Introduction. Nowadays osteopathy is an offi cial medical specialty. Many years of experience accumulated by osteopathic physicians in our country have proven its effectiveness. The analysis of research papers of those countries where osteopathy is widely used allows to draw the following conclusion: osteopathy is one of the least dangerous therapeutic methods provided that patients deal with well-trained and certifi ed specialists who work in the frame of possibilities of osteopathy. Due to the intensive development of this specialty in Russia it is necessary to provide scientifi c justifi cation to organizational and methodological approaches aimed at ensuring effective and high-quality osteopathic care to the population.Goal of research - to develop proposals in order to improve the quality and effectiveness of osteopathic care provision for the population, taking into account the current situation in health care.Materials and methods. Authors used the following research methods: historical and medico-organizational analysis, literary data analysis, content analysis as well as methods of descriptive statistics.Results. The research presents characteristics of clinics declaring osteopathic care provision, as well as qualities of osteopathic physicians. It also describes patients seeking osteopathic care, and sources of information they use.Conclusion. Authors propose a number of measures aimed at improving the availability and effectiveness of osteopathic care for patients such as training of doctors, creating of regulatory documents, developing quality criteria for osteopathic care provision and popularization of osteopathy among patients.

Introduction. The use of removable dental prosthesis often leads to the alteration of the function of the temporomandibular joint, which signifi cantly reduces patients' quality of life. Osteopathic correction can be considered as a method aimed to improve patients' quality of life after prosthetics.Goal of research - to study the effect of osteopathic correction on the quality of life of patients with removable prosthesis.Materials and methods. Two groups of patients took part in the study: The fi rst group consisted of 15 patients who underwent both orthopedic and osteopathic treatment. The second group (control group) received only removable dental prosthetics. Evaluation of the patients' quality of life was performed before the beginning of orthopedic treatment and after 3 months. Special quality of life questionnaire «Oral Health Impacts Profi le» (OHIP-14) was used.Results. As a result of combined osteopathic and dental treatment, the number and the severity of regional dysfunctions reduced, whereas the quality of life of patients signifi cantly improved.Conclusion. Osteopathic correction can be recommended as a method improving the quality of life of patients with removable dental prosthesis.

Introduction. To date, there have existed different sets of symptoms of CFS/ME. Scientifi c ideas about the clinical manifestation of this disease continue to appear.Goal of research - to justify osteopathic approach in diagnostics of CFS/ME.Materials and methods. Analysis of approaches to the diagnostics of CFS/ME, osteopathic diagnostics.Results. The author describes the possible pathogenesis of CFS/ME, which may be related to the neurolymphatic changes connected with the alteration of the drainage. All of this leads to dysfunctions of the sympathetic system. Medical history of patients with CFS/ME often contains indications on spinal trauma or congenital developmental disorders of the cranium and vertebral column, which may alter the function of the lymphatic system and lead to the further central neurotoxicity through perivascular spaces. The article presents a protocol of physical signs, typical for patients with CFS/ME, and the results of diagnostics of 94 patients: 52 patients with CFS/ME and 42 non-CFS/ME controls.Conclusion. The research concluded that examining for physical signs is both quick and simple for the practitioner and may be used as an effi cient screening tool for CFS/ME.

Goal of research - to evaluate the role of myofascial syndrome developing on the background of cervical pathology, dysfunction of the temporomandibular joint or occlusive disorders. The myofascial syndrome manifests itself in the development of pain phenomena, cochlear and vestibular symptoms similar to the symptoms of the diseases of the ENT organs.Materials and methods. We have analyzed the results of several studies conducted in 2012-2017 at L. I. Sver-zhevsky Otorhinolaryngology Research Clinical Institute, which involved more than 3 000 people with neck and head pain and/or cochleovestibular symptoms in combination with myofascial pain syndrome (MFPS), developing on the background of cervical pathology, dysfunction of the temporomandibular joint or occlusive disorders.Results. Patterns of development of the MFPS in head and neck regions, as well as peculiarities of diagnostics of trigger points with pain and non-pain manifestations (buzzing in ears, ear fullness, loss of hearing, dizziness) were defi ned. The principles of MFPS treatment with pain and non-pain manifestations and therapy options used in L. I. Sverzhevsky Otorhinolaryngology Research Clinical Institute were described. The effect of pathogenetic therapy is shown in the collaborative work of doctors of different specialties: ENT specialist, neurologist, physiotherapist and dentist.Conclusion. Myofascial syndrome of the pericranial muscles can be one of the causes of face and neck pain imitating diseases of ENT organs and dental pathologies. Treatment of such clinical forms should be the subject of an interdisciplinary approach. It should include pharmaceutical and non-pharmaceutical methods: analgesia, relaxation and stretching of the corresponding muscles.

Introduction. Objective measurement of the muscle tone, especially on specifi c areas, represents a serious clinical issue. The most objective and well-known method for studying muscular function is electromyography. A non-invasive assessment of muscle tone and rigidity is possible by using Myoton digital palpation device. However, these methods have a range of disadvantages, which disable them to be widely used for dynamic evaluation of muscles’ viscoelastic properties during treatment, including after osteopathic correction.Goal of research - to evaluate the viscoelastic properties of tissues using palpation and instrumental techniques before and after osteopathic correction.Materials and methods. 14 students (7 practicing sports and 7 not practicing sports) aged 18-23 without problems with the musculoskeletal system were examined. Osteopathic diagnostics and measurement of viscoelastic properties of muscles before and after osteopathic correction were performed by vibrational viscoelastometry.The results. The elasticity in sportsmen’s muscles is higher compared to the elasticity of muscles of those who do not practice sports (p=0,04). Viscosity comparison did not show any difference (p=0,6). In the non-practicing sports group, the osteopathic treatment decreased muscle elasticity (p=0,000002), that may indicate their relaxation. At the same time, the viscosity was practically unchanged (p=0,45). In the sports-practicing group the elasticity and the viscosity of the muscles increased after the osteopathic correction session (p=0,0000002 and p=0,001, respectively). In the same group, two weeks after the fi rst session, muscle elasticity decreased (p=0,02) and the viscosity increased (p=0,03). These changes may be considered as favorable. After the second session of osteopathic correction, the elasticity decreased even more (p=0,04), which means that muscles became relaxed.Conclusions. Therefore, reported results showed that the viscoelastometry method had a real potential for an objective evaluation of the skeletal muscles’ condition and the effects of osteopathic treatment. Modifi cations in the viscoelastic properties of the tissues demonstrate that the effects of osteopathic treatment are ambiguous and depend on the initial muscle’s condition.

Introduction. One of the main tools of an osteopath are soft tissue techniques, which have a number of particular qualities such as minimization of force and duration of indirect techniques with an emphasis on muscle and ligamentous structures; combination of gestures, tendency to maximal relaxation and exclusion of direct action on pathological symptoms such as tension, overtone and pain. Minimization of the force applied during the performance of soft tissue techniques often invites a question whether there are differences between the usual touch and the therapeutic touch of an osteopath.Goal of research - to reveal the changes in the bioelectrical activity of the cerebral cortex arising in the process of osteopathic treatment in order to prove its specifi city in comparison with nonspecifi c tactile stimulation (neutral touch).Materials and methods. 75 people were examined with the use of multiparameter analysis of multichannel EEG in different times. 25 patients were clinically healthy adults, whereas 50 patients had signs of somatic dysfunctions.Results. Computer encephalography permits to perceive the difference between the neutral touch and the therapeutic action. An identifi cation reaction is a response to the neutral touch (changes in brain bioelectrical activity with an increase in statistically signifi cant connections in the temporal lobes), whereas the therapeutic action provokes the state of purposeful brain activity during still point (intensifi cation of frontooccipital interactions).Conclusions. Osteopathic action causes additional tension in the processing of incoming information, which requires participation of different brain regions, including interhemispheric mechanisms associated with analysis, maintenance of attention and regulation of targeted activities.

Ntroduction. Celiac disease is a genetically determined disease, which is often associated with the dysplasia of the connective tissue, and may be considered as one of the causes of the secondary biliary dysfunction. Functional alterations play a signifi cant role in the formation of chronic pathology. The basis for osteopathic treatment is the correction of functional alterations, aimed at amelioration of work of the basic elements of the biliary system.Goals of research - to evaluate the clinical effectiveness of osteopathic correction in treatment of biliary dysfunction in patients with celiac disease.Materials and methods. 48 patients (23 men and 25 women) diagnosed with celiac disease aged from 18 to 35 took part in the research. Their average age was 26,5±2,1 years old. All the patients underwent clinical and osteopathic examination, I. A. Alexeev-Berkman coprological examination, ultrasound examination «SonolinePrima LC» («Siemens», Germany) performed according to the standard methodology with the determination of the fraction and the coeffi cient of the evacuation. Patients received osteopathic treatment during two months. Results. The assessment of the diagnostic fi ndings showed that among 48 patients with biliary disorders with a background of different anomalies of the gall bladder 41 (85,4 %) patients suffered from clinical manifestations of the disease. During the osteopathic examination of patients typical somatic dysfunctions were found: regional biomechanical disorders (cervical, thoracic, lumbar and pelvic regions) and local biomechanical disordes (cupula of the diaphragm on the right, lower ribs on the right, ligamentous apparatus of the liver, gall bladder, duodenum). The ultrasound examination of the abdominal organs revealed different anomalies of gall bladder in combination with the alteration of the colloidness of the content of the gall bladder. Statistically signifi cant contingency between the presence of the biliary sludge and the type of anomalies of the gall bladder was determined (χ2=8,12; р=0,017; С=0,55). After the course of osteopathic treatment the main clinical manifestations signifi cantly reduced, the mobility improved in all the regions of the spine, and in the thoracic diaphragm, the importance and the manifestation of somatic dysfunctions decreased in the liver, in the bile ducts, in the stomach, in the duodenum, and in the bone structures of the pelvis (р<0,01). Also the process of digestion improved: creatorrhoea, steatorrhoea, amylorrhea were less expressed (p<0,05), the contractile function of the gall bladder improved (emptying coeffi cient 59,8±1,84 %) and the anechogenic effect was achieved.Conclusion. The use of osteopathic methods showed high effectiveness in treatment of biliary pathologies in patients with celiac disease.

Introduction. The effect of the osteopathic treatment in the postpartum period has not been adequately studied in Western countries. The most part of the studies are focused on postpartum pain, whereas there is not enough information on the effect of osteopathic treatment on the recovery of perineal muscles.Goal of research - to study the effect of osteopathic treatment in combination with physical therapy on the recovery of the perineal muscle system in women in the postpartum period. Materials and methods. The study examined 38 women (mean age 30±5 years old) who underwent therapy in order to restore the perineal muscular system in the postpartum period. They were divided into two groups. Patients of the focus group received therapy in combination with the osteopathic correction. Women of the second group received therapy in combination with the imitation of manual treatment. Results. The data analysis shows a signifi cant difference in the results of testing of the perineal muscle strength in patients of both groups by the end of the treatment: from 24,51±18,55 to 148,21±127,51 in the focus group, and from 29,32±20,32 to 94,22±78,51 in the control group. The intensity and the duration of the perineal muscle contraction did not differ signifi cantly by the end of the treatment in both groups.Conclusion. Osteopathic treatment in combination with the rehabilitation therapy of the perineum signifi cantly improves the muscle tone and promotes the restitution of the perineal muscle quality in the postpartum period in comparison with classical treatment.

Introduction. In recent years, there has been a signifi cant increase in number and severity of spinal pathologies among the adult population of the Russian Federation. From 80 to 100 % of the adult population experience pain of different intensity in different parts of the spine after sitting for a long time. Modern treatment of patients with postural disorders does not always lead to positive results. In some cases it even causes progression of the disease. As a general rule, the existing methods of treatment do not take into account the concept of the integrity of the human body, which is fundamental for osteopathic treatment.Goal of research - to determine the incidence of somatic dysfunctions in patients of different age groups with postural disorders and to develop recommendations in order to optimize osteopathic correction taking into account patients’ age and type of postural disorder.Materials and methods. The study of the osteopathic status of patients of 3 age groups from 6 to 16 years, from 17 to 26 years and from 27 to 55 years was performed. The type of postural disorder in accordance with Stoffel classifi cation rules was determined with the use of computer optical tomography. Results. The study shows the infl uence of traumatic injuries on the formation of various types of postural disorders as well as the structure of the osteopathic status depending on the age and types of postural disorders.Conclusion. The analysis of the medical history data allowed to assume that traumatic impact may induce formation of various types of postural disorders. Patients’ age infl uences the structure of the dominant somatic dysfunctions. The incidence of somatic dysfunctions depends on the type of postural disorder.

Introduction. In 26-43 % of fractures of the bones of upper extremities secondary displacement of fragments occurs in the plaster bandage. It is probable that osteopathic treatment of patients with bone injuries of upper extremities promotes more rapid recovery of impaired functions of the damaged structure preventing possible complications and disability and improving patients' quality of life. That is why it is viable to study the infl uence of osteopathic correction on the healing process of the Colles’ fracture with displacement of bone fragments.Goal of research - to evaluate the effect of osteopathic treatment on the process of adhesion of Colles’ fracture with the displacement of fragments.Materials and methods. 40 patients took part in the research. 20 of them formed the main group. The other 20 formed the control group. An osteopathic examination of patients was performed and somatic dysfunctions were found. The visual analogue scale of pain was used. In order to evaluate the terms of adhesion, an X-ray diagnostic method was used.Results. Osteopathic diagnostics showed that somatic dysfunctions of the left or right wrist were dominant in patients admitted to the trauma bay with Colles’ fracture. Patients of the main group showed a faster normalization of the microcirculation, which meant that negative consequences of edema were less likely to appear.Conclusion. The study of the effect of osteopathic treatment of fractures of distal metaepiphysis of radial bone should be continued. The focus should be on the development and use of new diagnostic methods, which can prove the positive effect of osteopathic treatment on the terms of adhesion of the radial bone.

Goal of research - to evaluate the results of combined therapy of distal occlusion in patients aged 6 to 12.Materials and methods. 30 patients aged from 6 to 12 with a dentoalveolar overjet were examined. Patients were divided into two groups (main and control), depending on the treatment used. In the main group (12 cases), combined therapy (instrumental orthodontic and osteopathic treatment) was performed. In the second group (18 cases), only instrumental orthodontic treatment was performed. The study of sagittal and transversal parameters of teeth and dentition was carried out on the cast models of jaws. X-ray examination (orthopantomography of the jaws and teleradiography of the patient's head (lateral view)) was performed in order to determine the reason of the occlusion anomaly (slightly distal position of the lower jaw). Orthodontic treatment in both groups was performed with the help of the Fränkel Functional Regulator Type I. Patients of the main group underwent osteopathic correction according to the following scheme: once in two weeks during two months, then once in three-four weeks, in accordance with the individual plan.Results. Patients from the main and control groups had the same initial level of somatic dysfunctions. As a result of combined therapy in 8,0±0,3 months there was a positive dynamics in changes of anthropometric indicators, face profi le, and posture of patients from the main group. The number of somatic dysfunctions decreased. In the control group, similar results were obtained in 12,0±0,5 months. Thus the treatment in the control group was 1,5 times longer (p=2,61, p<0,01).Conclusion. Osteopathic correction signifi cantly reduces time of treatment of dentoalveolar overjet caused by slightly distal position of the lower jaw. Correction of dentoalveolar overjet decreases of somatic dysfunctions.

Introduction. Strokes of various etiologies are the leading cause of disability in adults. Post-stroke periarthropathy of the shoulder joint is a frequent complication of this disease. Thus, it is relevant to study the possibility of use of osteopathic correction, as a method allowing to reduce the amount of medications in treatment and rehabilitation of patients with this disease.Goal of research - to study the possibility of use of osteopathic treatment in complex rehabilitation therapy of patients with post-stroke periarthropathy.Materials and methods. 22 patients with post-stroke periarthropathy of the shoulder joint were divided into 2 groups. The first group received medications, physiotherapy and exercise therapy. The second group received osteopathic treatment together with the same set of procedures. In the course of treatment the osteopathic status and the intensity of pain syndrome according to the VAS were assessed. The intensity of the pain syndrome was evaluated immediately after the treatment and after 6 months.Results. As a result of osteopathic treatment some regional and local somatic dysfunctions disappeared, or their intensity decreased. Reduction in intensity of pain in patients who received osteopathic treatment was recorded up to six months after the treatment, whereas the control group showed good reduction in pain immediately after medical and physiotherapeutic treatment. Conclusion. There are grounds to use osteopathic treatment in a complex rehabilitation therapy of patients with post-stroke periarthropathy

Introduction. Many scientists have studied connection between the structure of the spinal column and its function, phylogenetic aspects of formation of its curves, etc. However, we cannot consider this issue resolved. Goal of research - is to justify connection between functionality of the spinal column and its structure, which was formed in order to support the required functionality. The structure has been evaluated in the view of mobility of structural elements. Materials and methods. The study compared mobility of individual vertebra and regions of spine. The concept of General Mobility (GM) of a region was introduced, where GM equals to the sum of all movements. GM of a region concerns all the verterbrae belonging to this area. Also, a concept of GM of individual vertebra was introduced. Results. The main functional movement of the lumbar spine is fl exion, which enables the solution of the nutrition problem (food gathering and farming). Thoracic spine possesses a unique combination of high mobility of the system as a whole and high stability of some of its elements, which is possible due to a high number of elements in the system. The function of thoracic spine is predominantly protective, whilst the shoulder girdle is mobile. Phenomenal mobility of the cervical spine permits to realize binocular visual control of almost entire space around a person, which provides him security. Interaction between cervical, thoracic and lumbar spines allows to attack and to defend in fi ghts. Conclusion. Analysis of the mobility of the individual vertebrae and regions of the spine suggests that their development depended on their functions. Life and well-being of species depend on these functions. Integration is the most important function of the spinal column. It connects regions having protective function with the regions having mainly communicative function.