Medical consequences of wars, catastrophes and natural disasters (world experience) and possibilities of the Center for medical and psychological rehabilitation
Lashko O.M.1, Zaitsev D.V.1,2, Baydalina V.Yu.1
1 State Institution «Kundiiev Institute of Occupational Health of the National Academy of Medical Sciences of Ukraine», Kyiv
2 Shupyk National Healthcare University of Ukraine, Kyiv
Full article (PDF): ENG / UKR
Introduction. The war in Ukraine continues to yield complex and atypical traumas that challenge peacetime healthcare systems. The use of explosive weapons has resulted in an increased percentage of patients with limb injuries, fractures, and defects of long bones. Often, civilian hospitals, with insufficient training, are drawn into the provision of care, placing added strain on healthcare systems and necessitating the development of new diagnostic and treatment protocols. Physical therapy plays a pivotal, sometimes primary, role in the rehabilitation of individuals with war-related musculoskeletal and nervous system injuries. Contemporary rehabilitative medicine combines traditional physical rehabilitation with advanced technologies, emphasizing a comprehensive approach. The success of treatment depends on timely initiation and the appropriate selection of rehabilitation programs.
Objective. This study seeks to establish a comprehensive approach to rehabilitation, specifically tailored to restore combatants' fighting capacity while enhancing their functional capabilities and overall quality of life.
Materials and methods. To assess the challenges of medical rehabilitation for combatants, we conducted a systematic analysis of literature published on the PubMed database over the past 30 years, given the historical context of large-scale armed conflicts. Our analysis encompassed scientific works focused on musculoskeletal and nervous system injuries, as well as superficial wounds and other conditions impacting self-care, quality of life, motor function, productivity, and combat readiness among servicemen who are veterans of combat operations. Based on a critical review of the existing medical rehabilitation program for veterans, offered by the State Institution "Kundiiev Institute of Occupational Health of the National Academy of Medical Sciences of Ukraine", we formulated approaches for its modernization. We propose a comprehensive suite of rehabilitation tools that harness modern robotic and computerized systems with validated diagnostic and treatment protocols, augmented by elements of virtual reality.
The results. Prolonged combat operations, involving modern weaponry and advanced protective measures, have led to profound and enduring changes in military and civilian healthcare. The use of explosive devices is on the rise, while gunshot wounds remain significant contributors. Injuries to the limbs, head, and neck dominate the wartime injury profile, yet the physiotherapy of such injuries remains inadequately explored. Combat injuries have emerged as a substantial factor in long-term disability. In response, the State Institution "Kundiiev Institute of Occupational Health of the National Academy of Medical Sciences of Ukraine" has established a Center for Medical and Psychological Rehabilitation for combatants involved in the Russian-Ukrainian war. The Center's comprehensive rehabilitation tools, based on modern robotic and computerized systems, authorized diagnostic and treatment protocols, and elements of virtual reality, encompass various elements: the A1-S robotic table with a tilt function (verticalizer) for gait recovery, the A2-2 intelligent system for restoring motor and sensory functions of the upper limbs, the Sigma platform for balance and proprioception training, and the Zimmer EnPuls radial shock wave therapy device for targeted correction of orthopedic conditions.
Conclusion. The proposed comprehensive rehabilitation complex promises to standardize objective diagnostics with high precision and dynamic monitoring capabilities. It facilitates interdisciplinary communication and streamlines the patient transfer process for continued rehabilitation, thereby optimizing the conditions for personalized hardware-assisted rehabilitation.
Keywords: Rehabilitation, combatants, musculoskeletal system, nervous system.
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