Osteopathic correction in the complex therapy of children with astigmatism
Authors: Kiryanova E. V. , Gurichev A. A. 
Published: March 2024

Introduction. One of the current tasks of healthcare is the preservation of vision in children, prevention of blindness and visual impairment. In Russia, more than 1 million children suffer from visual impairments: myopia, hypermetropia, astigmatism, amblyopia. It is especially important to identify refractive errors and their complex correction in primary school children, since actual school loads are comparable in intensity to the visual loads of adults engaged in visually strenuous work. Osteopathic correction has proven itself well in the complex therapy of accommodative asthenopia of adult patients with visually strenuous work. However, the effectiveness of osteopathic correction in the complex treatment of accommodative asthenopia in children has not been sufficiently studied.

The aim of the study was to evaluate the effectiveness of osteopathic correction in the complex therapy of children with astigmatism.

Materials and methods. The study involved 40 children aged 7 to 11 years with the presence of simple, complex hypermetropic astigmatism, complex myopic astigmatism, mixed astigmatism. Two groups were formed: the control group — 20 children who received standard treatment (constant wearing of corrective glasses, pleopto-orthoptic treatment); the main group — 20 children who additionally received a course of osteopathic correction (3 sessions with an interval of 1 month). In each group, two subgroups were additionally identified: children with hypermetropic astigmatism, HA (16 in the main group and 15 in the control group), and children with myopic astigmatism, MA (4 in the main and 5 in the control group). The number of these subgroups was insufficient to test any statistical data on them hypotheses. In each subgroup, the osteopathic and ophthalmological (visual acuity, astigmatism, fatigue of the visual analyzer) status before and after therapy was evaluated in each group. Descriptive statistics were calculated for all subgroups based on the results of the study. Statistical hypotheses were tested in relation to subgroups of children with HA.

Results. At the beginning of the study, 100 % of children with astigmatism had regional somatic dysfunctions of the head. Regional somatic dysfunction of the dura mater was detected in the main group in 69 % of children with HA and in 100 % of children with MA, and in the control group, respectively, in 73 and 100 %. After complex therapy, which included osteopathic correction, children with HA revealed statistically significantly (p<0,05) fewer cases of biomechanical disorders of the head regions and dura mater than children of the corresponding subgroup of the control group. Also, children with HA in the main group had statistically significantly (p<0,05) more pronounced positive dynamics in a number of indicators of ophthalmological status: an increase in visual acuity, a decrease in the magnitude of astigmatism. After complex therapy, children with HA were characterized by significantly (p<0,05) less pronounced fatigue of the visual analyzer.

Conclusion. The results of the study indicate the effectiveness of the inclusion of osteopathic correction in the complex therapy in children with HA. At the same time, it is advisable to continue research in this direction with the study of more ophthalmological parameters and on a more representative sample.