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Psychovegetal disturbances resulted in the aggravation of blood supply of highest vegetal centers due to involvement of pathologic process in a. vertebralis and its sympathic plexus significantly affected the manifestation of cervical pain syndromes. Complex examination of 124 patients with cervical pain syndrome was performed to study the influence of manual therapy. Clinical, neuro- orthopaedic, radiologic, miotonometric and rheographic methods were used. Manifestation and dynamics of psychovegetal disturbances were studied using pulsometry, psychologic tests and questionnaires. Manual therapy as well as correction of biomechanic disorders were detected to relieve psychovegetal changes and to be a pathogenetic curative method.

The functional echospondylography method which makes it possible without the use of the x-ray method to diagnose in patients the hypermobility in the cervical part of vertebral column is suggested. The examination can be repeated in process treatment and after it. The ultrasonic histographic study of the myofascial trigger points makes it possible using the numerical indices to estimate the degree of their activity in comparison with the histogram data of the unchanged muscle part and to estimate the treatment results by the histogram change.

The formation and development of osteopathy as a scientific discipline is considered. Despite its one and a half century history, osteopathy is a relatively young medical specialty. At the same time, throughout the history of the existence of osteopathy, its supporters carried out an active search for scientific evidence of its effectiveness. Currently, osteopathy is going through the stage of scientification, its formation as a scientific discipline. However, even now even the term osteopathy itself is often interpreted quite loosely and, in some cases, tendentiously. In this regard, the purpose of this work is to trace the development of osteopathy — from the earliest works of its founders to the latest stage of development, when osteopathy has become more and more consistent with the basic requirements of evidence-based medicine. To achieve this goal, much attention is paid to all stages of the formation and development of osteopathy, both abroad and in Russia. There are considered such problems as the formation of the basic terminology, the development and change of the basic concepts of osteopathy, including the concept of osteopathic lesion and the concept of somatic dysfunctions, the development of modern methods of evidence-based medicine, the dynamics of publication activity of osteopathic researchers. It concludes that new ways of obtaining the data about the health effects of osteopathy will continue to emerge, and the level of evidence and the number of quality clinical trials are likely to change.

Introduction . Psychosomatic disorders (PSR) develop as a result of somatization of psychogenic factors. In osteopathy, PSRs are reflected in the so-called psychoviscerosomatic disorder which is a variant of a global neurodynamic functional disorder characterized by poly-regional disorders of tissue mobility that are associated with psychoemotional overloads. In most cases of PSR, neurotization of patients is obligate due to the involvement of a number of nervous structures in the pathological process and the subsequent general decrease in the body's adaptive reserves. According to the polyvagal theory of S. Porges (1995), the vagus nerve is divided into two functionally different branches: nucl. dorsalis n. vagi and n. ambigius. Third core nucl. tractussolitarii is the endpoint of many afferent pathways through n. vagus from peripheral organs, which forms the central regulator of the vagal system. In the process of phylogenesis, the vagus nerve system became more complex due to the inclusion of the pathways of the trigeminal, facial, accessory and glossopharyngeal nerves. S. Porges distinguishes the autonomic vagus nerve associated with passive regulation of visceral functions and the social or intellectual vagus, which is responsible for the processes of attention, movement and communication. The auditory sensory system provides encoding and evaluation of acoustic stimuli that determine the ability to adapt. We suggested that by affecting the auditory system, it is possible to affect the autonomic nervous system and reduce the severity of individual symptoms of PSR. The goal of research — is to study the effect of white noise (WN) stimulation of the auditory sensory system on the manifestations of the disease in patients with cervicalgia (CA). Materials and methods . In the period from 03.2020 to 07.2020 on the basis of the «Professor Novikov'sFamily Osteopathy Clinics», an analytical one-stage (cross-sectional) study was conducted, which involved 109 patients with an established clinical diagnosis of CA, who were divided into two groups: an experimental group (76 people) exposed to WN, and a control group (33 people), in which there was no such exposure. To irritate the auditory sensory system, a WN with a frequency of 1-22,05 kHz was used. Patients of the experimental group were divided into 3 groups depending on the level of neuroticism: low (13 people), medium (49 people), high (14 people). The examination included an assessment of the level of neuroticism, biomechanical indicators that characterize the volume of movements in the cervical region, and the level of pain. The L. I. Wasserman questionnaire was used to assess the level of personal neuroticism. The volume of movements in the cervical spine in degrees was determined using an original device for determining the mobility of the cervical spine. Subjective assessment of pain was performed using the VAS scale. To obtain a quantitative assessment of the achieved result, a «B-A-analysis» method is proposed, based on the evaluation of the modules of 6-timer (by the number of analyzed indicators) vectors A (after the study) and B (before the study) and pairwise analysis of the corresponding components of these vectors. Results . Patients of the main group in subgroups with high, medium and low levels of neuroticism irritation auditory system has led to increased range of motion in the cervical spine that best identified patients with low levels of neuroticism, and minimally high. No significant changes were registered in the control group. There was no convincing difference in the dynamics of VAS indicators. Conclusion . The study showed the possibility of influencing biomechanical parameters when the auditory sensory system is irritated by WN in patients with CA, and the result differed depending on the level of neuroticism — high, medium, low. The subjective assessment of the pain syndrome in VAS case is significantly influenced by the emotional component. Thus, if the nervous system is exposed, the biomechanical parameters changes take place, and it indirectly confirms the integrity and interdependence of the neurodynamic and biomechanical components of functional disorders. The results suggest further study of the possibilities of using WN in patients with various somatic dysfunctions accompanying PSR.

According to experts of the World Health Organization the lower back pain (LBP) prevalence in developed countries reaches the pandemic size, and it is a serious medical and socio-economic problem. Acute back pain is transformed into chronic in 10–20 % of working age patients′ cases; this causes serious psychological disorders appearing, forms painful behavior and persists even when the initial pain trigger is eliminated. Data from metaanalyses of randomized controlled trials indicate the effectiveness of the osteopathic approach in the treatment of LBP patients. At the same time the osteopathic correction is effective not only for acute pain, but also for chronic pain. A case from clinical practice is described demonstrating the possibility of osteopathic correction of a LBP patient.

Introduction. According to the defi nition of the World Health Organization (WHO), tension-type headache (TTH) is the most common type of primary headache. Rehabilitation of patients with chronic tension-type headache continues to be an important socio-medical problem. Its main goal is the most complete restoration of the functions of the musculoskeletal system of the neck, the correction of vascular and psychoemotional problems, and the patient′s return to his everyday life and work. As a rule, the main emphasis in the treatment of such patients is placed primarily on drug therapy. At the same time, practitioners are faced with a number of problems — the low effectiveness of the treatment, the nonpersistency of the results, allergic reactions, polypharmacy and others. All this suggests that there is a need for differentiated rehabilitation treatment of patients with tension-type headache with the use of various non-pharaceutical methods. The goal of research — to evaluate the clinical effi cacy of complex non-drug therapy in patients with tension-type headache.Materials and methods. The prospective controlled randomized study, which was conducted from October 2017 to March 2019 at the Department of Medical Rehabilitation of the Bashkir State Medical University, included 110 patients with TTH from the age of 20 to 45 years. All patients, depending on the treatment methodology used, were randomly divided into two groups of 55 people. Patients of the main group received complex rehabilitation treatment with the use of non-drug methods: osteopathic correction, acupuncture and exercise therapy. Patients in the control group received treatment in accordance with the standard of medical care for TTH (analgesics, non-steroidal antiinfl ammatory drugs, antidepressants, vasoactive and nootropic drugs). The study of the clinical effectiveness of the therapy included: an assessment of the severity of pain with the use of a visual analogue scale and a tensoalgimeter, a goniometric study with an assessment of the volume of active movements in the cervical spine, transcranial ultrasound dopplerography with an assessment of quantitative indicators in the system of the middle cerebral artery.Results. The use of complex non-drug therapy in patients with TTH compared with standard drug therapy leads to a signifi cantly more important decrease in the severity of pain, an increase in pain threshold, an increase in the volume of active movements in the cervical spine. The effect of non-drug treatment methods on blood fl ow in the system of the middle cerebral artery is comparable in its effectiveness with the use of pharmaceutical drugs.Conclusion. The proposed complex rehabilitation treatment of patients with TTH with the use of non-drug methods has shown clinical effi cacy which is comparable, and in a number of indicators, superior to the effectiveness of conventional medical treatment. All this determines the necessity of wider implementation of multidisciplinary non-drug treatment of patients with this pathology.

The article aims to summarize modern ideas about the etiology and pathogenesis of cervical pain syndromes. It presents the latest data on the frequency of occurrence of various pain syndromes, and modern aspects of the etiopathogenesis of cervical pain syndrome. Three main types of pain are considered in detail, depending on the leading pathogenetic mechanism, which can be nociceptive, neuropathic, and dysfunctional.

Introduction.Muscular torticollis (MT) is the most common lesion of the musculoskeletal system in children, ranking third in pediatric practice. There are references in the literature confi rming high effi cacy of manipulative therapy, but in Cochrane′s 2015 Annual Review, experts did not fi nd evidence of the effectiveness of the manipulations. We carried out research in order to determine the effectiveness of osteopathic manipulative correction (OMC) in children with muscular torticollis (MT) due to birth injury (code for ICD X: P 15.8).Goal of research— to study the gradual effectiveness of OMC on the basis of clinical and instrumental studies and ultrasound examination of the relationship between the bone structures and the cervical muscles.Materials and methods.57 children aged 0–7 years with muscular torticollis due to birth injury were examined. All patients were randomly divided into 2 groups. Patients of the main group (32 children) received osteopathic treatment. Each child received from 3 to 5 sessions, depending on the severity of the birth injury and the duration of postural disorders. The time gap between the sessions was 2–3 weeks. Patients of the control group (25 children) received physiotherapy, massage and orthosis every day for 2 weeks. Along with the neurological examination the study of the effectiveness of treatment included assessment of the pain syndrome with the use of the behavioral numerical scale FLACC, and the assessment of the muscle tone with the help of the kinesthetic examination. Angle of rotation in the cervical spine was measured with the use of the goniometer. Moreover, all children underwent sonography of the cervical spine in order to determine the position of the tooth axis, with the calculation of the coeffi cient of asymmetry. The state of the musculus rectus capitis major (MRCM) and musculus sterno cleido mastoideus (MSCM) was also assessed.Results.It was observed that after OMC the clinically signifi cant improvement started earlier in patients of the main group. This improvement manifested by complete elimination or signifi cant reduction of biomechanical and tone disorders in the neck. Pain syndrome, measured with the help of the FLACC scale, signifi cantly decreased both after treatment and in catamnesis after 6 months (p0,05). When intercomparing left and right muscles in the groups, signifi cant differences were revealed (p0,05).Conclusion.The use of OMC (3 to 5 treatment sessions with the intervals of 2–3 weeks) in patients with MT is more effective than the treatment with the use of physiotherapy, massage and orthotics, which was received by patients every day for 2 weeks. This allows to recommend OMC for wider clinical use in this category of patients.

Introduction.In connection with the widespread introduction of osteopathy into practical medicine, new facts confi rming its effectiveness are appearing. These facts need theoretical justifi cation. The biodynamic approach is the least studied and scientifi cally proven approach in osteopathy. There are only a few works describing the benefi cial effects of this type of treatment on the autonomic nervous system based on an assessment of heart rate variability. One of the most sensitive indicators of changes in the state of the body is the electrical activity of the skin (EAS), which is widely used in modern polygraphic devices.Goal of research— to investigate the EAS in the physician and in the patient during the session of craniosacral biodynamics (CSB).Materials and methods.The study involved 32 patients who were randomly divided into 2 groups — control group (10 patients) and main group (22 patients). In the control group there were 8 women and 2 men aged from 20 to 65 years (mean age 42±20 years). In the main group, 16 women and 6 men aged from 18 to 68 years (mean age 40±16 years) were examined. Two professional certifi ed computerized polygraphs «Chris» were used, simultaneously recording the EAS values of the doctor and the patient. In the main group, the background indicators were recorded at the fi rst stage (10 minutes), then the procedure of the CSB, which lasted 20 minutes, was recordered. The control group was used only for registration of EAS. At the same time, patients were in the same conditions as in the main group.Results.During the CSB, the state of both the doctor (p0,05). However, there was a high relationship between the states of the doctor during contact and non-contact treatment (correlation coeffi cient 0,80, p0,05). However, in the process of craniosacral biodynamics, a statistically signifi cant relationship was formed between them with a correlation coeffi cient for non-contact exposure equal to 0,49 (pConclusion.The study of the electrical activity of the skin in craniosacral biodynamics is a highly informative method, which allows to verify and quantify the changes occurring in the patient and in the physician during the treatment.

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.