These guidelines are designed for osteopathic physicians providing osteopathic care in medical institutions of any type. Proper medical record keeping ensures continuity and the ability to monitor the progress of treatment; enables the use of data for statistical processing and research; and assists in resolving disputes and conflicts. Medical records are also an important tool for assessing the quality of medical care provided. This document contains a set of recommendations and clear guidelines for effectively completing medical records during medical care and helps select the best method for achieving the desired outcome.

Introduction. The official recognition of osteopathy in the Russian Federation and its inclusion in clinical medicine has provided a powerful impetus for the development of the specialty. Significant changes have been noted in the general methodology of osteopathy, primarily involving a shift from a purely local paradigm for identifying areas of osteopathic damage (somatic dysfunction) to a comprehensive assessment of osteopathic status. It has been proposed to consider somatic dysfunctions (SD) at three levels of manifestation: local, regional, and global (the level of the entire organism). Global somatic dysfunctions, to put it simply, can be viewed as a combination of a certain number of regional disorders (polyregionality). However, distinguishing between regional and local SD clearly requires separate studies to confirm the validity of this approach. Previous studies have revealed a decrease in local temperature and the presence of significant thermal asymmetry in the areas of identified regional SD. However, an assessment of changes in these parameters during osteopathic correction has not been conducted. All of the above determined the purpose of this study.

The aim of the study: to analyze the change in local temperature in areas of local and regional somatic dysfunctions in patients with cervical spine dorsopathy during osteopathic treatment.

Materials and methods. A prospective study was conducted from 2018 to 2025 at a specialized medical clinic in Saint-Petersburg. A total of 228 patients diagnosed with cervical dorsopathy were examined. They underwent osteopathic correction (three sessions, 10–14 days apart, each lasting approximately 45–50 min). All patients underwent an osteopathic assessment before and after treatment based on clinical guidelines. Local temperature was also measured using a portable infrared thermometer in the paravertebral neck region, symmetrically on the right and left sides.

Results. Patients with regional biomechanical disorders at the neck level (structural component) were characterized by the presence of statistically significantly (p<0,05) lower local temperature (right Me 33,1, min–max 31,5–34,7, left Me 33,3, min–max 31,9–35,6) and pronounced thermal asymmetry in the neck area (Me 0,67, Min–Max 0–2) compared to patients with local dysfunctions (right Me 34,2, min–max 32–37,2, left Me 34,5, min–max 32,4–36,9, thermal asymmetry — Me 0,29, min–max 0–1,2) and without dysfunctions of this area (right Me 34,6, min–max 32,6–37, left Me 34,4, min–max 32,6–36,7, thermal asymmetry — Me 0,26, min–max 0–1,1). The osteopathic correction allowed to eliminate regional SD, which was manifested by a statistically significant (p<0,05) increase in local temperature (on the right Me 34,5, min–max 32,5–36,7, on the left Me 34,6, min–max 32,1–36,6) and a decrease in thermal asymmetry (Me 0,3, min–max 0–1,5). The obtained positive changes in the thermodiagnostics parameters were maintained 1 month after the completion of treatment, which allows us to speak about the durability of the effect of the osteopathic correction.

Conclusion. In patients with cervical dorsopathies, regional cervical spinal dysfunction zones (neck region, structural component) exhibit a significant decrease in local temperature and thermal asymmetry compared to patients with localized cervical spinal dysfunction or no cervical spinal dysfunction at all. Osteopathic correction leads to a statistically significant increase in local temperature in the regional spinal dysfunction zone and a reduction in functionally significant thermal asymmetry. These findings support the validity of distinguishing between different levels of cervical spinal dysfunction (local and regional) and, on the other hand, provide objective evidence for the results of osteopathic treatment.

Introduction. The long stay of patients in intensive care units (ICU), especially requiring prolonged artificial lung ventilation (ALV), is one of the most acute problems of modern critical condition medicine. The pursuit of early excretion from respirator and restoration of self-adequate breathing is a key objective of intensive therapy, as the reduction in duration of ALV directly correlates with improved prognosis, lower frequency of complications, Reducing hospitalization and improving the quality of life for survivors. However, conventional rehabilitation methods involving respiratory gymnastics and verticalization are often insufficient for full recovery of respiratory function in patients with pronounced biomechanical disorders due to long-term immobilization. The medicamentous sedation and pathological processes leading to hospitalization require a comprehensive approach. Despite increasing interest in integrative treatment methods, the impact of osteopathic correction (OC) on gas-exchange dynamics and duration of ventilation support in critical long-term ALV patients remains poorly understood.

The aim of the study: evaluate the effectiveness of including osteopathic correction in complex therapy for long-term ALV patients in the intensive care unit.

Materials and methods. The randomized controlled study was carried out in the department of intensive care and intensive therapy 2 GKB named after S. S. Yudin (Moskow). The study included 48 patients who met the following inclusion criteria: age over 18 years, clear consciousness, productive contact, adequate analgesia, remaining on full respiratory arrest for more than 5 days. All patients were treated and examined according to their underlying disease and complications, as prescribed by the attending physician, including setting respiratory support regimens, performing therapeutic gymnastics, verticalization, and speech therapy if necessary. Patients were randomly divided into two groups: the control group included 24 patients who were not treated with OK; the main group included 24 patients who were treated with OC. To objectify the patient′s condition and assess the effectiveness of treatment, standard scales and clinical indices for patients were used ICU: Glasgow Coma Scale (GCS) — consciousness level assessment scale, Sequential Organ Failure Assessment (SOFA) — a scale for assessing the degree of organ dysfunction, Richmond Agitation-Sedation Scale (RASS) — a scale for assessing the level of sedation and excitation, oxygenation index (PaO2 /FiO2, p/f) — an indicator of the efficiency of gas exchange in lungs. An osteopathic diagnosis of the patient within the bed was also performed, evaluating the function of the diaphragm and the region of the thorax using the method proposed by Bruno Bordoni (2016).

Results. All patients were found to have «inhaled» diaphragm dysfunction. The inclusion of OC in the set of therapeutic interventions for ICU patients resulted in a statistically significant reduction in the number of days spent by patients on ALV. In the main group, the duration of stay of patients on ALV was 9,5 days on average, while in the control group — 17 days (p<0,005). The osteopathic correction resulted in statistically significant improvements in gas exchange rates: increased PaO2 /FiO2 (p/f), increased SatO2 compression, and decreased PaCO2. The evaluation of clinical condition of patients by scales GCS, SOFA, RASS at treatment stages did not reveal statistically significant differences in compared groups, which indicates a sufficient degree of safety OC in intensive care patients.

Conclusion. Osteopathic correction in long-term resuscitation patients on the ventilator shows a statistically significant positive effect on gas exchange rates and reduction of duration of ventilation support. The results of the study support the feasibility of including osteopathic methods in the comprehensive treatment of this category of patients.

Introduction. With the advent of new medical technologies and the steady increase in maternal and perinatal morbidity, there is a need for continuous monitoring of the effectiveness of treatment and the prevention of complications in maternal and child health. Increasing financial costs may prove impractical without evidence-based studies of the effectiveness of medical interventions. To assess the clinical effectiveness and feasibility of a specific intervention in clinical practice, special indicators (surrogate and endpoints) have recently been used. These indicators are called clinical effectiveness points. These indicators represent the degree to which a specific medical (clinical) outcome (improved quality of life, health status, restoration of lost functions of individual organs and systems) is achieved following a specific medical intervention. Analysis of the clinical effectiveness of medical technologies, including non-drug ones, in the comprehensive treatment of somatic diseases in pregnant women is necessary for making rational healthcare decisions, which, in turn, contribute to improving the quality of medical care. This requires studying the issue with arguments for the effectiveness of using non-drug osteopathic methods as part of complex restorative treatment of chronic pyelonephritis in pregnant women to prevent associated complications.

The aim of the study: to evaluate the effectiveness of osteopathic correction as part of the complex treatment of chronic pyelonephritis in pregnant women based on evidence-based medicine indicators.

Materials and methods. A prospective, controlled, randomized study conducted from 2018 to 2025 at the «Mokhov Institute of Osteopathy», included 180 pregnant women suffering from chronic pyelonephritis without renal failure, aged 25–45 years, and 13–27 weeks pregnant. All pregnant women were divided into three homogeneous groups, depending on the treatment method used, using a simple randomization method using a random number generator: a study group (60 participants) and two control groups (60 participants each). All patients received standard drug therapy for chronic pyelonephritis. Those in the study group additionally received osteopathic correction (three procedures at 12–15-day intervals). Treatment for patients in control group 1 was limited to drug therapy alone. Pregnant women in control group 2, in addition to drug therapy, performed physical exercise twice a week for 1,5 months as prescribed by a physical therapy physician. At the end of the study, the clinical effectiveness of osteopathic correction was assessed for all pregnant women, using the number needed to treat (NNT) as the basis for calculating the number needed to treat.

Results. In the group that received osteopathic correction as part of the complex treatment, the risk of premature birth is 16,7 % lower (NNT=6); the risk of operative delivery is 35 % lower (NNT=3); the risk of newborn asphyxia is 8,3 % lower (NNT=12); the risk of relapse of chronic pyelonephritis is 65 % lower (NNT=2); by surrogate points after treatment: the risk of persistent pain syndrome is 23 % lower (NNT=4); the risk of no improvement in quality of life is 71,1 % lower (NNT=2); the risk of persistent enlarged renal calyx and pelvis is 100% lower (NNT=1); the risk of persistent global somatic dysfunctions is 18,3 % lower (NNT=5); the risk of cases of persistence of characteristic regional diabetes is 100 % lower (NNT=1).

Conclusion. The use of osteopathic correction as part of the comprehensive treatment of chronic pyelonephritis during pregnancy can reduce the risk of premature birth, operative delivery, neonatal asphyxia, the risk of recurrent chronic pyelonephritis and enlarged renal pelvis, as well as the risk of persistent pain and low quality of life, which can be used to improve medical care for this population.

Introduction. The use of the International Classification of Functioning, Disability, and Health (ICF) in dentistry is a subject of discussion, since most of its domains have not been validated for assessing the health of the oral cavity.

The aim of the study: to study the prospects of using the ICF to classify dysfunctions after reconstructive surgeries on the oral mucosa, depending on the treatment and rehabilitation scheme used.

Materials and methods. The study involved 281 patients after vestibuloplasty for soft tissue deficiency in the oral cavity. All patients were divided into three groups: I (n=90), II (n=86), and III (n=105), depending on the treatment and rehabilitation scheme used. The study participants were classified and evaluated for pain (b28010), gingival mobility (s3201), inflammation in the donor and recipient sites, the implantation area (b43501), the degree of gingival bleeding (b4151), subjective satisfaction with the treatment results (d7108), speech difficulties (d330), eating (d550), and oral care (d5201). The prevalence of various disorders was compared using the Pearson chi-square test.

Results. A significantly high level of satisfaction with treatment after surgery was determined in 68 % of patients in Group III, 45 % of patients in group II, and 24 % of patients in group I, while 28 % of patients in group I rated the effectiveness of rehabilitation therapy as low. On the 8th day after surgery, severe disorders (7–8 points on the VAS) were recorded only in patients from group I in 10 % of cases, while 99 % of patients from group II and 72 % of patients from group III showed mild (1–3 points) and moderate (4–6 points) disorders. In 28 % of patients from group III, the pain completely regressed. On day 14, 98 % of patients in group III had no gingival mobility, while 23 % and 17 % of patients in groups I and II, respectively, had no gingival mobility. On day 4, 10 % of patients in group III had mild to moderate inflammation in the donor area, 16 % had mild inflammation in the recipient area, and there was no inflammation in the implantation area. On day 4, 3 % of patients in group I had no gingival mobility.

Conclusion. The obtained results can be used to validate the ICF tools for assessing oral health during rehabilitation after surgeries on the maxillofacial area.

Introduction. A distinctive feature of the osteopath profession is the doctor′s long-term perceptual «dialogue» with the patient′s tissues. Between them are realized certain kinds of sensory, motor, emotional contact and remote interactions, with the osteopathic reception taking place in the near zone of social contact, 0–45 cm. There is an interrelation of perceiving biological systems, and it is the osteopath doctor with his perceptual skills who is responsible for creating a «trust space» in which the patient′s nervous system can come into balance, into a more resourceful state to overcome somatic dysfunction.

The aim of the study: systematize neurophysiological and psychological phenomena occurring in the «near zone» of the osteopath and patient.

Materials and methods. The study sample consisted of osteopaths with varying levels of training and experience (from 3 to 15 years of work), 14 people, including 5 men, 9 women, age 32 to 57, average age 46. Semi-structured in-depth interviews were organized to study the psychological phenomena of the experience of medical respondents. The subsequent processing of interview texts was carried out by the descriptive phenomenological method of A. Georgie, in which doctors described both their own experience of experiencing successful sessions, and the difficulties of an emotional nature that arose in the process of interacting with the patient. The bioelectric activity (BEA) of osteopathic brains was recorded and processed by multiparameter computer electroencephalography (EEG) during patient work. There were 10 osteopaths, 5 men and 5 women, with different experience in osteopathy: 6 doctors with more than 5 years of experience, 4 doctors with less than 5 years of experience. Age of subjects 35 to 63, median age 47.

Results. The feeling of synchronization with the patient while maintaining personal boundaries, calmness, slowing down, changes in space are characteristic of the manifestation of the phenomenon of co-presence and contribute to an effective intake. The neurophysiological markers of productive intake were changes in the BEA of doctors′ brains, with a general decrease in activity and right-hemispheric shift in the lower right area, increasing the correlation links of biopotentials in the lower brain shifts, which reflects the degree of concentration, concentrateness, and perceptual literacy of a doctor. The phenomenon of co-presence may be due to the activity of the talamo-parietal associative system, which is «bound» to the present moment and to the analysis of spatial relationships of divergent traits and activation of the brain′s mirror neuron system. Factors that reduce the effectiveness of osteopathic treatment, according to the results of the interview, were excessive rationality, the «rescuer′s» attitude, fear of not being successful, lack of communication skills in understanding their own boundaries. The nature of BEA changes in the brains of doctors under emotional strain during patient work has shifted toward increasing cross-correlation between the lower frontal and the posterior frontal, possibly related to changes in the activity of the medical departments of the prefrontal cortex. Actively involved in the modulation of the affect. The nature of the doctor′s BEA changes in this case is related to emotional blockages that prevented us from establishing quality contact with the patient, rather than a lack of perceptual skills.

Conclusion. In the future, it makes sense to collaborate with osteopaths and psychologists in the field of designing and testing educational programs aimed at improving sensitivity to one′s own personal boundaries, emotional literacy of doctors, Development of a safety device for establishing a healthy and complete dialoic exchange with the patient.

Introduction. The establishment and development of osteopathy in Russia was accompanied by the formation of many professional associations, which led to fragmentation of the community and created difficulties in the elaboration of common standards, development of scientific base and dialogue with state authorities. Under these conditions, the Russian Osteopathic Association (ROA) has become a key player whose strategic development was aimed at consolidating the professional field. An important element in assessing the effectiveness of this strategy is the analysis of the satisfaction of current members of the Association.

The aim of the study: to analyze the strategic role of the Russian Osteopathic Association as a center for managing projects and programs aimed at consolidating the professional community and, based on the analysis of ROA member satisfaction, determine priority areas for further development.

Materials and methods. The study is based on case study methodology and document analysis. The articles of association of Russian Federation, archive of Russian Osteopathic Journal (ROJ), data on regional representations of the Association, as well as open information about activities of other Russian osteopathic associations for comparative analysis were used as materials. Additionally, an online survey of ROA members (n=80) was conducted in January–February 2025. The survey assessed satisfaction with the association′s activities in five key areas (professional association, scientific exchange, advocacy, international cooperation, and information), calculated the Net Promoter Score (NPS), and collected suggestions for development. Data processing included descriptive statistics, correlation analysis, and content analysis of open-ended questions.

Results. The member survey results confirmed the high rating of scientific exchange (4,10 out of 5) and identified a key area for improvement — protection of rights (3,18). They also generated a demand for the development of practical legal support (45,5 % of proposals). Integration of this data allows for the adjustment of strategic priorities to increase member satisfaction and loyalty.

Conclusion. The analysis carried out showed that the strategy of ROA, focused on systemic work in the fields of scientific infrastructure (ROJ), regulatory regulation (professional standard), educational programs and regional policy, was highly effective. The Association has become a central element consolidating the professional community and a key partner of the state in integrating osteopathy into the Russian health care system.

Introduction. Improving the system of training medical personnel is an integral part of the reforms permanently carried out in the education system and health care. One of the first places in the industry is the problem of improving the quality of higher medical education. The training of a doctor should meet the needs of health care, and if wider, then the needs of society as a whole. The current trend is the growing popularity of non-drug, including manual methods of treatment, the growing demand for the services of osteopathic doctors, the need to ensure the staffing of medical organizations with these specialists. In 2003, osteopathy was officially recognized in Russia as a method of therapeutic effect, and as a medical specialty approved by the state in 2015 and is part of clinical medicine, osteopathic doctors provide medical care to patients with somatic dysfunctions — reversible structural and functional disorders at all stages of medical care. An analysis of the personnel situation showed that in the early 2000s, osteopathic doctors were practically absent in medical organizations, there were no osteopathic doctors officially working in state-owned organizations, and it was impossible to meet the needs of the health care system and the emerging demands of society for non-drug medical technologies. It became obvious the need for a systematic solution to the issues of organizing the training of such specialists.

The aim of the study: to study the formation of the specialty «osteopathy», to identify the most demanded knowledge and skills, qualification requirements for specialists in the field of osteopathy, corresponding to international practice.

Materials and methods. The study used qualitative methods of scientific research, including literature analysis and a combined approach, comparative analysis. Data Collection Period — 2010–2025.

Results. The approval of osteopathy as a separate medical specialty has led to the fact that the training of specialists for its further development in our country takes place within the framework of the system of higher and additional professional education. The recognition of osteopathy at the state level allowed it to take its place in the existing health care system on a par with other medical specialties. Qualification requirements for osteopathic doctors have been supplemented by other medical specialties that entitle doctors to undergo professional retraining in osteopathy.

Conclusion. The development of a multivariate multi-level educational system for the training of practice-oriented osteopathic doctors, ensuring the continuity of education at all stages and meeting the objectives of the Strategy for the Development of Medical Education of the Russian Federation. The problem of providing the population of the Russian Federation with highly qualified personnel, both providing medical care in the field of «osteopathy», and capable of conducting scientific research in the field of osteopathy, based on the principles of evidence-based medicine, and carrying out pedagogical activities for the reproduction of osteopathic doctors has been resolved.

Voice disorders lead to a reduced quality of life, impair social and professional relationships, and for professionals whose work directly involves the voice, can lead to professional incompetence. Early diagnosis and timely correction of dysphonia are now considered a priority in modern phoniatrics and otolaryngology. According to modern research, 30 to 40 % of patients seeking specialized care suffer from functional voice disorders. Functional hypertonic dysphonia (FGD) is a functional voice disorder characterized by excessive muscle tension in the larynx and vocal apparatus. Etiologically, FGD often develops after inflammatory diseases of the upper respiratory tract, such as acute laryngitis, as well as due to increased vocal strain and stress. Treatment of FGD requires a multidisciplinary approach, including phonopedic therapy, psychotherapeutic methods, and, if necessary, osteopathic correction to normalize muscle tone and eliminate somatic dysfunctions. Combined approaches allow for the best results in the shortest possible time. A clinical case is presented that illustrates the typical course of FGD in a patient in a voice-speech profession after acute laryngitis. Interdisciplinary collaboration between a phoniatrist, a voice therapist, and an osteopath demonstrated a positive effect on both subjective and objective parameters, demonstrating the potential of this collaboration. 

Introduction. The processes of adaptation to professional sports activities affect various systems and subsystems of the athlete′s body, influencing the condition of bone tissue, which can be reflected in the bone remodeling indicators.

The aim of the work is to analyze modern scientific publications devoted to the features of the bone remodeling cycle in the process of professional sports activities.

Material and methods. The review is based on publications from the PubMed, Google Scholar, Cyberleninka, eLIBRARY databases. Preference was given to articles published in peer-reviewed sources over the past 10 years.

Results. The sports subpopulation, in contrast to the general population, is characterized by higher values of bone remodeling indicators, which change under the influence of physical activity. The dynamics of bone remodeling markers in the process of professional sports activity varies depending on the intensity and duration of physical activity, and the athletes′ tolerance of training impact, and can be delayed — from several hours to months after the training process. Changes in osteosynthesis markers are related to the athlete′s level of training. Different sensitivity of the bone remodeling cycle to changes in the training regimen was noted: markers of osteosynthesis showed greater sensitivity compared to resorption, the activation of which is caused by more intense physical activity. Oxygen supply during exercise influences changes in bone remodeling indices. High training loads activate resorption to a greater extent and slow down bone synthesis, which can have a negative impact on bone mass and act as a risk factor for the development of bone pathology. In athletes, osteocalcin is involved in carbohydrate and fat metabolism. Bone remodeling cycle markers correlate with indices of the composite composition of athlete′s body mass.

Conclusions. Professional athletes are characterized by a higher rate of bone remodeling than in the general population. Bone remodeling indices change under the influence of physical activity, reflecting its duration, intensity and tolerance of training effects by an athlete with the dominance of resorption processes over synthesis against the background of high-intensity loads with the participation of bone remodeling in energy metabolism. Thus, markers of bone remodeling can be informative in monitoring an athlete′s functional fitness. 

The term «text neck syndrome» entered medical practice in 2008, driven by the increasingly widespread occurrence of pathological symptoms, associated with the specific position of the head and neck while using mobile phones and other modern miniature electronic devices. The surge in cervical pathology is associated with the coronavirus pandemic, when many workers and students switched to remote work. This review article describes in detail the causes and mechanisms of TNS development, as well as methods for preventing and correcting the syndrome′s components in the acute phase and stable state. The conclusion emphasizes the role of TNS prevention and the need for multicenter studies to develop general recommendations. 

Postural disorders are balance disturbances that arise from dysfunctions and diseases of the sensory systems, central nervous system, and musculoskeletal system. They are common in all age groups and often lead to chronic pain, discomfort, and an increased risk of falls and injuries. The purpose of this lecture is to systematize the causes of postural disorders and methods for studying balance indicators and fall risk, based on current literature. This lecture presents an overview of the current state of knowledge regarding the causes of postural imbalance and the body′s possible compensatory responses. Numerous methods used to examine patients with postural disorders are systematized, indicating the minimum clinically significant difference.