The possibility of evaluating the readiness of osteopath and chiropractor to work independently
Authors: Belyaev A. F. 
Published: September 2020

Introduction. One of the important tasks in preparing an osteopath and a manual therapist for independent work with patients is to assess the adequacy of the state of his neuromuscular apparatus, psycho-vegetative status for physical and psychological stress. Relevant is the search for informative express techniques for studying the state of the neuromuscular system and the doctor’s regulatory systems.

The goal of research — to substantiate a non-invasive express method for assessing the state of the neuromuscular system in osteopaths and manual therapists.

Materials and methods. The study was attended by specialists from the Primorsky Institute of Vertebroneurology and Manual Medicine. For the diagnosis, a method was used to assess the adequacy of the muscular effort of specialists, which has proved its effectiveness in individuals whose work is associated with physical activity against the background of emotional stress. The distribution of doctors was as follows. The first group consisted of novice specialists who did not have the practice of independent work (21 people). The second — experienced, with significant experience and showing stable treatment results (19 people). The groups did not have any special differences by age and gender. Statistical processing was carried out using standardized functions of Excel programs. The significance of differences in average values was determined using parametric analysis. Student t-test was used. Differences between groups were evaluated by the Pearson χ2 method. Differences were considered statistically significant at p<0,05.

Results. Features of the state of the musculoskeletal system in both groups were analyzed. In the first group (novice specialists), non-optimal motor stereotype was found in 19 of 21 doctors (90,5 %), and in the second group (experienced specialists with work experience) — only in 3 of 19 (15,8 %), χ2=3,32, p<0,05. In the first group, 12 of 21 doctors (63,2 %) first appeared or worsened pain in the spine, somatic dysfunctions appeared in the spine, limbs, internal organs, 3 of 21 doctors (14,3 %) postural instability was observed after work. The doctors of the second group also had back pain, but they were compensated in nature, they were less worried, did not cause psycho-emotional disorders. Of the physiological parameters, a characteristic was a decrease in the strength and endurance of the muscles of the hand, increased fatigue, and, most importantly, inadequacy of muscle effort. The average value of spontaneous muscle effort in the first group was 0,56±0,12 units, significantly exceeding the figures in the second group 0,32±0,10 units. Dynamic monitoring of the work of specialists showed that after 2–3–4 months the main symptoms in most are leveled, confidence in work appears, pains go away, the optimality of the motor stereotype and autonomic regulation is restored.

Conclusion. In osteopaths and manual therapists with a low degree of adaptation to the conditions of selfadministration of patients, the muscle effort during the procedure becomes inadequate to the load; fatigue occurs much faster and is more pronounced by the end of the working day. They are more often diagnosed with a non-optimal motor stereotype, which leads to an exacerbation of vertebrogenic pain syndrome and other diseases. The method of rapid diagnosis of the adequacy of muscle effort allows you too quickly and with minimal cost to identify osteopaths and manual therapists with a low degree of adaptation to working conditions and to carry out the necessary prevention.