Introduction. Myogenic torticollis is the most common injury in children′s musculoskeletal system. Atlantoaxial rotatory subluxation is one of the main reasons for this pathology. In the newborn even a minor injury during pathological delivery can cause this. The ultrasound method allows you to conduct a real time examination and provide the physician by complete information about the state of pulpal nucleus, fi brous ring, and relative position of cervical vertebrae bodies, spinal canal and radicular canals. Also it allows you to estimate neck muscles thickness and area, which is an informative complementary method of osteopathic diagnosis.

Goal of research — clarifi cation of the criteria for biomechanical component of local and regional level somatic dysfunction by ultrasound examination of the cervical spine Materials and methods. The paper presents the data of cervical spine ultrasound examination for 57 nursing infants, infants and preschoolers with myogenic torticollis due to birth injury (ICD code X: P 15.8).

Results. An ultrasound examination of the cervical spine determined the quantitative parameters of the atlantoaxial joint and the spinal canal, which was 17,57±0,44 mm. By posterior approach, the asymmetric position of the C II odontoid bone with respect to lateral masses of the atlas was determined; a statistically signifi cant width difference in atlantoaxial joint space was revealed (p<0,001). By muscles ultrasound examination, signifi cant thickness differences between left and right larger posterior straight muscles of the head (p<0,05) were found. Signs of instability at the CII–CIII level were detected in all patients, with no instability signs at other levels.

Conclusion. The established criteria for ultrasound examination are atlantoaxial joint state, hypermobility of spinal motor segments, as well as muscles thickness and area in region under study. This allows us to verify instrumentally biomechanical SD of both local and regional levels, thus dynamic control over osteopathic treatment effectiveness is possible.

Introduction. Cancer is the second leading cause of death in the world. WHO predicts that the incidence of cancer will grow from 14 million in 2012 to 22 million in the following decades. It is impossible to achieve an adequate effect in the medicamentous treatment of malignant tumors without the use of accompanying therapy. The search and use of new methods of correction of complications arising in children during polychemotherapy will not only signifi cantly reduce the lethality of this category of patients, but also signifi cantly intensify specifi c therapy and thereby increase the percentage of complete remissions and event-free survivals.

Goal of research — to assess the effectiveness of osteopathic treatment in eliminating the side effects of adjuvant PCT in children in the postoperative period.

Materials and methods. 42 children aged 6–16 years with a history of malignant neoplasm of the musculoskeletal system took part in the research. At the time of the study they were undergoing adjuvant PCT after the radical surgery. Patients were divided into two equal and comparable in all parameters groups (the main group and the control one) by method of blind selection. Patients of the experimental group (21 patients) underwent osteopathic correction according to the standard protocol with the frequency 1 session per 7–14 days. In order to assess the severity of PCT complications, a number of non-specifi c indicators from the toxicity criteria proposed by the International Society of Pediatric Oncologists (laboratory markers of hematological toxicity and clinical manifestations of gastrointestinal toxicity) were used. The osteopathic status was assessed in accordance with the recommendations «Osteopathic Diagnostics of Somatic Dysfunctions» with limitations in active tests because of the severity of the condition and postural problems related to the short time period after surgical treatment (tumor resection, endoprosthetics). The indices for each PCT course were calculated separately. Patients were included in the study during the start of the next course of PCT. The duration of each patient′s observation was at least 21 days, which corresponds to the time between two subsequent courses of PCT.

Results. In this group of patients, osteopathic correction led to the elimination of global biomechanical dysfunctions, a decrease in the absolute number of global and regional somatic dysfunctions, and a change in the structure of regional dysfunctions. It has been established that osteopathic support does not signifi cantly affect the intensity of hematological toxicity in PCT (the severity of leukocytopenia, anemia, thrombocytopenia). However, it leads to a signifi cant decrease in such manifestations of gastroenterological toxicity as emetogenic syndrome and abdominal pain.

Conclusion. The reasonable use of individual osteopathic correction in the course of accompanying therapy can reduce the intensity of intoxication and improve the quality of life of patients during PCT courses.

Introduction. Neurological manifestations of osteochondrosis of the spine are among the most common
processes contributing to the onset of chronic pain syndrome. For a number of reasons, there are still diffi culties in treatment of this group of diseases. That is why in recent years the interest of the medical community to non-medicamentous methods of treatment, such as osteopathy, has reasonably increased. At the same time, the problem of objectifying somatic dysfunctions, as well as the results of osteopathic treatment, is quite acute.

Goal of research — to assess the dynamics of the local temperature in the zones of regional somatic dysfunctions against the background of osteopathic treatment in patients with dorsopathy at the cervicothoracic level.

Materials and methods. Longitudinal study was carried out in the specialized osteopathic clinic «Mokhov Institute of Osteopathy» from 01.2018 to 06.2018. The study involved 18 patients aged 25 to 45 years with dorsopathy at the cervicothoracic level. All patients underwent a clinical osteopathic examination. A visual analogue pain scale was used to assess the severity of the pain syndrome. Local thermometry was performed in the areas of identifi ed regional somatic dysfunctions. Each patient underwent individual osteopathic treatment based on the results of osteopathic diagnosis. At the time of the study patients did not receive any other treatment.

Results. Against the background of osteopathic treatment, the mean number of revealed somatic dysfunctions decreased from 9±0,5 to 4±0,2 (p<0,05) per patient. Prior to treatment, there was a decrease in the local temperature and the presence of signifi cant thermic asymmetry in the cervical, thoracic, lumbar and pelvic regions. In the region of the head, on the contrary, there was an increase in the local temperature. In other regions the level of thermal asymmetry was insignifi cant. After osteopathic correction, a statistically signifi cant (p<0,05) dynamics (a decrease in the expression of thermic asymmetry) was obtained in the following regions: the cervical region (the structural component), the thoracic region (the structural component), the lumbar region (the structural component), the region of the head. Also, the treatment contributed to the signifi cant reduction in the severity of pain syndrome in patients.

Conclusion. At the present stage, non-pharmacological methods of treatment can signifi cantly expand the possibilities of therapy and rehabilitation of different kinds of patients including neurological ones. The local thermometry method can potentially be used to objectify the effect of osteopathic treatment.

Introduction. Currently, not enough attention is paid to diagnosis and treatment of cervical spine soft tissue injuries in newborns. Clinical evidence of soft tissue birth injuries in cervical spine is scarce and masked by symptoms of ischemic damage to the central nervous system. This leads to the fact that they are downplayed and timely treatment is not carried out. The effectiveness of osteopathy treatment in somatic dysfunctions diagnosis and correction for this natal pathology is underrepresented.

Goal of research — to investigate the osteopathic correction effect of cervical somatic dysfunctions onabnormalities in the neurological status of young infants. Materials and methods. The study involved infants from 1 to 6 months, divided into main and control group, each of 20 patients. The control group infants received routine neurological treatment, in the main group osteopathictreatment was added. Neurological syndromes plotted against time and cervical somatic dysfunctions intensity were assessed in all infants.

Results. When analyzing the treatment results, statistically signifi cant decrease in total number of neurologicalsyndromes is stated, as well as cervical somatic dysfunctions intensity decrease. By the end of follow-up period in main group infants statistically signifi cant improvement in following symptoms was found: head malposition,body posture, delayed motor development and nervous-refl ectory irritability syndrome.

Conclusion. Based on the results of the study, the osteopathic treatment effi cacy has been proven, which allows us to recommend it in management regimen for infants with neurological disorders.

Introduction. Chronic pyelonephritis occupies one of the fi rst places in the structure of extragenital pathologies of pregnant women. The approach to the treatment of pyelonephritis in pregnancy consists in the use of both pharmacological and non-pharmacological methods of treatment. One of the non-medicamentous methods is osteopathic correction of somatic dysfunctions. However, the structure of these functional disorders is virtually unexplored.

Goal of research — to describe somatic dysfunctions (SDs) in pregnant women with chronic pyelonephritis before and after osteopathic correction, as well as to defi ne its effect on the intensity of subjective indices.

Materials and methods. A simple longitudinal randomized study conducted in 2016–2018 on the clinical basis of the St. Petersburg Institute of Osteopathy — LLC «Mokhov Institute of Osteopathy» included 120 pregnant women aged 25–45 years with a gestation period of 13–27 weeks. All pregnant women with chronic pyelonephritis were divided into two groups with the use of random number generator. The two groups of 30 people each were comparable in age, parity, presence of concomitant pathology and the duration of the disease. The main group received pharmacological and osteopathic treatment, the control group received only pharmacological treatment. In a similar way, a comparison group of women comparable in age and parity was formed. It included 60 pregnant women in the second trimester of pregnancy without clinical, instrumental and laboratory data of chronic kidney diseases; the patients of this group underwent dynamic observation. All patients were subjected to clinical obstetrical and osteopathic examination. The severity of the pain syndrome was assessed with the use of the visual analogue scale.

Results. In the course of osteopathic diagnostics, the following dominant SDs have been revealed: in patients with chronic pyelonephritis, a global rhythmogenic disorder of the development of the cranial rhythmic impulse (GRD (C)) — 26,7 %, a global neurodynamic disorder (psycho-viscero-somatic) — 25 %, regional SDs: the lumbar region — 33,3 %, the pelvic region — 6,7 %, and the thoracic region — 5 %; in healthy pregnant women, GRD (C) — 6,7 %, GNDD (PVS) — 6,7 %, and regional SDs: the pelvic region — 28,3 %, the thoracic region — 23,3 % and the duramatral region — 26,7 %. As a result of osteopathic correction of SDs in patients with chronic pyelonephritis, there was a decrease in the total number of SDs (from 174 to 30) and a change in their structure (global before the treatment and local after the treatment). The severity of the pain syndrome in accordance with the VAS has also decreased from 29±3,16 to 11±0,79 points in the main group, whereas in the control group it has increased from 20±1,78 to 26±1,53.

Conclusion. In pregnant women with chronic pyelonephritis, the majority of SDs manifest themselves at the global level, whereas in healthy pregnant women, most dysfunctions are regional. Osteopathic correction of SDs in complex therapy of pregnant women with chronic pyelonephritis signifi cantly contributes to the reduction of the pain syndrome according to the VAS compared with isolated traditional pharmacological therapy.

Introduction. Hip dysplasia in infants is one of the most common congenital defects of connective tissue. It is assumed that correction of somatic dysfunctions, which are formed in this orthopaedic pathology, will affect the timing of treatment and rehabilitation.

Goal of research — to explore the opportunities of osteopathic correction for somatic dysfunctions in comprehensive conservative treatment of hip joint congenital orthopaedic pathology in young infants.

Materials and methods. There were 40 infants under 6 month with diagnosis of hip joint dysplasia under observation, divided into two groups of 20 infants each. Functional orthopaedic treatment (massage, physiotherapy, exercise therapy, orthopaedic splint) and osteopathic correction were performed for infants of the main group. Infants of the control group received the orthopaedic treatment only. Osteopathic status was rated in addition to provided treatment in both groups. Treatment results were evaluated by using hip joints radiography, namely, by the acetabular index.

Results. It was found that global somatic dysfunctions are not typical in infants with hip joint congenital defects. The most frequently identifi ed somatic dysfunctions were regional, in a region of head, neck, pelvis, as well as thoracic region. Somatic dysfunctions of head and pelvis region are the most signifi cant. It proves the functional connection between these dysfunctions and hip joint congenital defexts. X-ray examination data analysis let us suggest a direct effect of somatic dysfunctions correction on the acetabular index in infants with congenital orthopaedic pathology, and thus on rehabilitation periods reduction.

Conclusion. The study showed that osteopathic correction of somatic dysfunctions is effective in combination with orthopaedic treatment of hip dysplasia performed from the fi rst months of infant′s life. It should be recommended as a part of comprehensive therapy of this orthopaedic pathology.

Introduction. From 30 to 92 % of reproductive age women suffer from menstrual pain (algomenorrhea). The effectiveness of drug treatment of this suffering does not exceed 50–70 %. Moreover, it is temporary and accompanied by a high incidence of side effects. Dysfunction of the autonomic nervous system is the basis of the algomenorrhea pathogenesis; it is resulting from chronic exposure to psychogenic factor and adaptive mechanisms decrease in thalamus and hypothalamus which is leading to the nociceptive system excitation. Currently, there are scientifi c studies showing the effectiveness of osteopathic correction of autonomic dysfunction that can eliminate menstrual pain.

Goal of research — to justify the osteopathic treatment effectiveness for patients with primary algomenorrhea.

Materials and methods. The study included 30 women aged from 15 to 29 years who applied to the gynecological offi ce, diagnosed with primary algomenorrhea and a disease period of 3 to 16 years. They were randomly divided into 2 groups: experimental and control, of 15 people each. The patients of experimental group received osteopathic treatment, the patients of control group received drug therapy only. Osteopathic status was determined in all patients before and after treatment. Pain intensity was assessed by using a visual analogue scale (VAS), the direction of autonomic dysfunction — by using the Kerdo index and the severity of autonomic dysfunction — according to the Wayne questionnaire.

Results. Dura mater RBN S (93 % of patients) and RBN in the visceral chest region (70 %) were specifi c regional somatic dysfunctions. The remaining regional somatic dysfunctions were common less than in 50 % of patients. Specifi c local somatic dysfunctions (LD) in patients with algomenorrhea were uterus LD (73 %) and mediastinum LD (70 %). Due to osteopathic treatment, the number of regional and local somatic dysfunctions was decreased in the experimental group. Autonomic dysfunction severity and pain syndrome intensity were decreased as well.

Conclusion. The results of the study allow us to recommend osteopathic treatment for patients with primary algomenorrhea.

Introduction. Combat stress is characterized by extreme impact on the human mind, the psychological consequences of which are expressed in extreme manifestations in post-traumatic stress disorder (PTSD). With the participation of a large number of people in local armed and interethnic confl icts PTSD can cause health problems, complete or partial disability and lead to social disadaptation.

Goal of research — objective is to identify the main psychosomatic disorders after suffering combat stress.

Materials and methods. 268 men between 21 and 49 years old, combat veterans (main group), and 60 military men of the same age who did not take part in combat operations (control group) were examined. In order to study the disorders of the cardiovascular system in veterans, the following methods were used: ECG monitoring for 12 hours and for 24 hours, blood pressure monitoring, bicycle ergometry, and echocardiography, clinical and biochemical examinations, plain and contrast X-ray examinations, CT imaging of the thoracic and abdominal cavities and pelvic organs, ultrasound of the internal parenchymal organs, endoscopic examination of the hollow organs in order to detect dysadaptation in the gastrointestinal and hepatobiliary zones. Adaptation disorders in the musculoskeletal system were examined with the use of laboratory and instrumental techniques. Changes in the reproductive system were assessed in accordance with the quality of spermogram and the level of the corresponding hormones in the blood serum.

Results. According to the results of the research psychosomatic disorders were observed in almost a half of the examined veterans of military operations. In the period up to 3 years after the effect of combat stress from psychosomatic disorders various manifestations of autonomic dysfunction dominated. Vegetative disorders were combined with affective disorders mainly of anxiety-depressive spectrum. In the period of long-term consequences of combat trauma polysystemic somatic nosological forms were observed due to the failure of compensation mechanisms and generalization of pathological processes. The most important aspect of the development of psychogenic pathology is the gradual loss of specifi city with the transition to nonspecifi c somatic organic pathology. This refl ects the peculiarity of the course of psychosomatic pathology in the form of a subsequent increase in «somatization» and the relevance of the search for methods of treatment.

Conclusion. In this regard osteopathy based on the principles of holism is able to offer unique techniques. It is advisable to study involving of osteopathic doctors in the treatment and rehabilitation of veterans.

Introduction. In paediatric population the prevalence of refraction pathology, including astigmatism of more than 0,75 diopters, exceeds 30 % in average. Visual perception disorder with underlying non-corrected ametropia in children, especially in sensitive period of visual system development, can manifest itself in amblyopia, strabismus, binocular and stereoscopic vision dyspoiesis. Astigmatism of more than 0,75 diopters requires a mandatory correction, even at 1 year age, to provide conditions for the complete vision formation. It is possible that if we try osteopathic methods on astigmatism triggers, it will decrease the astigmatism degree in infants.

Goal of research — to explore the opportunities of osteopathic treatment for infants with refraction disorders based on age, and develop recommendations for pediatric ophthalmologists.

Materials and methods. 37 infants from 3 to 11 month were divided in two groups. An experimental group consists of 21 infant, and control group consists of 16 infants. Before starting the study, an ophthalmologic and osteopathic examination was done to all infants. «Plusoptix A09» pediatric autorefractometer was used to determine the refraction. Osteopathic treatment for the experimental group included 4–6 sessions with an interval of 7–14 days. The control group did not receive osteopathic treatment, they were just observed. Observation period was 6–12 months.

Results. For all the examined children with astigmatism, regional somatic head dysfunctions were determined and characteristic. Regional somatic dysfunction of dura mater was detected in 75– 90,9 % of cases. Regional somatic dysfunctions of the neck were found in 60–75 % of cases. It was found that in experimental group, astigmatism rate was decreased by 2,2 times in infants less than 6 months of life and by 1,4 times in infants older than 6 months due to osteopathic correction of somatic dysfunctions. In control group, no signifi cant changes in astigmatism rate were observed at the end of the observation period. Statistically signifi cant differences with a high confi dence level between the degree of astigmatism severity and somatic dysfunctions of the head and dura mater regions were revealed.

Conclusion. Osteopathic treatment should be recommended for infants with astigmatism under 1 year old.

Introduction. Epilepsy is a chronic brain disease, which treatment consists of relieving the seizures with the help of constant long-term use of anti-epileptic drugs. This, in turn, can cause various negative effects on the body. Epilepsy is not a single disease with various attacks, it is a whole spectrum associated with comorbid conditions, including anxiety and depression. Additional medication is suggested to correct this. Therefore, developing the effective drug-free methods with the help of osteopathic treatment to correct anxiety and depression in epilepsy complex therapy received priority.

Goal of research — to study the osteopathic treatment potential to reduce anxiety and depression levels in children with various forms of epilepsy.

Materials and methods. The study included 72 children with various forms of epilepsy, aged from 7 to 17 years, 35 girls, 37 boys. The selection criteria were as follows: at least 1 year of epilepsy course duration, no status or serial course of epileptic seizures, no motor and cognitive deteriorations, all children studied in public schools. All children received osteopathic treatment for 2 months, along with medical treatment. Before and after treatment, each patient′s anxiety and depression levels were assessed according to the Hospital Anxiety and Depression Scale (HADS), along with an osteopathic examination.

Results. All children taken in the study revealed a range of somatic dysfunctions of craniosacral system, skull and reciprocal tension membranes, with biomechanical abnormality. By initial testing, anxiety and depression average values according to HADS scale were above normal in all children. After osteopathic treatment, a statistically signifi cant decrease in anxiety and depression levels was found.

Conclusion. Osteopathic treatment is effi cient for epilepsy complex therapy in children. It helps to reduce drug load in correction of anxiety and depression that accompany the underlying disease.

The quality of life (QoL) of a patient does not refl ect the absence of disease, but the satisfaction of his/her needs and adaptation in the physical, psychological and social spheres. At the beginning of the 21st century the «Quality of Life» (QoL) concept in medicine transformed into the subject of scientifi c research and became more precise — «health related quality of life» (HRQL). In medical practice QoL is used for various purposes: to evaluate the effi ciency of modern methods in clinical science and various rehabilitation technologies, to assess the patient′s conditions severity, to determine the disease prognosis, treatment and prevention programs results. At present QoL criteria are recognized as essentials for integrated analysis of new methods of diagnostics, treatment and prevention. Currently, there is an intensive development of QoL methods for the most common chronic diseases all over the world. The widespread use of QoL assessment provides health authorities with a tool for additional analysis of medical service activity, as well as for making decisions on funding priority areas.

The review aims to systematize the main factors affecting the joint mobility. These factors can be divided into anatomical and functional, normal and pathological. Various anatomical elements of the joint and periarticular tissues serve as restraints of movement in the joint. Muscles are the main restraints. Under the infl uence of physical loads related to sports or profession, joints can undergo functional and structural changes that increase or decrease their mobility. With age, mobility in the joints decreases and degenerative diseases can develop. Risk factors for osteoarthrosis can be unchangeable (gender, age, heredity, history of trauma) and changeable (body weight, level of physical activity). By infl uencing changeable factors, it is possible to prevent and treat degenerative joint lesions.

The aim of this review is to systematize the currently accumulated knowledge on post-stroke periarthropathy, obtained as a result of various research studies of many years. The review shows the evidence that in modern world poststroke periarthropathy manifestation is increased in quantity, as well as discusses its consequences. Anatomical and biomechanical features of the shoulder joint are considered, together with pain syndrome mechanism and risk factors. Analysis of relation between age and complications development probability is performed. The focus is on currently developed set of treatment options. They include medication, physiotherapy, reflexology, manual treatment, as well as osteopathic treatment methods. At the moment, osteopathic treatment is an innovative and, thus, the least understood way of working with this problem. But the results achieved by now suggest that osteopathy can help many patients with stroke consequences. The conclusion is that post-stroke periarthropathy of the shoulder joint always requires a comprehensive treatment approach and an individual program is developed in each case.

This paper describes the most frequent cases of musculoskeletal system injuries in professional swimmers, based on the scientifi c journal articles analysis. The main causes of shoulder and knee joints injuries in athletes who use various swimming techniques are presented. It is shown that training the correct movement pattern allows to reliably prevent damage to the musculoskeletal system. The study conducted focuses on the further search for new methods for the rehabilitation of swimmers, including osteopathic correction, both independently and in combination with other types of exposure.

There is a specifi c interest to the development of research in the osteopathic fi eld: fi rst in order to understand better its effects, then to continue to optimize its practice. To objectivise and quantify the effects of osteopathy would not only legitimate its practice but would also permit progression for the practitioners. These practitioners usually have a somewhat unclear notion of what research is. Firstly this article plans to describe the different types of studies of interest for the osteopathic fi eld, secondly to give an example of scientifi c process, including a step-by-step guide to the osteopath in devising his/her refl exion and building his/her project.