SI «Kundiiev Institute of Occupational Health of the NAMS of Ukraine», Kyiv
Background. One of the proposed methods for rehabilitation of combatants is volumetric pneumopressing (VP). The VP procedure increases activity and decreases the tension of the regulatory systems (promotes the development of autonomy and influence of parasympathetic centers), decreases a cardiac load, and restore the functional state. However, the dynamics of the body state in the course of VP requires further study.
Purpose: to identify peculiarities of the functional state of combatants in the course of the complex rehabilitation, to define a period of the greatest therapeutic success in the rehabilitation course by the state of the autonomic nervous system.
Methods. 41 combatants with adaptative disorders, engaged in the anti-terrorist operation (aged 19–45), took part in the investigarion after giving the informed consent. They received a course of complex rehabilitation with the VP procedure in the area of head and back for 20 minutes. The heart rate variability (HRV) was recorded for 5 minutes: first time - before the procedure, four times - during it and once after it. The measurements were made four times (on the 1st day of the course, on the 3rd -4th days, 6th -7th days and 10th -11th days). The variation and non-parametric statistics were used.
Results. The state of vagotonia was characteristics for combatants with adaptation disorders by the data of the HRV. Fluctuations of indices in the stress index by Bayevsky were recorded, being typical for adaptation processes. There was a statistically significant shift in the vegetative balance towards sympathetic activity, which could be assessed as normalization (compensation) of the functional state. 44.8% cases of the functional normalization and 33.4% cases of the increased deviations from the boundaries of the norm were recorded in the course of the rehabilitation. So, the normalization dynamics was prevailing (p<0.05). When assessing the biological reactivity in the combatants under the action of the VP procedure, the greatest short-term functional changes (maximum of adaptation reactions) were found after 4 days from the beginning of the course (p<0.05). The greatest changes in indices of the HRV in comparison with the data at the beginning of the course were recorded after 6-7 days.
Conclusion. Vagotonia was the primary state in combatants in the process of rehabilitation. The main adaptive changes are observed on the 3rd -7th days from the beginning of the complex rehabilitation course. There were observed fluctuations in the vegetative balance towards compensation of the state. The duration of the VP procedure as a part of the complex rehabilitation in treatment of adaptation disorders should be 7-10 days.
Key words: heart rate variability, combatants, rehabilitation, volumetric pneumopressing, autonomic nervous system
ORCID ID of the author:
Zaitsev D.V. (ORCID ID 0000-0002-0841-1504)