Introduction. The main medical consequences of amputations are: phantom pain syndrome, degenerative changes in soft tissues, increased muscle tone of the stump, deterioration of microcirculation in the amputated limb. Methods of rehabilitation of such patients are physical therapy, physiotherapy, psychotherapy, mechanotherapy. The search for new methods of rehabilitation of patients with amputation of the lower limb is constantly underway due to the social significance of this disease. Osteopathic correction has proven effects of normalization of muscle tone, improvement of blood circulation, which can be assessed using infrared thermography.Aims: to evaluate the effect of osteopathic correction on blood circulation in the stump in patients with transtibial amputation.Materials and methods. The study includes 30 patients (21 men and 9 women) with transtibial amputation, undergoing diagnostic examination using infrared thermography on an outpatient basis in Albrecht Federal Scientific Centre of Rehabilitation of the Disabled. Patients were divided in two groups in random: main group (n=15), receiving osteopathic correction, and control group, receiving sham therapy. Both groups were divided in subgroups depending on amputation cause: cardiovascular diseases and trauma. Regardless the group infrared thermography was performed before and after first session of therapy or osteopathic correction and before and after second session. On thermograms, the temperature of the distal part of the stump was evaluated, the second limb — in the projection of the distal part of the stump.Results. The method of infrared thermography objectively confirmed the positive effect of osteopathic correction on blood flow in the lower leg stump: in patients with traumatic and vascular genesis of amputation — in the form of a decrease in the severity of distal hypothermia after the first, before the second and after the second session of osteopathic correction compared to the data before osteopathic correction. In the control group, there was also a statistically significant increase in the temperature of the distal part of the stump after the first session and the second sessions of sham therapy, which returned to its original values before the second session, which indicates the short-term nature of the changes.Conclusion. The study showed an improvement in blood circulation in the truncated limb, confirmed by an increase in the temperature of the stump in patients with transtibial amputation of traumatic and vascular genesis, which underwent osteopathic correction.

Introduction. In the comprehensive rehabilitation of patients with lower limbs amputations (LLA), there are currently used: physical therapy, mechanotherapy, physiotherapy. Despite the availability of rehabilitation methods, full correction of postural balance in patients with lower limbs amputations remains an urgent medical problem. Osteopathy has not been used in the rehabilitation of such patients until recently, despite the proven effect of normalizing muscle tone, neurohumoral system, as well as improvement of blood circulation and lymphatic outflow after osteopathic correction.Aims: To study the effect of osteopathic correction on postural balance in patients with lower limb amputations at the transtibial level.Materials and methods. 59 patients (37 men and 22 women, average age 57 years) with LLA at the transtibial level were examined using stabilography in outpatient on the basis of the Albrecht Federal Scientific Center for Rehabilitation of the Disabled. The patients were randomly divided into 2 groups: the main group (n=32) receiving osteopathic correction and the control group (n=27) receiving sham therapy. Both groups were divided into subgroups depending on the cause of amputation: traumatic and vascular. All patients underwent stabilography 4 times: before and after the first session of osteopathic correction or sham therapy, as well as before and after the second session. The stability of the position was assessed by the amplitude of the 1st maximum of the spectrum in the sagittal and frontal component, statokinesiogram area, work expended indicator, speed deviation of the center of pressure, standard deviation of the center of pressure in the sagittal and frontal planes.Results. The method of stabilography objectively confirmed the positive effect of osteopathic correction on postural balance in patients with traumatic and vascular genesis of amputation — in the form of stability increase after the 1st, before the 2nd and after the 2nd session of osteopathic correction compared to the data before osteopathic correction for all studied parameters (p<0,05). Patients from the control group of vascular genesis also had a statistically significant increase in stability after the 1st session and the 2nd sessions of sham therapy in terms of work expended, which returned to its original values before the second session, which indicates the short-term nature of the changes.Conclusion. The study showed an improvement in postural balance according to stabilography data in patients with lower limbs amputations of traumatic and vascular genesis who underwent osteopathic correction.

Introduction. The main tool of the osteopathic physician, which carries out most of the diagnostic and therapeutic actions, is the hands. To conduct scientifi c research in osteopathy, it is necessary to understand the nature of the impact and its quantitative characteristics, in particular, the pressure force of the physician′s hands on the patient′s body. In the available literature, it was possible to fi nd single instrumental studies of the pressure force of the osteopath′s hands during performing cranial techniques. Similar studies about the performance of other techniques could not be found in the available literature.Aims: to measure by an instrumental method the pressure force of the osteopath hands during various osteopathic techniques (cranial, visceral, structural).Materials and methods. The study was conducted on the basis of the Mokhov Institute of Osteopathy Clinic in January 2023. The study involved 6 lecturers of the Institute of Osteopathy (St. Petersburg), their experience as an osteopath is at least 5 years; the age is from 33 to 53 years. As patients, the residents of the Osteopathy Department of Mechnikov North-West Medical State University were involved. There were 2 men and 4 women, aged from 24 to 26 years, with a normosthenic constitution and a body mass index from 19,5 to 24. The following devices were used to measure the pressure strength of the osteopathic physician′s hands: Fsr402 resistive pressure sensors (Arduino Italy) and A402 (Tekscan USA), FlexiForce Prototyping Kit with FlexiForce MicroView software (Tekscan USA), and a device for determining skin elasticity and human skin scars (strain gauge attached to a caliper, Patent RU 2763 843 C1). Each physician demonstrated several osteopathic techniques on one patient. During the execution of each technique, three measurements were made, and the arithmetic mean was calculated. Structural, visceral and cranial techniques of osteopathic correction were performed.Results. The Friedman test showed a statistically signifi cant difference in pressure strength for different techniques (p<0,01). The greatest pressure force was measured during the mobilization of the descending colon (3,6±0,3 Newton); the minimum force was measured during the mobilization of the thoracic spine in the extension (1,5±0,3 Newton). When performing each technique, there was a range (the difference between the minimum and maximum values) between physicians from 0,95 Newton for performing a frontal bone lift to 1,8 Newton for mobilizing the sigmoid colon. Conclusion. The pilot study showed that during performing different techniques, the pressure strength of the osteopathic physician′s hands differed signifi cantly. It is advisable to continue the study on a more representative sample.> <0,01). The greatest pressure force was measured during the mobilization of the descending colon (3,6±0,3 Newton); the minimum force was measured during the mobilization of the thoracic spine in the extension (1,5±0,3 Newton). When performing each technique, there was a range (the difference between the minimum and maximum values) between physicians from 0,95 Newton for performing a frontal bone lift to 1,8 Newton for mobilizing the sigmoid colon.Conclusion. The pilot study showed that during performing different techniques, the pressure strength of the osteopathic physician′s hands differed signifi cantly. It is advisable to continue the study on a more representative sample.

The article provides an overview of instrumental methods and technical means allowing to evaluate some of the proven effects of osteopathic correction, such as an increase in the range of motion in the joints, normalization of muscle tone, postural balance and walking, anti-inflammatory effect and improvement of blood circulation in patients with amputation defects of the lower extremities. The article provides an overview of instrumental methods and technical means used for diagnostic purposes in the rehabilitation of patients with amputation defects of the lower extremities. The possibility of it to verify some of the osteopathic correction effects, such as an increase in the range of motion in the joints, normalization of muscle tone, postural balance and walking, anti-inflammatory effect, and improvement of blood circulation, has been evaluated.Purpose — to present instrumental methods applicable to assess the results of osteopathic correction in the rehabilitation process of patients with amputation defects of the lower extremities.