Possibilities of osteopathic correction of functional disorders in children

The survival rate of children who require intensive care for life-threatening diseases or injuries has recently increased significantly. In pediatric intensive care, a decrease in mortality is accompanied by an increase in morbidity. This trend has led to a shift in focus of attention from reducing mortality to optimizing outcomes in critically ill patients. A broader approach and focus on outcome in critically ill survivors has been greatly facilitated by the development of a concept that integrates post-intensive care (PIC) diseases into Post Intensive Care Syndrome (PICS). The concept of PIC syndrome implies the occurrence of disorders in patients after IC in three main areas: mental health, cognitive functions and physical health, and also takes into account the state of the family of surviving patients, in particular, parents, who often have a deterioration in mental health. Diagnosis and treatment of this condition involves the work of a multidisciplinary team, in which it is desirable to include an osteopathic doctor in order to more effectively and timely diagnose and correct reversible functional disorders.

Post-intensive care syndrome (PICS) in children

Karimova

Белаш²

2021

Investigation of the possible effectiveness of osteopathic correction in the complex treatment of children in the first year of life with hip dysplasia

Fabristova¹,

Gainullin

2021

Introduction. Congenital dysplasia of the hip joints is one of the main among congenital diseases of the musculoskeletal system in children and requires a long period of treatment, including in a hospital settings. Standard methods of treatment contain the orthopedic and rehabilitation measures: the use of abduction splints, a complex of physiotherapy exercises, general massage, the use of various physiotherapeutic procedures. Osteopathic correction is not included in the standards of care for this category of patients. At the same time, these standard treatment methods do not always give a desired result, and sometimes even lead to the development of complications. All this facts determines the need to search for additional therapeutic techniques.The aim of the study is to research the possible effectiveness of osteopathic correction as part of the complex treatment of children in the first year of life with hip dysplasia.Materials and methods. The study included 34 children with a diagnosis of hip dysplasia (ICD code-10 — Q65.8). The patients were randomly divided into 2 equivalent groups: study and control. Participants in both groups received standard treatment; the participants of the main group additionally underwent osteopathic correction of the revealed somatic dysfunctions. Before and after the course of treatment, the patients' osteopathic status, the disease clinical manifestations, and the X-ray data of the hip joints were assessed.Results. The inclusion of osteopathic correction in the complex with standard treatment procedures for children of the first year of life with hip dysplasia is accompanied by a statistically significant decrease in the detection frequency of the somatic dysfunctions at the regional and local levels. The median duration of standard orthopedic treatment also decreases (p<0,05).Conclusion. The obtained results demonstrate that the inclusion of osteopathic correction in the complex treatment of children in the first year of life with hip dysplasia shortens the treatment time for patients. It is recommended to continue research in this direction with a larger sample size.

The effect of general osteopathic treatment on muscle tone according to electromyography data

Cherednikova,

Zhang,

Potekhina

et al. 2023

Introduction. Clinical research in osteopathy is criticized for the lack of standardization of treatment and insufficient use of instrumental methods to assess its effectiveness. Therefore, in order to increase evidence in osteopathy, it is relevant to search for instrumental methods that allow recording and measuring objective indicators and their changes after standardized osteopathic correction. The aim of the study is to research the effect of general osteopathic treatment on muscle tone using electromyography in practically healthy people. Materials and methods. A study was conducted on the basis of the Department of Osteopathy of the Mechnikov NWSMU. 30 practically healthy volunteers without any active complaints, aged 20 to 42 years (median 25 years), took part in the study. The criteria for non-inclusion were the presence of diseases and/or conditions that are an absolute contraindication to osteopathic correction, taking muscle relaxants or acetylcholinesterase inhibitors, diseases belonging to the G00-G83 group according to ICD-10, the presence of a trauma history for less than 1 year. All volunteers underwent general osteopathic treatment (GOT) as a standardized variant of osteopathic correction. Before and immediately after the GOT, muscle tone was studied using surface electromyography (sEMG), which was performed on the complex of wireless monitoring of electrophysiological signals «Kolibri» (manufacturer LLC «Neurotech», Russia). At rest, the average amplitude of the electrical activity of the muscles of the upper arms, the interscapular region, the anterior and posterior muscle groups of the thigh and lower legwere measured. The recording was made simultaneously from several muscle groups, synchronously from the right and left sides of the body. Results. After the GOT, a statistically significant decrease in the average amplitude of the thigh anterior surface muscles electrical activity from the median of 8 MV to 4 MV (p = 0,00001), the lower leg anterior surface from the median of 9 MV to 7 mv (p = 0,008) was detected, which indicates their relaxation. The tone of the other muscle groups did not change statistically significantly. The asymmetry of the average amplitude of electrical activity was observed in the studied muscles, which shows an imbalance of tone between symmetrical muscles. In most of the studied muscle groups, this indicator did not change statistically significantly after the GOT. And only in the anterior thigh muscle group, the asymmetry of the average amplitude of electrical activity decreased statistically significantly from the median of 7 MV to 2 MV (p = 0,0046). Conclusion. With the help of the sEMG, it was found that one session of GOT leads to a decrease in the tone of the anterior thigh and lower leg muscle groups, as well as a decrease in the asymmetry of the tone of the anterior thigh muscle group. These results can be explained from the standpoint of the GOT effect on skeletal muscles by means of improving the characteristics of the muscle tissue itself and the surrounding fascia, as well as by inhibitory and harmonizing effects on the nervous system, which ensures the maintenance and regulation of muscle tone. Surface EMG can be used to objectively record and measure the results of osteopathic correction to increase the evidence of clinical trials in osteopathy.