1State Institution "Kundiiev Institute of Occupational Health of the National Academy of Medical Sciences of Ukraine", Kyiv
2Ukrainian Military Medical Academy, Kyiv
3Military Medical Clinical Center of the Northern Region, Kharkiv
Introduction. Traumatic brain injuries (TBI), received in 2017 as a result of military operations in the East of Ukraine, accounted for 30,8 % of all mechanical combat injuries. In this, ear injuries due to ear barotraumas among TBI made 22,8 %. Such combined pathology, almost always leading to defects in the motor function, including impaired posture control, makes these studies actual.
The purpose of research was to analyze the results of stabilometry as a method of monitoring the state of poise in patients with mild TBI during treatment and rehabilitation and, also, to determine the normal parameters of posturography examination in practically healthy individuals.
Materials and methods. Two groups of servicemen were examined. The main group - practically healthy servicemen (124 men, aged 20–30) who were recognized by the military medical commission as fit for service in airborne troops. The second group consisted of patients with mild TBIs complicated by ear barotrauma (23 persons) with an average period of (8 ± 2) days after head injury. The study of static spatial stability (poise function) was conducted using "MPPI Stabilograph 1" device and StabiliS software within one minute. In persons with pathology, these studies were conducted at admission to the hospital and after five days of intensive treatment.
Results. It is confirmed that the participation of vision in the control of the vertical posture (VP) and its deprivation, affects the individual complex of postural control and changes the meanings of the registered parameters in the norm. The revealed significant changes in the parameters of support for VP in the mode of visual control and without it, indicate a decrease in the activity of the central apparatus for controlling the body's balance in the deprivation of vision. The orienting normative values of the parameters of static posturography with open and closed eyes in practically healthy men have been determined. The indices of computer posturography, obtained in the absence of the visual control in the maintenance of VP, are the most informative characteristics that can serve as the criteria for diagnosing functional disorders after mild TBI complicated by ear barotrauma. Among twenty-three investigated indicators there are identified six of the most informative posturography indicators, according to which it is possible to estimate the degree of improvement of the functional state during of restorative treatment in the hospital.
Conclusions. The borders of the normative values of posturography parameters with open and closed eyes in practically healthy men have been determined. The peculiarities of improvement of the functional state in servicemen with mild TBI complicated by ear barotrauma after five days of inpatient treatment based on posturography parameters have been determined. Informative indices have been revealed, according to which these improvements can be assessed (the average frequency of the spectrum of pressure center oscillation in the frontal plane, the quality of the poise function, the average speed of the pressure center displacement, and the path length of the pressure center oscillation). The importance of periodic evaluation of the functional state by posturography indices in persons during treatment of mild TBI complicated by ear barotrauma for improving and individualizing the technology of restorative treatment such pathology has been shown.
Key words: ear barotrauma, traumatic brain injury, posturography, functional state
ORCID ID of co-authors and their contribution in preparation and writing of the paper:
Kannysh V.V. (ORCID ID 0000-0002-5033-6659) - analysis of stabilographic indicators of military service of civilians - participants of combat operations, evaluation of received results, formation of conclusions;
Shvets AV (ORCID ID 0000-0002-9461-7129) - review of literature on the subject of work, research and evaluation of stabilographic indicators for practically healthy soldiers - participants in combat operations, analysis of research results, formation of conclusions;
Gorliuk D.O. (ORCID ID 0000-0002-0374-4027) - research and estimation of stabilographic indicators in military personnel after acurabrouma, statistical processing of the received data, formation of conclusions.