Randomized controlled study of the effectiveness of osteopathic manipulative correction for muscular torticollis due to birth injury

Author(s):  
Yu. O. Novikov ◽  
D. E. Mokhov ◽  
J.-P. Amigues ◽  
G. M. Musina ◽  
A. R. Shaiakhmetov

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.

2021 ◽  
pp. 20-33
Author(s):  
V. O. Belash ◽  
A. E. Vorobyova ◽  
D. A. Vasyukovich

Introduction. Back pain is not only a high prevalence, but also a costly health problem. That is why the search for new and the optimization of existing methods of dorsopathies treatment acquire an important clinical and medico-social significance. In recent years, the medical community has increased the interest in non-drug methods of treatment, including osteopathy. Previous studies have substantiated the possibility of effective application of osteopathic correction methods in the treatment of patients with dorsopathies. A specific object of the osteopath′s work is somatic dysfunction (SD). And if earlier SD was perceived from the standpoint of purely biomechanical disorders, then in recent years there have been serious changes in understanding the heterogeneity of this state nature. The biomechanical, rhythmogenic and neurodynamic components are conventionally distinguished in the structure of SD. One of the neurodynamic disorders types is the violation of motor stereotypes, the so-called static-dynamic disorders, revealed through special dynamic tests and manifested in the functional impossibility of building of active movement at various levels. At the same time, the generally accepted biomechanical approaches do not allow to completely eliminate violations of the statodynamic stereotype.The goal of research — the study was to research the effectiveness of the osteopathic approach using in combination with kinesitherapy for correction of the statodynamic stereotype violations in patients with dorsopathy at the cervicothoracic level.Materials and methods. A controlled randomized prospective study was conducted on the basis of a private rehabilitation center «Ezramed-Clinic» in Omsk in the period from February 2019 to December 2019. 52 patients with a diagnosis of dorsopathy at the cervicothoracic level were observed. 12 people were knocked out during the study in accordance with the exclusion criteria. As a result, 40 patients participated in the study. Depending on the applied treatment method, the patients were divided by simple randomization into two groups (main and control), each of which consisted of 20 people. Both groups of patients received osteopathic correction three times with a frequency of receptions 1 time in 7–10 days. The main group of patients additionally independently performed daily for 10 minutes a set of exercises aimed to restore the disturbed motor stereotypes (normal synkinesis). The control group of patients additionally independently performed a set of exercise therapy for the cervical spine every day for 10 minutes. All patients, regardless of the group, underwent an osteopathic examination before and after treatment with the formation of an osteopathic conclusion; the severity of pain syndrome and the volume of active movements in the cervical spine were assessed. The severity of the pain syndrome and the range of active movements were assessed before and immediately after treatment, as well as 3 months after the first session.Results. The use of osteopathic correction in conjunction with kinesitherapy (both special exercises and a complex of exercise therapy) in patients with a diagnosis of dorsopathy at the cervicothoracic level leads to a statistically significant increase in the range of motion in the cervical spine in the sagittal and frontal planes (p<0,05). The combination of osteopathic correction together with exercise therapy in patients of the control group led to a statistically more significant increase (p<0,05) in the range of motion in the cervical spine in the frontal plane after treatment compared with the results of the main group. However, 3 months after treatment, the indicators in patients of both groups did not have statistically significant differences.The combination of osteopathic correction in conjunction with kinesiotherapy in the form of special exercises for the motor stereotype correction in the main group of patients with diagnosed dorsopathy at the cervicothoracic level led to a statistically significant (p<0,05) decrease in the intensity of the pain syndrome at the 2nd session.Conclusion. In order to increase the effectiveness of treatment, osteopathic correction of somatic dysfunctions in patients with dorsopathy at the cervicothoracic level can be supplemented with complex kinesitherapy, both in the form of traditional exercise therapy, and in the form of special exercises for correction of altered motor stereotype.


Author(s):  
E. V. Stroganova ◽  
O. N. Shadrin ◽  
Yu. O. Kuzmina

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.


Author(s):  
Yu. V. Antonova ◽  
A. M. Iskandarov ◽  
I. B. Mizonova

Introduction.Coccygodynia is a multidisciplinary disease which is diffi cult to treat. It seriously limits the ability to work and signifi cantly affects the quality of life of patients. The study of somatic dysfunctions in patients with coccygodynia and the analysis of the results of osteopathic treatment of such patients makes it possible to justify the necessity of osteopathic correction of coccygodynia.Goal of the study— to determine the structure of the leading somatic dysfunctions in patients with coccygodynia and to study the effectiveness of osteopathic treatment of this pathology.Materials and methods.The study involved 44 patients from 25 to 65 years old, randomly divided into two groups. The main group of 24 people (20 women and 4 men) received osteopathic treatment, in accordance with the identifi ed leading somatic dysfunctions. Patients of the control group (16 women and 4 men) were treated locally with soft manual techniques (the treatment area was limited by the pelvic region). In order to assess the results of the treatment, we examined the intensity of the pain syndrome and the psycho-emotional state of patients. The severity of the pain syndrome was assessed in accordance with the visual analogue scale (VAS). The psycho-emotional state (with physical and mental components) was assessed with the help of the SF-36 quality of life questionnaire.Results.Somatic dysfunctions typical for patients with coccygodynia have been identifi ed. Osteopathic treatment has proven to be more effective in comparison with local manual therapy of coccygodynia both in early periods and in 3 months after the end of the treatment course.Conclusion.Osteopathic treatment of post-traumatic coccygodynia is effective, and can be recommended for treatment of such patients.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Shamekh Mohamed El-Shamy ◽  
Ehab Mohamed Abd El Kafy

Abstract Background TheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis. Results Children in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group. Conclusions The use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy. Trial registration This trial was registered in the ClinicalTrial.gov PRS (NCT03037697).


2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.


2021 ◽  
Vol 23 (3) ◽  
pp. 17-22
Author(s):  
Aleksey A. Sazonov ◽  
Nicolay A. Maistrenko ◽  
Pavel N. Romashchenko ◽  
Ivan A. Makarov

The effectiveness of the original technique of hemorrhoidectomy with lateral ultrasonic dissection in the cutting mode was analyzed from a clinical standpoint and studied according to pathomorphological changes in tissues during its use. A comparative assessment of the immediate results of treatment as well as pathomorphological changes in the tissue of removed hemorrhoids in two groups of patients was performed. The main group included 30 patients in whom the original hemorrhoidectomy technique with lateral ultrasound dissection in the cutting mode was used. The control group consisted of 30 patients who underwent Milligan Morgan hemorrhoidectomy using electrocoagulation. No significant difference was found between these groups in terms of the age and sex structure of patients, as well as the main clinical characteristics of the disease. In a comparative analysis of the immediate treatment results, the intensity of the pain syndrome and the incidence of postoperative complications were lower in the main group than in the control group. In the assessment of pathomorphological changes, the depth of coagulation necrosis and the severity of necrobiotic changes in the underlying layer after hemorrhoidectomy with lateral ultrasonic dissection in the cutting mode were significantly less than those after Milligan Morgan surgery using electrocoagulation. A significant difference was also revealed in the timing of tissue regeneration. The formation of active granulations in the postoperative wound area in the main group was noted on postoperative days 1416, while this process developed no earlier than on postoperative day 20 in the control group. As a result, complete epithelialization of wounds after hemorrhoidectomy with lateral ultrasound dissection in the cutting mode occurred much earlier, i.e., postoperative days 2630. A similar process after the Milligan Morgan hemorrhoidectomy using monopolar coagulation was completed only on postoperative days 3638. Thus, the use of the original technique of lateral ultrasound dissection provides a more sparing effect on tissues, which is the key to a favorable course of the postoperative period and rapid rehabilitation of patients.


2019 ◽  
Vol XXIII (2) ◽  
pp. 49-60
Author(s):  
Marta NIEDBAŁA ◽  
Grzegorz MAGOŃ

<b>Introduction.</b> Manual therapy is a standard method of physiotherapy to deactivate the interfering potential of the trigger points thus eliminate the subsequent tension within the area of the connective tissue. <b>Aims.</b> The aim of the study is the evaluation of the influence of the myofascial trigger points therapy on the increased neck muscle tension, pain and ROM in people who suffer from cervical pain. <b>Material and methods.</b> A diagnostic method was linear measurements of ROM of the cervical spine and a visual analogue scale (VAS) to assess the pain level. The examination included 35 people aged 25-55, performing whitecollar work in sitting position, selected by a neurologist or orthopedist, with identified increased muscle tension in the cervical region. Achieved results were statistically evaluated. To show the importance of the differences in cervical ROM, the intensity of pain and disability level before and after rehabilitation, a non-parametric signedrank test was utilized. The differences were found as significant for p<0,05. <b>Results and conclusions.</b> A comprehensive physiotherapy of myofascial painfull points results in decrease the pain level in patients suffering from pain syndrome of the cervical spine. Proposed physiotherapy plan lead to improved movement of the cervical spine in all directions.


2015 ◽  
Vol 9 (1) ◽  
pp. 0-0
Author(s):  
Белых ◽  
E. Belykh ◽  
Несмеянов ◽  
A. Nesmeyanov ◽  
Борисова ◽  
...  

The article demonstrates the importance of the application of new biomedical technologies in the correction of somatoform disorders in athletes. In observation were 86 athletes playing sports. Comprehensive clinical, psychological and instrumental examination showed that 11, 3% of them have some somatic pathology, but the complaint didn’t match up to this pathology, she had overdone character. Moreover, in this group in 36.4% of cases, there are previous histories of acute infectious diseases. The athletes were divided into two equal groups (main and control) by 43 people. In the main group, the athletes were treated orally with shungite in the form of tablets, in the control group - the psycho-pharmacotherapy. The same clinical and instrumental effect was observed in both groups. In the control group the undesirable effect of reducing muscle tone, drowsiness was detected. This allowed the authors to consider that it is expedient to use shungite for the correction of sym-tomatics in athletes with somatoform disorders.


Author(s):  
E. N. Nenashkina

Introduction. The presence of somatic diseases during pregnancy leaves a serious imprint on the emotional state of a woman, significantly worsens the quality life indicators and affects the clinical characteristics of pregnancy. One of these diseases is chronic pyelonephritis. There are a fairly large number of recommendations for the treatment of this pathology. However the focus is mainly on drug therapy. At the same time the existing restrictions on the number of drugs using during pregnancy, the problem of polypragmasia, and the increase in the number of allergic complications of drugs using dictate the need to search alternative methods of treatment, primarily non-drug ones. Moreover, the problems of pregnant women life quality with chronic pyelonephritis during complex drug therapy are often not given due attention.The goal of research — to assess the impact of osteopathic correction on the psycho-emotional state and life quality of pregnant women with concomitant pathology of the urinary system.Materials and methods. A prospective controlled randomized study was conducted in the period 03.2016– 01.2018 on the basis of medical clinics of LLC «Mokhov Institute of osteopathy» and LLC «Vasileostrovskaya clinic of reproduction and genetics». There were observed work 48 pregnant women with chronic pyelonephritis aged 25–45 years, with a gestation period 13–27 weeks. During the processing of the clinical material, 8 patients were eliminated. As a result of the selection process, a group of 40 people was formed. All pregnant women with chronic kidney disease, depending on the used treatment method, were divided into two groups using a simple randomization method with a random number generator. There was formed the main group (20 people), and the control group (20 people). Patients of the main group received medication and osteopathic correction (3 procedures with an interval of 7–10 days). Patients in the control group received only traditional drug therapy. All pregnant women with chronic pyelonephritis had an osteopathic examination before and after treatment with forming an osteopathic conclusion, and the assessment of the pain syndrome severity by a visual analog scale (VAS), the general psycho-emotional state (the method of rapid assessment of health, activity and mood — HAM), and the level of life quality (Questionnaire Medical Outcomes Study — Short Form).Results. Pregnant women with chronic pyelonephritis were characterized by a weak pain syndrome, a psychoemotional state violations in the categories «well-being» and «activity», and a decrease in both the physical and mental components of life quality. After the complex treatment including the additional to traditional drug therapy osteopathic correction methods, the statistically significant decrease of the pain severity degree (p=0,001), increase of psychoemotional state rates in the category of «activity» (p=0,05) and the increase of physical and mental components of life quality (p=0,02) were observed in the main group compared with the control.Conclusion. Chronic pathology of the kidneys during pregnancy affects the emotional state of a woman, significantly worsens life quality indicators. The use of osteopathic correction as a part of the complex therapy of pregnant women with chronic pyelonephritis can improve the emotional state and life quality; reduce the pain severity, and so can be used to improve medical care for this population category. 


2019 ◽  
Vol 15 (1) ◽  
pp. 49-53
Author(s):  
Оксана Соловьева ◽  
Oksana Solovieva ◽  
Карен Караков ◽  
Karen Karakov ◽  
Нелли Ванченко ◽  
...  

Importance. Exfoliative cheilitis is an inflammatory disease accompanied by damage to the red border of the lips. With dry exfoliative cheilitis, scales form on the lips, which are densely soldered to the underlying tissue in the center, and along the periphery, on the contrary, are raised. At the same time, patients indicate a feeling of dryness, burning. When the exudative form of cheilitis is observed puffiness, sore lips. Diagnosis of exfoliative cheilitis is reduced to the collection of complaints, the preparation of anamnesis of the disease, physical examination. For the treatment of exfoliative cheilitis, Bucca rays, moisturizing creams, acupuncture techniques, as well as agents that increase body resistance are used. As it turned out, in practice, all existing methods of treatment are ineffective, and the disease is manifested by frequent relapses. Pathology is more common in women. The dry form of the disease is mainly detected at the age of 16-40 years. Exudative cheilitis is diagnosed in patients aged 16-65 years. Objectives ― evaluate the effectiveness of lip balm based on lamb fat, and make a conclusion based on the clinical data and patient's subjective sensations. Methods. Twenty patients aged from 18 to 45 years with a diagnosis of exfoliative cheilitis were selected for work. All patients were divided into two groups: control (10 people) and main (10 people). Local therapy in both groups began according to the generally accepted scheme: sanation of the oral cavity, treatment of periodontal diseases according to indications, selective grinding off of the sharp edges of the teeth. In the main group, patients received treatment in the form of an application with a cool furatsilina solution, and applying the dosage form in the form of lip balm., Consisting of red-hot lamb fat and filtered through gauze, lanolin, pumpkin oil, ylang ylang oil, geranium oil, and also vitamins oil A and E and medical paraffin, this dosage form was prepared in paraffin and sterilized, after complete cooling it was applied to the lips with a spatula, and the patients easily used it at home as a balm for K in the morning and evening. Patients of the control group received the traditional treatment of cheilitis, anestezin applications, lip treatment with an antiseptic solution and keratoplasty applications - vitamin A and E oil. The results of the treatment were evaluated according to the clinical examination of patients, as well as taking into account the subjective feelings of the patients. Results. Based on the schemes of complex treatment of exfoliative cheilitis in patients of the main group, a positive result was obtained after the 3rd visit. A decrease in pain syndrome, a decrease in lesion elements (flakes), epithelization of cracks, a decrease in pain syndrome, a decrease in complaints of dryness of the red border of the lips were revealed. Conclusions. The development of this algorithm for treating ecfoliative cheilitis, including a mutton fat lip balm, has reduced the treatment time for this pathology.


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