Possibility of osteopathic correction in the complex therapy of patients after sternotomy performed in connection with the surgical treatment of acquired heart defects
Authors: Glushkov A. A. , Salakhov R. G. , Yunusova A. D. , Lebedev D. A. 
Published: June 2020

Introduction. Acquired heart defect affect people of different ages and lead to permanent disability, so this is important social problem. The single effective way to treat acquired heart defect, which can significantly increase the life expectancy of patients, is surgical correction aimed at eliminating severe hemodynamic disorders. Sternotomy mediates subsequent changes in the biomechanics of respiration, contributes to the appearance of pain in the thoracic region of the spinal column and ribs. In this regard, the possibility of osteopathic diagnosis and correction of such patients in the postoperative period is an actual question.

The goal of research — is to investigate the possibility of osteopathic correction in the complex therapy of patients after sternotomy in the connection with the surgical treatment of acquired heart defect.

Materials and methods. The study involved 80 patients after surgical treatment of acquired heart defect. Osteopathic diagnosis was performed before and after surgery. Then, the control (patients received standart treatment) and experimental (patients received standart treatment and osteopathic correction) groups were selected using a simple randomization method. The both group included 40 people. There were assessed the fl uid volume in the pleural cavities (as one of the heart failure indicators) using the ultrasound method for the study of pleural cavities, and the pain intensity (using pain verbal-analogue scale) in both groups before starting treatment. Then the osteopathic diagnostics and theassessment of pain intensity and fl uid volume in the pleural cavities were repeated in each group after completion of the treatment. The collected data was processed by the methods of parametric and nonparametric statistics.

Results. Patients after median sternotomy connected with surgical treatment of acquired heart defect had characteristic somatic dysfunctions: global rhythmogenic (cardiac and respiratory) and biomechanical disorders, regional biomechanical disorders of the thoracic region, dura mater and pelvic region, local somatic dysfunctions of the sternoclavicular joint, sternum, ribs, mediastinum, pericardium and ligaments of the liver. Osteopathic correction in patients of the experimental group after median sternotomy leads to a statistically significant (p<0,05) in the comparison with the control group decreasing in the detection frequency of global (rhythmogenic respiratory and cardiac) and regional (thoracic and pelvic region) somatic dysfunctions. A statistically significant decrease in the pain severity and fl uid volume in the pleural cavities (p<0,05) was also recorded after the treatment in the experimental group.

Conclusion. There was revealed that patients after surgical treatment of acquired heart defect suffered from developed somatic dysfunctions of global, regional and local levels. It was established that osteopathic correction leads to a decrease in the detection frequency of some global and regional somatic dysfunctions, pain severity and fluid volume in the pleural cavities. So the obtained results allowrecommendingthe osteopathic correction as an effective complement to the standard methods of treating patients after surgical treatment of acquired heart defect.