The impact of osteopathic correction on craniosacral mechanism parameters in patients with different pathologies: multidisciplinary analysis

Introduction. Chronic sympathicotonia and visceral somatic dysfunctions are closely interrelated pathological patterns that are often resistant to standard pharmacotherapy. Anatomical structures associated with autonomic regulation – the diaphragms, the craniocervical junction and the ligamentous apparatus of the internal organs – are potentially accessible to manual intervention, which providies a theoretical prerequisites for pathogenetically oriented correction of autonomic imbalance by means of osteopathic medicine. Objective. To assess the dynamics of autonomic tone, measured by the Kerdo index, and the frequency of visceral somatic dysfunctions in patients with various clinical conditions after a course of osteopathic treatment, compared with standard therapy. Materials and methods. A retrospective analysis was performed using primary data from 35 clinical studies conducted on a unified methodological platform at the Department of Osteopathy of Yaroslav-the-Wise Novgorod State University in 2020-2024. The total number of patients was more than 400. Each study used envelope randomisation. The intervention group underwent osteopathic treatment, consisting of 3-6 sessions at intervals of 7-14 days; the comparison group underwent standard therapy according to relevant clinical guidelines. The assessed outcomes included the Kerdo index, frequency of somatic dysfunctions, blood pressure, heart rate and coprological markers, including steatorrhea and creatorrhea. Quantitative variables were analysed using the Wilcoxon signed-rank test and the Mann-Whitney U test; categorical variables were analysed using McNemar’s test, the χ² test or Fisher’s exact test. Results. In all 35 intervention groups, a statistically significant decrease in the Kerdo index was observed (p < 0.01), from the pathological sympathicotonic range, with a median of +16 to +22 units, to the level of eutonia, with values of +4 to +7 units. The incidence of somatic dysfunctions in the hepatobiliary region, upper gastrointestinal tract and pelvis decreased by 5-8 times, from 60-100% to 7-25%. Coprological markers of exocrine pancreatic insufficiency regressed in 80-85% of patients in the intervention groups. In the study involving patients with stage I-II arterial hypertension, normalisation of the Kerdo index was accompanied by a decrease in systolic blood pressure from 145 to 120 mmHg (p = 0.005). No statistically significant dynamics of autonomic or visceral parameters were recorded in the comparison groups. Conclusion. The findings indicate that osteopathic treatment provides systemic normalisation of autonomic tone and restoration of functional indicators of internal organs across a broad spectrum of nosologies. The effect exceeds the dynamics achieved with standard pharmacotherapy and cannot be explained by symptomatic action alone. Taking into account the limitations of the retrospective design, the findings support the feasibility of prospective randomised controlled trials with instrumental assessment of heart rate variability and standardised blinded evaluation of the incidence of somatic dysfunctions.