Staging of Plantar Fasciitis According to Ultrasonography

Objective. Analysis of sonographic examination of plantar aponeurosis in norm and in plantar fasciitis, determination of the staging of plantar fasciitis depending on the duration of the pain syndrome and sonographic changes in plantar aponeurosis. Materials and Methods. 193 patients (272 cases) with plantar fasciitis (131 females and 62 males). The average age of patients was 47.69±0.97 years (18-81 years). Unilateral pathology was noted in 114 patients (114 cases) and bilateral – in 79 patients (158 cases). The average body mass index was 26.68±0.24. The average duration of pain syndrome was 101.12±5.83 days (7-390 days). The pain syndrome lasted up to 1 month in 26 patients (37 cases), from 1 to 6 months – in 126 patients (181 cases), and more than 6 months – in 41 patients (54 cases). The control group included 20 healthy volunteers (40 feet). Clinical radiological, sonographic, and statistical methods were used. Results. The average thickness of plantar aponeurosis in the study group was 6.14±1.49 mm (2.3-7.7 mm) and in control group – 3.5±0.1 mm (2.5-4.4 mm). There were three stages of the plantar fasciitis. Stage I was characterized by the absence of thickening of the plantar aponeurosis and structural changes, and by signs of local perifocal edema in the subcutaneous fat of the area adjacent to the aponeurosis, which are manifested by a zone of heterogeneous echogenicity. Stage II was characterized by a spindle-shaped form of aponeurosis, a thickening of enthesis more than 4 mm, significant reduction in echogenicity, erased or missing fibrous pattern, fuzzy contour of the aponeurosis, and modified contour of the calcaneus. At stage III, inequality of the cortical calcaneal contour and small focal hyperechogenicity points in enthesis were detected. Distal free part of the aponeurosis also changed. Loci of vascularization were detected using power Doppler sonography. Conclusions. A quantitative sonographic sign of plantar fasciitis is the thickening of the enthesis of the plantar aponeurosis of more than 4 mm. Qualitative signs were changes in echogenicity and structure, changes in the contours of the cortical layer of enthesis and plantar aponeurosis, and distribution of echographic changes distally to the free part of the aponeurosis. The described signs, when compared with the duration of the pain syndrome, determine the stage of plantar fasciitis.

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Up to a quarter of patients with certain chronic recalcitrant tendinopathies may have central sensitisation: a prospective cohort of more than 300 patients

British Journal of Pain ◽

10.1177/2049463718800352 ◽

2018 ◽

Vol 13 (3) ◽

pp. 137-144

Author(s):

Patrick C Wheeler

Keyword(s):

Lower Limb ◽

Plantar Fasciitis ◽

Pain Syndrome ◽

Achilles Tendinopathy ◽

Control Group ◽

Greater Trochanteric Pain Syndrome ◽

Duration Of Symptoms ◽

Central Sensitisation ◽

Clinical Records ◽

Insertional Achilles Tendinopathy

Introduction: To identify the possible prevalence of ‘central sensitisation’, in patients with chronic recalcitrant lower limb tendinopathy conditions, with the Central Sensitisation Inventory (CSI) questionnaire. Methods: Patients with chronic lower limb tendinopathy conditions treated within a single hospital outpatient clinic specialising in tendinopathy were identified from clinical records. As part of routine care, self-reported numerical markers of pain, global function (using the EuroQol-5D (EQ-5D) questionnaire) and the CSI score to investigate the possibility of central sensitisation were completed. Results: A total of 312 suitable patients with chronic lower limb tendinopathy and similar conditions were identified, who had completed a CSI questionnaire. Of these, 108 presented with greater trochanteric pain syndrome, 12 with patella tendinopathy, 33 with non-insertional Achilles tendinopathy, 48 with insertional Achilles tendinopathy and 110 with plantar fasciitis. A total of 66% of the patients were female, the median age was 54.9 years and the median duration of symptoms was 24 months. There was a median CSI score of 25%, with statistically significant differences noted between the different conditions studied. Overall, 20% of patients scored above a threshold of 40% on CSI questionnaire, indicating that central sensitisation was possible. Greater trochanteric pain syndrome and plantar fasciitis had the highest proportions in the conditions studied. Weak correlations were found between CSI and other pain scores studied. Conclusion: The CSI questionnaire may identify up to a quarter of patients with some chronic lower limb tendinopathy and associated conditions as being more likely to have central sensitisation, and these proportions differed between conditions. The clinical significance of this is unclear, but worth further study to see if/how this may relate to treatment outcomes. These are results from a single hospital clinic dealing with patients with chronic tendinopathy, and comparison with a control group is currently lacking. However, on the information presented here, the concept of central sensitisation should be considered in patients being treated for chronic tendinopathy.

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New Approaches in the Study of the Pathogenesis of Urethral Pain Syndrome

Diagnostics ◽

10.3390/diagnostics10110860 ◽

2020 ◽

Vol 10 (11) ◽

pp. 860

Author(s):

Olga Streltsova ◽

Anton Kuyarov ◽

Muhhamad Shuaib Abdul Malik Molvi ◽

Svetlana Zubova ◽

Valery Lazukin ◽

...

Keyword(s):

Structural Changes ◽

Complete Blood Count ◽

Transvaginal Ultrasound ◽

Optical Tomography ◽

Pain Syndrome ◽

Proximal Region ◽

Laboratory Evaluation ◽

Control Group ◽

Proximal Fragment ◽

Urethral Pain

Introduction: Urethral pain syndrome (UPS) is still a pathology in which the diagnosis is formulated as a “diagnosis of exclusion”. The exact pathogenetic mechanisms are not yet fully understood and clear recommendations for the prevention and treatment of UPS are absent. Methods and Participants: A clinical and laboratory evaluation of 55 patients with established UPS included history taking, basic laboratory tests (e.g., complete blood count and clinical urine test), physical examination, uroflowmetry, and cystourethroscopy. Additionally, transvaginal ultrasound (TVUS) with compression elastography and cross-polarization optical tomography (CP OCT) were performed in 24 and 33 patients with UPS, respectively. The control group consisted of 14 patients with no complaints from the urinary system. Results: TVUS showed an expansion in the diameter of the internal lumen of the urethra, especially in the proximal region compared with the norm. Compression elastography revealed areas with increased stiffness (presence of fibrosis) in urethral and surrounding tissues. The performed CP OCT study showed that in UPS, the structure of the tissues in most cases was changed: trophic alterations in the epithelium (hypertrophy or atrophy) and fibrosis of underlying connective tissue were observed. The proximal fragment of the urethra with UPS underwent changes identical to those of the bladder neck. Conclusion: This paper showed that the introduction of new technology—CP OCT—in conjunction with TVUS will allow verification of structural changes in tissues of the lower urinary tract at the level of their architectonics and will help doctors understand better the basics of the UPS pathogenesis.

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Results of osteopathic correction of patients with post-traumatic coccygodynia

Russian Osteopathic Journal ◽

10.32885/2220-0975-2019-1-2-19-27 ◽

2019 ◽

pp. 19-27

Author(s):

Yu. V. Antonova ◽

A. M. Iskandarov ◽

I. B. Mizonova

Keyword(s):

Quality Of Life ◽

Emotional State ◽

Pain Syndrome ◽

Control Group ◽

Life Questionnaire ◽

Treatment Area ◽

Diffi Cult ◽

Osteopathic Treatment ◽

Post Traumatic

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.

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Clinical and sonological features in endometriomas in women of reproductive age

HEALTH OF WOMAN ◽

10.15574/hw.2016.114.85 ◽

2016 ◽

pp. 85-89

Author(s):

О. Shapoval ◽

Keyword(s):

Endometrial Hyperplasia ◽

Benign Tumor ◽

Pain Syndrome ◽

Reproductive Age ◽

Control Group ◽

Women Of Reproductive Age ◽

Ovarian Endometriosis ◽

Gynecological Examination ◽

Different Characteristics ◽

Ovarian Endometriomas

The objective: to study the prevalence of ovarian endometriosis in women of reproductive age, the features of clinical and ultrasound picture of endometriosis. Patients and methods. The study involved 22 patients with endometriomas, the control group – 50 women gynecological and somatically healthy. Results. The incidence of ovarian endometriomas in the structure of benign tumor-like formations of ovaries is 0.62%. In 72.73% of ovarian endometriomas occur on a background of concomitant gynecological pathology. Clinically, in 77.27% of cases there is a pain syndrome, in 59.09% – algomenorrhea, in 13.64% – infertility; 18.18% of cases endometriomas remain «dumb» and proceed with the erased clinical picture. Sonologically in patients with endometriomas adenomyosis, endometrial hyperplasia, changes in the contralateral ovary are determined. Conclusion. Without additional methods of diagnostic gynecological examination may identify the 3 cm tumor-like formation of the ovary with different characteristics, which does not allow to differentiate endometrioma from inflammation, functional and ovarian tumors. Ultrasound can diagnose pathological ovarian formation of 1 cm, detailing the nature of the cyst. Key words: endometriosis, reproductive age, retrospective analysis, ultrasound.

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EVALUATION OF LEFT VENTRICULAR MASS IN THE PREHYPERTENSIVES BY ELECTROCARDIOGRAPHY AND ECHOCARDIOGRAPHY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.6.15 ◽

2011 ◽

pp. 119-125

Author(s):

Thi Thuy Hang Nguyen

Keyword(s):

Left Ventricular Hypertrophy ◽

Left Ventricular Mass ◽

Ventricular Hypertrophy ◽

Structural Changes ◽

Left Ventricular ◽

Control Group ◽

Concentric Left Ventricular Hypertrophy ◽

Increased Risk ◽

Lv Mass ◽

Left Ventricular Morphology

Objective: Prehypertensive individuals are at increased risk for developing hypertension and their complication. Many studies show that 2/3 prehypertensive individuals develop hypertension after 4 years. ECG and echocardiography are the routine tests used to assess LV mass. The objective of the research to determine the percentage of change in left ventricular morphology in the ECG, echocardiography, which explore the characteristics of left ventricular structural changes by echocardiography in pre-hypertensive subjects. Materials and method: We studied a total of 50 prehypertensive, 30 males (60%) and 20 females (40%), mean age 48.20±8.47years. 50 normotensive volunteers as control participants. These subjects were examined for ECG and echocardiography. Results: In prehypertensive group, with 18% of left ventricular hypertrophy on electrocardiogram, 12% of left ventricular hypertrophy on echocardiography; in the control group, we did not find any subjects with left ventricular hypertrophy. In the group with left ventricular hypertrophy, mostly eccentric left ventricular hypertrophy (83.33%), concentric left ventricular hypertrophy is 16.67%. Restructuring of left ventricular concentric for 15.9% of subjects without left ventricular hypertrophy on echocardiography. Conclusion: There have been changed in left ventricular morphology even in prehypertensive

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Interaction of Lactoferrin with Unsaturated Fatty Acids: In Vitro and In Vivo Study of Human Lactoferrin/Oleic Acid Complex Cytotoxicity

Materials ◽

10.3390/ma14071602 ◽

2021 ◽

Vol 14 (7) ◽

pp. 1602

Author(s):

Anna Elizarova ◽

Alexey Sokolov ◽

Valeria Kostevich ◽

Ekaterina Kisseleva ◽

Evgeny Zelenskiy ◽

...

Keyword(s):

Oleic Acid ◽

Structural Changes ◽

Unsaturated Fatty Acids ◽

Structural Features ◽

Control Group ◽

Acid Complex ◽

Hepatoma 22A ◽

Constitutive Parameters

As shown recently, oleic acid (OA) in complex with lactoferrin (LF) causes the death of cancer cells, but no mechanism(s) of that toxicity have been disclosed. In this study, constitutive parameters of the antitumor effect of LF/OA complex were explored. Complex LF/OA was prepared by titrating recombinant human LF with OA. Spectral analysis was used to assess possible structural changes of LF within its complex with OA. Structural features of apo-LF did not change within the complex LF:OA = 1:8, which was toxic for hepatoma 22a cells. Cytotoxicity of the complex LF:OA = 1:8 was tested in cultured hepatoma 22a cells and in fresh erythrocytes. Its anticancer activity was tested in mice carrying hepatoma 22a. In mice injected daily with LF-8OA, the same tumor grew significantly slower. In 20% of animals, the tumors completely resolved. LF alone was less efficient, i.e., the tumor growth index was 0.14 for LF-8OA and 0.63 for LF as compared with 1.0 in the control animals. The results of testing from 48 days after the tumor inoculation showed that the survival rate among LF-8OA-treated animals was 70%, contrary to 0% rate in the control group and among the LF-treated mice. Our data allow us to regard the complex of LF and OA as a promising tool for cancer treatment.

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FRI0342 POST-EFFORT SYNOVIAL AND ENTHESIC RESPONSE IN PATIENTS WITH PSORIATIC ARTHRITIS IN REMISSION OF LOW DISEASE ACTIVITY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6279 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 765.2-765

Author(s):

C. Guillén-Astete ◽

P. Zurita-Prada ◽

C. Urrego-Laurín

Keyword(s):

Disease Activity ◽

Power Doppler ◽

Control Group ◽

Healthy Population ◽

Dominant Hand ◽

Synovial Joint ◽

Low Disease Activity ◽

Post Exercise ◽

Eular Recommendations ◽

The Mean

Background:Synovial inflammation is part of the pathophysiological process of PsoA although it is considered secondary to enthesitis. It is of interest to assess the synovial joint, peritendinous and enthesic response of patients with PsoA in remission under controlled mechanical stress.Objectives:Our aim is to present our observational experience in patients with APso in remission or low activity of the disease exposed to controlled manual physical efforts adapted to the own grasping capacity of each subject.Methods:Before-after study of a consecutive cohort of patients with PsoA (CASPAR criteria), of at least two years d evolution and DAPSA≤14 at present. Patients with positive rheumatoid factor, patients with exclusively axial forms and patients on biological therapy at the beginning of the study were excluded. All patients underwent controlled basal ultrasound and post-dynamometric exercise (CAMRY EH101-17) of the dominant hand which included the carpus, MCFs, IFPs and IFDs of the 2nd to 5th fingers. The ultrasound findings were scored according to EULAR recommendations in grey scale (GS) and power Doppler (PD) for synovitis, enthesitis and tenosynovitis (maximum scores 71 and 87, respectively). For statistical analysis, comparisons were made with the results of their baseline and post-exercise ultrasound scores between subjects diagnosed with PsoA and controls. The Student’s T test was used for related and unrelated data according to correspondence.Results:Nineteen patients and controls were included, of which 73.7% were male. Mean age: 42.2 SD 6.6 and 42.21 SD 8.28, respectively. Basal DAPSA among patients: 7.26 SD 4.53. Mean traction strength of patients and controls: 23.8 SD 7.3 and 26.1 SD 6.9 kg, respectively (P=0.336). In the group of patients, the post exercise DAPSA had a mean of 7.52 SD 4.62 (P=0.021, with respect to the basal DAPSA). The mean total GS score in the patient group was 3.94 SD 2.36 and 7.31 SD 3.3, pre- and post-exercise, respectively (P<0.001). The mean total score in the PD study was 0.73 SD 0.73 and 2.57 SD 1.16, respectively (P<0.001). In patients with PsoA there were no detectable enthesic changes. In the control group, no ultrasound changes were statistically significant, although the score for tenosynovitis ranged from 0.1 SD 0.31 to 0.42 SD 0.6 (P=0.055).Conclusion:Patients with APso in clinical remission or low disease activity develop ultrasound changes after controlled exercise. These changes are appreciable in the joint synovium and tendon but not at an enthesic level. Although these changes are also detectable in a healthy population, their prevalence is much lower. Our interpretation is that control of the disease correlates with an absence of enthesic inflammatory activity although synovial susceptibility remains less evident. This reinforces the idea that PsoA is an inflammatory enthesitis with associated arthritis and not its opposite.Disclosure of Interests:None declared

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Higher Impulse Electromyostimulation Contributes to Psychological Satisfaction and Physical Development in Healthy Men

Medicina ◽

10.3390/medicina57030191 ◽

2021 ◽

Vol 57 (3) ◽

pp. 191

Author(s):

Kangho Kim ◽

Denny Eun ◽

Yong-Seok Jee

Keyword(s):

Body Image ◽

Body Shape ◽

Subcutaneous Fat ◽

Self Esteem ◽

Analysis Of Covariance ◽

Whole Body ◽

Control Group ◽

Visceral Fat Area ◽

Total Fat ◽

Muscle Groups

Background and Objectives: This study investigated the various impulse effects of whole-body electromyostimulation (WB-EMS) on psychophysiological responses and adaptations. Materials and Methods: The participants included fifty-four men between 20 and 27 years of age who practiced isometric exercises for 20 min, three days a week, for 12 weeks while wearing WB-EMS suits, which enabled the simultaneous activation of eight muscle groups with three types of impulse intensities. Participants were allocated to one of four groups: control group (CON), low-impulse-intensity group (LIG), mid-impulse-intensity group (MIG), and high-impulse-intensity group (HIG). Psychophysiological conditions were measured at week 0, week 4, week 8, and week 12. Results: Compared with the CON, (1) three psychological conditions in LIG, MIG, and HIG showed positive tendencies every four weeks, and the analysis of covariance (ANCOVA) test revealed that body image (p = 0.004), body shape (p = 0.007), and self-esteem (p = 0.001) were significantly different among the groups. (2) Body weight, fat mass, body mass index, and percent fat in the CON showed decreasing tendencies, whereas those in LIG, MIG, and HIG showed a noticeable decrease, which revealed that there were significant differences among the groups. Specifically, a higher impulse intensity resulted in a greater increase in muscle mass. (3) Although there was no interaction effect in the abdominal visceral fat area, there were significant interactions in the abdominal subcutaneous fat (ASF) and total fat (ATF) areas. Both the ASF and ATF in the CON showed decreasing tendencies, whereas those in other groups showed a noticeable decrease. The ANCOVA revealed that the ASF (p = 0.002) and ATF (p = 0.001) were significantly different among the groups. In particular, the higher the impulse intensity, the greater the decrease in abdominal fat. Conclusions: This study confirmed that high-impulse-intensity EMS can improve psychophysiological conditions. In other words, healthy young adults felt that the extent to which their body image, body shape, and self-esteem improved depended on how intense their EMS impulse intensities were. The results also showed that higher levels of impulse intensity led to improved physical conditions.

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POS1405 OPTICAL SPECTRAL TRANSMISSION (HANDSCAN) IN PATIENTS WITH PSORIATIC ARTHRITIS: FIRST DATA ON DIAGNOSTIC VALUE AND ASSOCIATIONS WITH CLINICAL AND ULTRASOUND DISEASE ACTIVITY MARKERS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3670 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 985.1-985

Author(s):

K. Triantafyllias ◽

S. Liverakos ◽

C. Noack ◽

A. Schwarting

Keyword(s):

Rheumatoid Arthritis ◽

Psoriatic Arthritis ◽

Disease Activity ◽

Power Doppler ◽

Patient Characteristics ◽

Diagnostic Value ◽

Control Group ◽

Spectral Transmission ◽

Grey Scale ◽

Assessment Of Disease Activity

Background:Valid assessment of disease activity leads to improvement of long-term outcomes in patients with inflammatory arthritis (1). Optical spectral transmission (OST) is a modern diagnostic tool able to assess the blood-specific absorption of light transmitted through a tissue, promising quantification of inflammation in the finger and wrist joints of patients with rheumatoid arthritis (RA) (commercial device: HandScan – Demcon/Hemics, The Netherlands) (2). Even though an increasing number of studies have evaluated diagnostic value of this new technology in RA patients (2,3), no data exist regarding psoriatic arthritis (PsA).Objectives:To examine for the first time the diagnostic value of OST in detecting inflammation in patients with PsA and to evaluate its relationship with disease activity markers and various epidemiological and anthropometric patient characteristics.Methods:OST-Measurements were performed in a group of PsA patients and a group of healthy controls. The difference between OST in the two groups was statistically examined and relationships of OST with clinical (tender / swollen joint counts, disease activity on a visual analogue scale) and serological disease activity markers were evaluated. Moreover, joint ultrasound (US) examinations were performed in a subgroup of PsA patients and OST associations with a Power Doppler- and a Grey Scale-US score were examined. Finally, relationships of OST with various anthropometric and epidemiologic parameters (BMI, hand-size, gender, age) were assessed.Results:We recruited 49 PsA patients [65.3% female; mean age 53.3 years (± 11.8 SD)] and 114 control subjects [77.2% female; mean age 46 years (± 12.8 SD)]. OST was statistically significantly higher in the patient group, compared to the control group [14.95 (12.04 - 17.18, IQR) vs. 10.31 (7.84 – 13.79, IQR); p<0.001]. OST correlated moderately-strongly with both examined US scores (Power Doppler-score: r = 0.5; p = 0.026 and Grey Scale-score: r = 0.52; p = 0.028). Moreover, OST showed a moderate, statistically significant association with C-reactive protein (CRP) (r = 0,298; p = 0,037). Finally, males had significantly higher OST values than females and OST associated moderately-weakly with body mass index (BMI) in the control group (rho = 0.24; p< 0.001).Conclusion:This is the first report of a possible diagnostic value of OST in patients with PsA. OST correlated with ultrasound and serological activity markers and may thus prove to be a useful tool of disease activity assessment, next to well established diagnostic modalities, such as the joint US. Correlations of OST with patient characteristics implicate the need to take also anthropometric and epidemiological patient characteristics into account when interprenting OST results in order to avoid confounding.References:[1]Katchamart W, et al. Systematic monitoring of disease activity using an outcome measure improves outcomes in rheumatoid arthritis. J Rheumatol 2010;37:1411–1415.[2]Triantafyllias, et al. Diagnostic value of optical spectral transmission in rheumatoid arthritis: associations with clinical characteristics and comparison with joint ultrasonography. J Rheumatol 2020 1;47(9):1314-1322.[3]Onna M Van, et al. Assessment of disease activity in patients with rheumatoid arthritis using optical spectral transmission measurements, a non-invasive imaging technique. Ann Rheum Dis 2016;75:511–518.Disclosure of Interests:Konstantinos Triantafyllias Speakers bureau: Pfizer, Novartis, Janssen, Chugai, Stefanie Liverakos: None declared, Claudia Noack: None declared, Andreas Schwarting: None declared

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Possibilities of correction of the statodynamic stereotype violations in patients with dorsopathy at the cervical-thoracic level

Russian Osteopathic Journal ◽

10.32885/2220-0975-2021-1-20-33 ◽

2021 ◽

pp. 20-33

Author(s):

V. O. Belash ◽

A. E. Vorobyova ◽

D. A. Vasyukovich

Keyword(s):

Cervical Spine ◽

Range Of Motion ◽

Exercise Therapy ◽

Frontal Plane ◽

Pain Syndrome ◽

Main Group ◽

Medical Community ◽

Control Group ◽

Active Movement ◽

Social Significance

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.

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