Shvets A. V.1, Kikh A. Yu.2, Volyansky O. M.2, Lukyanchuk I. A.1
PECULIARITIES OF RECOVERING THE FUNCTIONAL STATE OF PARTICIPANTS OF ANTITERRORIST OPERATIONS DURING REHABILITATION PERIOD IN HOSPITALS
1Ukrainian Military Medical Academy, Kyiv
2Military Medical Clinical Center of Occupational Pathology of the Armed Forces of Ukraine, Irpin
Full article (PDF), UKR
Introduction. The moral and psychological unpreparedness, non-coping fear with the responsibilities, feeling of guilt to the deads, striving to survive in conditions of destructions and deaths of other people, extreme strain of work, disorders in eating and rest patterns and other harmful factors of duty undoubtedly reduce human adaptive reserves and lead to non-constructive changes of behaviors and the disadaptation syndrome, which require their assessment in order to solve a problem on the need of further rehabilitation treatment.
The purpose of the study. To identify the characteristics and approaches for assessment of the degree of recovery of the functional state (FS) in participants of antiterrorist operations during their rehabilitation period in hospitals.
Materials and methods. There were selected two groups of 25–45 aged men: Ist group – 30 persons with brain concussion over 2014–2015, 2nd group – 30 people, who were on treatment/rehabilitation with other somatic pathology. 90 % of them were in the ATO area at least for one year. As the control group there were exanimated 76 healthy men of the same age. Each serviceman was treated by an individual rehabilitation program for 12–14 days. The assessment of FS was based on heart rate variability (HRV) and electroencephalography (EEG) data before and after the rehabilitation treatment.
Results. Peculiarities of EEG characteristics of recovering were significantly worse in the Ist group FS (only 23,3 % with a positive dynamics) as compared with the 2nd group (83,4 %; p < 0,001). Similar changes were recorded in the HRV characteristics. There
were described structural features of 3 types of EEG phenomena, which occur in patients with brain concussion. The analysis of EEG and HRV data interconnections additionally confirm a slow FS recovery among the Ist group people. A model for supporting a decision making in order to prognose a human rehabilitation potential as well as rehabilitation effectiveness assessment in hospital conditions based on the factor analysis of the rated changes of EEG and HRV data shifts before and after treatment has been developed.
Conclusions. The physiological value of FS regulation is the highest among individuals with a brain concussion. The developed supporting model for the FS recovery assessment makes it possible to quantitatively predict the rehabilitation effectiveness in hospital conditions, which is necessary in order to unify approaches for the rehabilitation process and implementation of succession and continuity of providing rehabilitation aid at all stages to ATO participants. It was shown that the use of the hardware research methods of EEG and HRV for rehabilitation of ATO participants in hospital conditions are useful for assessment of morphological defects and in oder to specify the rehabilitation potential according to FS recovery degree, to predict the probability of development of inappropriate and/or paradoxical reactions on medical treatment measures, to provide recommendations on therapy optimization, taking into account a background of neurohumoral regulation.
Key words: functional state, heart rate variability, electroencephalography, rehabilitation potential, participants of anti-terrorist operations
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