopathic correction alongside standard drug therapy and psychological-speech therapy significantly improves speech development levels—normalizing them—compared to standard pharmacological and psychological-speech therapy alone in this patient category.

Introduction. Acute cerebrovascular accident (ACA) circulatory disorders are the cause of persistent motor disorders in the form of impaired static-dynamic functions and psychoemotional disorders, which significantly affect the quality of life of patients. Disability due to stroke ranks 1st among all causes of disability in Russia and is an important medical and social problem requiring a comprehensive rehabilitation approach. The biofeedback method (biofeedback therapy), as one of the modern methods of hardware rehabilitation, demonstrates its effectiveness in research on restoring lost functions in patients who have undergone ACA. One of the methods of neurorehabilitation of patients with ACA is osteopathic correction (structural, visceral, cranial), which improves the regulation of static and dynamic postural balance.
The aim of the study: to study the effectiveness of osteopathic correction on the formation of a motor stereotype in the rehabilitation of patients with ACA in the early recovery period.
Materials and methods. The study was conducted at the Biomechanics Laboratory of the Moscow Scientific and Practical Center for Medical Rehabilitation, Rehabilitation and Sports Medicine from November 2019 to March 2021. A randomized controlled prospective study involved 155 patients with stroke aged 40 to 75 years who underwent rehabilitation for 10 days in hospital. The patients were divided into two groups by simple randomization. Patients of both groups received standard preventive therapy for stroke (antiplatelet, lipidlowering, hypotensive therapy), as well as 10 sessions of physical therapy and Bio-feedback therapy. The main group underwent osteopathic correction after the first and fifth sessions of Bio-feedback therapy, while the control group underwent standard treatment without osteopathic correction. All patients underwent stabilometry, osteopathic examination, and a 10-meter walking time.
Results. The inclusion of osteopathic correction in the course of biofeedback therapy in patients in the early recovery period improves the function of postural control according to stabilometry (p<0,05) compared with standard treatment. Somatic dysfunctions at the global and regional levels were revealed in both groups. Among global-level somatic dysfunctions, rhythmogenic cranial impairment was identifi ed, which was also the dominant somatic dysfunctions in these patients.
Conclusion. Osteopathic correction in patients with ACA in the early recovery period improves the static-dynamic characteristics of the motor stereotype.

This article continues the topic of osteopathic physician personal brand raised in the magazine in issue 2 of the current year. Рatients go to the clinic but return to see a particular osteopathic physician. In this regard, the relevance and practical significance of the topic raised is obvious. Since little attention is traditionally paid to the issues of personal brand in the osteopathic environment, the authors set themselves the goal of filling the existing deficit and offering the osteopathic community a technology for the formation of personal brand of an osteopathic physician, developed on a scientific basis and based on extensive consulting experience in the formation of personal brand for specialists of helping professions. It is worth noting the fact of increased interest to the issue of personal brand formation on the part of representatives of public authorities, science, education, culture, not to mention the steady interest on the part of small and medium-sized businesses. Judging by the appearance of fresh scientific articles on the personal brand of a doctor, the topic is becoming relevant for medicine as well. New media systematically publish content of varying quality containing recommendations on how to create and develop a personal brand. However, the authors of such content often only broadcast basic approaches that are more or less obvious and have been repeated many times. In this article we will consider the author′s view on the approaches to the formation and development of personal brand of an osteopathic physician, considering the specifics of work in a particular field of clinical medicine. For successful branding, it is necessary to implement three important goals, such as the positioning of professional osteopathic physician; education of society, including potential patients, in osteopathy; the fight against unfair competition in the market of osteopathic services, which includes the proposed model of positioning an osteopathic physician.

Introduction. One of the important conditions for osteopathic work is physical neutrality of the osteopathic physician — such a spatial position of the body that allows the physician to perform his work as effi ciently as possible, minimize fatigue and not to transfer his musculofascial tension to the patient. It has been found that very effective for the formation of stabilized posture is the use of various methods of recovery developed in the tradition of China and known under the common names of qigong and taichichuan. Stabilometric studies of postural balance, as well as electromyographic indices when performing taichichuan practice (in the stationary state of taichi) have not been found in the available literature.
The aim of the study: to compare the characteristics of postural balance and bioelectrical activity of muscles under normal and taichi condition.
Materials and methods. A pilot study of taichichuan instructors was conducted on the basis of the Institute of Osteopathy: a woman 56 years old, practicing for 25 years, and a man 53 years old, practicing for 10 years. The state of taichi is the so-called «pillar standing» in a straight-back, head-suspended position. For the study of postural balance, the «ST-150» stability platform was used. The following integral stabilometric parameters of vertical posture balance (Romberg test with American parallel foot placement) were studied: time-normalized area of statokinesiogram (S, mm2); average velocity of the center of pressure movement (V, mm/s); energy expenditure index (Av, mJ/s). Functional tests were performed: a belt was put on the subject in the shoulder girdle area and pulled forward or sideways with a force of about 5 kg; the subject was asked to make a movement with the straightened arm in the shoulder joint and hold it in a horizontal position. The electromyogram (EMG) of the deltoid muscle was additionally recorded using surface electrodes and the average amplitude of the EMG signal (A cf.) was measured in μV using the «Kolibri» wireless electrophysiological signal monitoring system.
Results. Most of the stabilographic indices in the normal state went beyond the reference values, although insignificantly. In the taichi state, all analyzed indices significantly decreased (in a woman all changes were statistically significant, p=0,028, in a man V and S, p=0,028), approaching or entering the normal limits, which indicates an improvement in postural balance. The externally influenced trials significantly changed the stabilographic indices, which is to be expected. In the taichi condition in both subjects, all indices statistically significantly decreased (p<0,05), and some even came within the reference values for the normal Romberg test without influence. Tests with holding the straightened arm in a horizontal position significantly changed the stabilographic indices, as the general center of gravity of the body was shifted. In the taichi condition, all indices decreased statistically significantly (p<0,05), and the mean velocity of the center of pressure displacement fell within the reference values for the normal Romberg test in both subjects. In the taichi condition, the mean amplitude of the EMG signal from the deltoid muscle is smaller, and there is less variation between the minimum and maximum values than in the normal condition. However, this difference was not statistically significant (p>0,05), most likely due to the small number of measurements.
Conclusion. Based on the results of the pilot study, it can be concluded that the state of taichi and the use of stabilized posture signifi cantly improves the stability of the human body in upright posture, including when the position of the common center of gravity changes as a result of both arm movement and external infl uence, and reduces energy expenditure to maintain the upright posture of the body. This result may be related to the harmonization of muscle tone and fascial framework, which requires further research. Movements that are performed according to taichichuan principles occur with a decrease in the electrical activity of the muscles, which should also be studied in more detail.

Introduction. Chronic apical periodontitis (CAP), affecting 11,2 % of the world′s population and ranking sixth in prevalence, is a serious public health problem. Despite the studied pathology, there are still gaps in understanding both the systemic effects of inflammation and the peculiarities of the local inflammatory response.
The aim of the study: to study the effect on inflammatory markers of the chronic periapical process with the description of the peculiarities of the inflammatory profile.
Materials and methods. The study was conducted from August to December 2024 on the basis of Yaroslavl SMU and the Medical Centre for Diagnostics and Prevention «Sodrugestvo» (Yaroslavl). The study included 94 patients of both sexes divided into three groups: the group with symptomatic CAP — 35 people; the group with asymptomatic CAP — 33 people; the control group — 26 people. The study was single-centre, prospective. Three groups of patients were examined before and after treatment. The treatment of CAP consisted of extraction of the affected tooth, which allowed the assessment of changes in the inflammatory profile both locally and systemically. The examinations were performed at two time points: before treatment (baseline) and 5 weeks after tooth extraction (after regeneration was complete). To assess the inflammatory profile, the content of 5 pro-inflammatory and 4 anti-inflammatory cytokines was examined. Blood sampling was performed twice: immediately before tooth extraction and 5 weeks after surgery. The level of cytokines in plasma was analysed using a special panel of NPO «EcoMed» (Russia) on a «Clima MC-15» device («DIACON-DS JSC», Russia). The results of measurements were presented in pg/ml. Statistical analysis was performed using Statistica v.14 programme. Normality of data was assessed by the Shapiro–Wilk test. Continuous data were presented as mean M±m. Differences between groups were analysed using analysis of variances. Group profiles were constructed by cluster analysis procedures. The probability of error was at p<0,05.
Results. The study showed a significant effect of CAP on inflammatory markers in peripheral blood. Before treatment, there was a significant increase in the levels of the pro-inflammatory cytokines IL -1β, IL -6, TNF-α and G-CSF in both symptomatic and asymptomatic patients compared to the control group. Multivariate analysis allowed us to identify characteristic features of the cytokine profiles for each group. A clear predominance of proinflammatory mediators was found in patients with symptomatic CAP, confirmed by high correlations between IL -1β and IL -6 (r=0,76), IL -1β and G-CSF (r=0,93). The asymptomatic group showed a less pronounced but still significant inflammatory response, characterized by moderate correlations of IL -1β with IL -6 (r=0,59) and TNF-α with OPG (r=0,62). The control group showed a balanced cytokine profile with low correlations between proinflammatory mediators (IL -1β and IL -6 r=0,38; TNF-α and RANKL r=0,26) and a dominance of anti-inflammatory factors. Changes in the ratio of OPG to RANKL confirmed the involvement of these proteins in the alteration of bone metabolism in CAP. After extraction of the offending tooth, statistically significant changes in OPG/RANKL parameters were observed, indicating the onset of bone regeneration processes.
Conclusion. The influence of CAP on the systemic inflammatory profile has been established. An increase in the levels of pro-inflammatory cytokines IL -1β, IL -6, TNF-α and G-CSF in both symptomatic and asymptomatic forms was noted before tooth extraction compared to the control group. Multivariate analysis revealed unique cytokine profiles of each group: dominance of pro-inflammatory cytokines in symptomatic course, moderate inflammatory response in asymptomatic and balanced profile in control group. Changes in the OPG/RANKL ratio confirmed the modification of bone metabolism in CAP and its correction after treatment.

Multimorbidity is the coexistence of two or more chronic diseases in the same person, without prioritization, in contrast to comorbidity, where the main disease is highlighted. Multimorbidity increases the burden of medication, significantly impairing the quality of life of patients, which prompts the search for additional non-drug methods of care. Osteopathic correction can have a positive effect on the main pathogenetic links of diseases, among which are biomechanical and neurogenic manifestations of somatic dysfunction (SD), as well as on emotionalaffective disorders, functional disorders of segmental and suprasegmental autonomic structures, nociceptive and antinociceptive systems. In the treatment of patients with diseases of the nervous system, the literature notes the effectiveness of osteopathic correction in a comprehensive approach, including those confirmed by neurophysiological and neuroimaging methods. However, data regarding the effectiveness of osteopathic treatment in multimorbid patients are insufficient. We present a clinical case demonstrating the possibilities of osteopathic treatment in a patient with multimorbidity — with focal reflex epilepsy, classical migraine with aura, combined with chronic tension headache and nonspecific chronic musculoskeletal pain. Each of her chronic conditions requires medication intervention: focal reflex epilepsy — constant administration of anticonvulsant medication, migraine attacks, chronic tension headache and musculoskeletal pain — management with non-steroidal anti-inflammatory drugs and/or analgesics. Also background — anxiety is noted, she is consulted by a psychologist and periodically takes anxiolytics (tranquilizers). In our opinion, among the complex of factors contributing to the realization of diseases of the nervous system, including epilepsy, trigeminovascular syndromes, chronic tension headache, chronic musculoskeletal pain in the neck and upper back, there may be morphological and functional features of the skull and associated tissues and structures, in addition to the main and other causes. In the present clinical case, the patient had several regional SD identified on osteopathic examination. The dominant biomechanical disorder is the head region SD, and in the structure of this regional disorder the most attention was attracted by: SD of the sphenobasillary synchondrosis of the lateroflexion with rotation (SBR) type and SD of the right temporal bone. The first osteopathic procedure with correction of the head region in general and the temporal bone in particular resulted in a significant improvement of the patient′s condition. Background headache, pain in the neck and lumbar region disappeared, the patient began to feel alert, increased activity and improved mood. Retrospectively, epilepsy and migraine attacks are rare, chronic tension headaches and nonspecific chronic neck and back pain are also rare.
Conclusion. The present clinical example is illustrative, as it demonstrates the appropriateness and relative efficacy of osteopathic treatment in a particular patient with several chronic diseases of the nervous system.

The relevance of this article is due to the desire to expand the understanding of osteopathic methods of treatment, which, according to the principles of osteopathic medicine, can not only improve the function of the musculoskeletal system, but also positively affect the work of internal organs, contributing to the prevention of their diseases. The data of studies devoted to the mechanosensitivity of cells of various organs and tissues, primarily due to the work of mechanosensitive ion channels (piezo channels), are presented. Despite the accumulated knowledge of the clinical manifestations of somatic disfunction, the relationship of these disorders to plastic and regulatory changes in visceral organs requires further investigation. Understanding how somatic disfunction affects these processes may significantly enrich our knowledge of the therapeutic effects of osteopathic treatment and other physical modalities, as well as their potential in the prevention of various diseases.

The lecture is devoted to the project of building integrative medicine based on the ideas of biotensegrity as an important concept of osteopathy. The ideas of holism and reductionism and their synthesis within the framework of holoreductionism are introduced. The concept of rational holoreductionism is considered as a philosophical and methodological basis of integrative medicine. On the example of biotensegrity constructions it is proposed to realize the ideas of rational holoreductionism in osteopathy. This approach is further generalized in the framework of the so-called physical-information model of biosystems, which is proposed to be considered as a starting theoretical model of integrative medicine.