The article presents a model of quality management in clinics providing medical services. The model proposes a systematic approach and considers the necessary input data of the quality of the structure, of the technologies (processes) used, of the results of medical care, patients’ satisfaction, and permits to assess the quality and the safety of medical activity on different levels of management. The work describes the forms and the levels of control, persons responsible for the quality of medical services and the quality management. The tables present the quality assessing and correcting algorithms.

An anonymous sociologic inquiry of 292 osteopathic physicians from 7 Russian cities and of a similar group of chiropractic physicians (control group) was held. 415 patients who received osteopathic medical care in St. Petersburg were interviewed. The specific character of osteopathic medicine requires doctor’s particular attention to the compliance with ethical standards. However, not all osteopathic physicians exactly follow the principles of medical ethics: only 69 % provide the patient the complete information about his/her disease. Half of patients said that doctors did not ask directly their permission to treat them. In general osteopathic physicians respect ethical standards more than chiropractic physicians. It seems useful for osteopathic and chiropractic physicians to undergo an extra training on medical ethics.

The article describes a new model of a skull with movable articulations designed for practical use. The model provides an imitation of bone mobility in the sutural region of the interosseous joints. It appears as a skull simulator, designed to develop the skills of palpation of cranial tissues. The model composition and characteristics reflecting the possibilities of using are presented in the description.

The article presents the results of the implementation of an algorithm and of the creation of interdisciplinary teamwork methodological approaches in order to provide aid to children presenting speech and dentoalveolar disorders. Creation of a common educational and terminological space for specialists (osteopaths, neurologists, dentists and orthodontists and speech therapists) is realized in consequence of organization of seminars, round tables and workshops.

Introduction. The cranial rhythm is represented by the rhythmic movement of the skull bones associated with the cyclic changes in production and pressure of the cerebrospinal fluid. The existing methods of instrumental recording of the quantitative characteristics of the cranial rhythm are either invasive, either contact, or very complex. Objective. To evaluate the EHF-bioradiolocation method as a method of recording of the quantitative characte-ristics of the cranial rhythm. Methods. Twenty volunteers were examined. At the first stage of the study, we determined the optimal conditions for registering the cranial rhythm with the help of the EHF bioradiolocator. At the second stage, the volonteers’ cranial rhythm was registered with the use of an EHF-bioradiolator. Then the volonteers were subjected to osteopathic diagnostics and correction. After that the cranial rhythm was recorded again. Results. For the first time we registered the cranial rhythm with the help of the EHF-bioradiolocator. In most cases, the frequency of the cranial rhythm recorded by the device coincided with the frequency determined by an osteopath. After the osteopathic treatment, the total amplitude of the oscillations increased in all the patients. Assessment of changes in the frequency of the cranial rhythm was difficult due to the presence of several harmonics. Conclusion. With the help of the EHF-bioradiolocator, it is possible to register the quantitative characteristics of the cranial rhythm - frequency and amplitude. The methodology we developed is safe and relatively simple. It is non-contact, and can be used both for diagnostic purposes, and for monitoring and evaluation of the treatment results.

Introduction. In recent years there has been an increase in the frequency of obstetric operations and surgical deliveries. A high percentage of obstetric complications in labor has been recorded. These complications often require surgical interventions. Traumatism of parturient women and newborns require a comprehensive approach in order to prevent this undesirable phenomena. In this case, one of the methods that can improve the state of the birth canal and of the woman’s body as a whole is osteopathic correction. Objective. To evaluate the influence of osteopathic prenatal care on the birth process. Methods. 103 pregnant women who had more than 13 weeks of pregnancy, took part in the study. They had no severe extragenital pathologies and no aggravated obstetric anamnesis. All the women were divided into two groups by randomization method. The main group ( n =53) included women who received osteopathic treatment during the preparation for childbirth. In the control group ( n =50), no osteopathic treatment was performed. The parturient women were assessed according to the way of labor, the frequency of complications and the duration of labor. Results. It has been discovered that the parturient women who received osteopathic treatment of the somatic dysfunctions presented a statistically significant decrease in the number of deliveries by cesarean section ( p <0,05), a decrease in the frequency of perineal injuries ( p <0,05) and a higher incidence of labor with a normal duration ( p <0,05) in comparison with the control group.Conclusion. Osteopathic correction of somatic dysfunctions can be recommended to pregnant women in order to prevent labor complications.

Introduction. According to the world statistics, the number of speech disorders in children is steadily growing, and therefore it becomes very important to detect and to correct them. At the same time, there are no research proving the effectiveness of osteopathic treatment of children presenting speech pathologies.Objective. To justify the effectiveness of osteopathic treatment of children presenting pseudobulbar dysarthria aged from 3 to 6 years old using objective data of neurological, osteopathic, ultrasound and neurophysiological examinations. Methods. 44 children aged from 3 to 6 years old with a diagnosis of the pseudobulbar dysarthria took part in the study. The average age at the beginning of the study was 4,2±0,7 years old. Two homogeneous groups of 22 children each were formed by simple randomization method with the use of a random number generator. Neurological, logopedic and osteopathic status of all the patients was evaluated. Duplex scanning of brachiocephalic vessels and an electro- encephalogram were made. Patients of the main group received osteopathic treatment in combination with neurological and logopedic treatment, while the control group was treated only by the neurologist and the speech therapist.Results. The study showed that the combination of osteopathic treatment with medical therapy and logopedic correction significantly improved the indices of cerebral hemodynamics and bioelectric activity of the brain, contributing to more active recovery of speech functions and decrease of concomitant neurological disorders, in comparison with the medication therapy combined with logopedic treatment.Conclusion. The results obtained permit to recommend the inclusion of osteopathic treatment in the standards of medical care for children presenting pseudobulbar dysarthria.

Introduction. Platypodia, taking the lead in the structure of children’s pathologies of the locomotor system, makes from 30 to 60 % of all the diseases of this type. It is considered that different somatic dysfunctions can cause platypodia, and thus the use of methods of osteopathic diagnostics and correction can provide high effectiveness in treatment of platypodia in children.Objectives. To justify the use of osteopathic diagnostics and correction in combined therapy of platypodia in children.Methods. 30 patients aged from 10 to 11 presenting platypodia were examined. They were divided in two groups of 15 participants. Children from the trial group received osteopathic correction together with the traditional treatment. The results of the treatment were evaluated in accordance with the dynamics of the complaints. The state of the feet was evaluated according to the results of plantography. Moreover, the patient’s osteopathic status was evaluated.Results. The treatment dynamics in children from the control group showed that the number of complaints decreased in a statistically significant manner, the Chizhin index showed the rendering of the foot arch to the norm, somatic dysfunctions disappeared. It was noted that children from the control group presented less complaints, the Chizhin index decreased, but the foot was flat and the number of somatic dysfunctions didn’t change.Conclusion. The results of the research proved the effectiveness of osteopathic correction in treatment of flatfoot in children, which permits to recommend to include osteopathic treatment in combined therapy of the flatfoot in children’s polyclinics working practice.

In 26 patients presenting confirmed primary gonarthrosis, clinical and instrumental examinations were conducted in order to evaluate the effect of the energy osteopathy. The examination was followed by the statistical processing of the obtained data. Three types of the organism’s reactions to the treatment were identified: instant, quick and delayed, which permitted to make a conclusion about the effectiveness of the method used, despite the different informative value of the data of the polyparametric study.

Introduction. The problem of psychosomatic effects is one of the most difficult problems of modern medicine. There are a large number of theories describing the causes and mechanisms of the emergence and development of psychosomatic diseases from the perspective of various scientific schools. In particular, the neurophysiological branch explains the emergence of psychosomatic disorders by the alteration of cortico-visceral relationship.Objective. To study the role of the limbic system in the genesis of psychoviscerosomatic disorders.Methods. Analysis and synthesis of the literature data.Conclusion. In the lignt of knowledge about the structure and functioning of the limbic system, it can be assumed that the cause of many psychosviscerosomatic disorders is the containment of one's wishes and emotions, which find their way out in the form of disturbances in the work of an organ or a system. The development of psychosomatic diseases occurs when there is a predisposition to certain reactions.

Proposed model of an algorithm of differential and diagnostic approach to the children’s problems is necessary for determination of indications and contra-indications for osteopathic aid in pediatric practice. The model is non-invasive and not labor-intensive. It may be used by osteopathic physicians with a view to provide better osteopathic aid to children.

The existing concepts, principles and notions accepted in osteopathy are described on the basis of the analysis of literature. The branches of osteopathy and the principles on which the osteopathic diagnostics is based, models of structural and functional relations, types of disorders and dysfunctions are considered.Methods. Content analysis and analysis of literature data.

The article considers the main notions of vertebroneurology, the history of its development, classification of vertebrogenic diseases, their etiology and pathogenesis. The main clinical manifestations and the possibilities of diagnostics of vertebrogenic diseases are described. Both surgical and conservative methods of treatment of vertebrogenic pathologies are considered. Special attention is paid to the possibilities of osteopathic treatment of the diseases of the vertebral column as it is the most harmless and effective method. A number of frequently used osteopathic techniques which proved to be the most effective are described.