Development of the skill of dosed pressure in doctors in the process of professional retraining in the speciality «Osteopathy»

Introduction. The main instrument of diagnosis and treatment for an osteopathic physician is the hands. In the process of professional retraining in the speciality of osteopathy, doctors master various types of palpation and hundreds of osteopathic correction techniques, which require various strictly dosed pressure forces on tissues.The goal of the study is to research the development of pressure force dosing skill in primary retraining trainees in osteopathy during training.Materials and methods. The cohort prospective study was conducted during 2022–2024. The object of the study was the students of the professional retraining cycle in the speciality «Osteopathy» at the Institute of Osteopathy (Saint-Petersburg) — 15 people aged 32–65 years (median — 51 years), 8 men and 7 women. The survey was conducted 4 times: at the end of the 2nd course, in the first and second half of the 3rd course and in the 4th course. Also during 2023, a cohort one-time survey of 16 doctors working in various specialities in the Lipetsk State Institution of Health Care № 4 «Lipetsk-Med» was conducted. This control group included doctors with work experience of at least 3 years, there were 10 men and 6 women aged 30 to 60 years (median 49 years), and according to these indicators, as well as work experience, there were no statistically significant differences from the main group of osteopathy trainees (p>0,05). The subjects pressed their hand on the electronic scales and achieved weights of 30; 250; 800 g. They pressed the scales once with open eyes and saw the result, then tried to repeat it three times with closed eyes. The arithmetic mean was calculated from the three values and then the target weight was subtracted from it and the deviation from it was obtained in absolute numbers (g) and in %.Results. The survey of the cadets of primary retraining in the speciality «Osteopathy» at the end of the 2nd year of training, and doctors from the control group, showed that the future osteopaths demonstrated statistically significantly (p<0,05) smaller error (p<0,05) when trying to reproduce the weight of 30 g (from 0 to 220 g, median 50 g) and 250 g (from –190 to 350 g, median 41 g) from the doctors of the control group (respectively from 20 to 200 g, median 90 g and from –70 to 260 g, median 75 g). At the same time, physicians of both groups were more often mistaken in the larger direction. Calculating the % deviations from the target weight showed that for both groups of physicians, the minimum weight of 30 g was the most difficult to reproduce and the maximum weight of 800 g was the easiest. The relative values of deviations from the target weight were statistically significantly lower in the group of future osteopaths (p<0,05). In the process of training doctors on the course of professional retraining in osteopathy, the absolute values of deviations from the target weight systematically decreased, for the weights of 30 g (p=0,001) and 800 g (p=0,041) these changes were statistically significant. The most pronounced dynamics was observed for the improvement of the 30 g weight set. Men were more accurate in 800 g weight set, women were more accurate in 250 g weight set. The dynamics of the skill of dosing the 30 g pressure force showed similar results regardless of gender. In the experimental group, 9 people had been using manual therapy techniques in their medical practice for 3 to 17 years before the training. Calculation of correlations between the number of years of chiropractic practice and absolute deviations from the target weight showed low values of correlation coefficients in all courses of training (p>0,05).Conclusion. The skill of dosed pressure is better developed in the trainees of the 2nd year of the professional retraining course in osteopathy than in doctors who are not trained in osteopathy. In the process of osteopathic training, the skill of dosed pressure improves. Its development was independent of years of chiropractic practice, and little influenced by gender. The most pronounced progress occurred on the small (p=0,001) and large scales (p=0,041) in the 4th year of training.