PERSONALIZED REHABILITATION PROGRAM FOR A PATIENT WITH A MINE EXPLOSIVE INJURY
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i1.13723Keywords:
mine explosive injury, post-traumatic stress, complex assessment of a condition of an organism, typical pathological processes (TPP), bioregulatory correction, personalized rehabilitation interventionsAbstract
SUMMARY. Under the conditions of combat operations in Ukraine, there has been a significant increase of injured with mine explosive injury, both among the servicemen and the civilian population. A lethal high-energy weapon with an extra powerful explosive wave, used by an aggressor, causes serious post-traumatic stress disorders.
A mine explosive injury is often combined, accompanied by damage of 2–3 anatomical areas. This type of injury is the dominant fighting pathology and the main cause of military losses [4, 30].
The consequences of mine explosive injuries are not only serious damage to various organs and body systems, but also the development of anxiety, asthenic, dysphoric, somatoform syndromes, as manifestations of post-traumatic stress. According to the data of national researchers (L. V. Radetskaya, 2020), when studying psychological changes of servicemen who were injured, it was established that the signs of post-traumatic stress response are found in 38.8 % of cases [8].
The aim – to describe a clinical case of rehabilitation of a soldier with a mine-explosive injury, which presents personalized patient rehabilitation tactics based on based on the complex assessment of the patient’s health.
Material and Methods. The basis of the work was the technology of complex regulatory therapy of conditions, which involves assessing the state of the body with the determination of the main typical pathological processes (hereinafter –TPP): inflammation, endogenous intoxication, immune, metabolic, energy disorders, vegetative dysregulation and bioregulatory correction of detected disorders.
Results. Against the background of the rehabilitation interventions, a decrease in the intensity of the inflammation, absence of endogenous intoxication, and normalization of indicators of nonspecific immunological reactivity, energy metabolism, and vegetative regulation were achieved. The evaluation of the effectiveness of the rehabilitation interventions was also carried out according to functional tests and scales. Thus, the short-term goals were achieved.
Conclusions. A comprehensive individual assessment of the patient’s health made it possible to influence the polymorphism of clinical symptoms due to a mine-explosive injury, overcome the symptoms of PTSD, provide effective support for the organism and improve the quality of life.
References
Byanchi, I. (2016). Koenzim kompozitum i Ubikhinon kompozitum i ikh rol v poddezhke funktsiy mitokhondriy [The role Coenzyme compositum and Ubiquinone compositum in support of mitochondrial functions]. Biologicheskaya meditsina – Biological Medicine, 1, 16-24; 27-31 [in Russian].
Hulii, M.A., & Soloviova, V.S. (2022). Perevahy biorehuliatsiinoho pidkhodu v likuvannia ta reabilitatsii patsiientiv z COVID-19 Klinichnyi dosvid [Advantages of the bioregulatory approach in the treatment and rehabilitation of patients with COVID-19. Clinical experience]. Zdobutky klinichnoi i eksperymentalnoi medytsyny – Achievements in Clinical and Experimental Medicine,, 4, 64-73. [In Ukrainian]. DOI: 10.11603/1811-2471.2021.v.i4.12801. DOI: https://doi.org/10.11603/1811-2471.2021.v.i4.12801
Dzuhkoev, S.H., Dzuhkoeva, F.S., Marhyeva, O.Y., & Mozhaeva, Y.V. (2020). Biokhymycheskie markery effektivnosti korrektsyy okislitelno-vosstanovitelnogo potentsyala i funktsyi endotelia s primeneniem antioksidanta Koenzima kompozituma [Biochemical markers of the effectiveness of the correction of the redox potential and endothelial function using the antioxidant Coenzyme compositum]. Sovremennye problemy nauki i obrazovanyia – Modern Problems of Science And Education, 3, 499-502 [in Russian].
Kozlova, Yu.V., Koldunov, V.V., & Aleksieienko, O.A. (2021). Vybukho-indukovana neirotravma (patofiziolohichni ta patomorfolohichni osoblyvosti) [Explosion-induced neurotrauma (pathophysiological and pathomorphological features)]. Ukr. zhurnal medytsyny, biolohii ta sportu – Ukr. Journal of Medicine, Biology and Sports, 6, 5(33). DOI: 10.26693/jmbs06.05.083 [in Russian]. DOI: https://doi.org/10.26693/jmbs06.05.083
Kruk, B.R., Rokoshevska, V.V., & Bilianskyi, O.Yu. (2015). Fizychna reabilitatsiia osib iz cherepnomozkovoiu travmoiu [Physical rehabilitation of persons with craniocerebral trauma]. [Electronic resource]. Sportyvna nauka Ukrainy – Sports Science of Ukraine, 1 [In Ukrainian].
Smiyan, O.I., Sichnenko, P.I., Horbas, V.A., & Moshchych, O.P. (2020). Pat. Ukrainy, Sposib optymizatsii otsinky zahalnoho stanu zdorovia orhanizmu liudyny za dopomohoiu alhorytmu kompleksnoi otsinky stanu khvoroho na pidstavi analizu typovykh patolohichnykh protsesiv ta funktsionalnykh mozhlyvostei orhanizmu [Patent of Ukraine. The method of optimizing assessment of general health of human body by means of algorithm of complex assessment of patients condition on the basis of analysis of typical pathological processes and functional possibilities of organism]. No. 143026 MPK A 61 B 5/00, G 01 N 33/00. Zaiavnyk i patentovlasnyk Sumskyi derzhavnyi universytet. № u 2019 12205; zaiavl. 24.12.2019; opubl. 10.07.2020, Biul. № 13 – Applicant and patent owner Sumy State University. – No. u 2019 12205; statement 24.12.2019; publ. 10.07.2020, Bull. No. 13 [in Ukrainian].
Popovych, S.V. (2014). Tserebrovaskuliarnyie zabolevanyia: vozmozhnosti addityinoi biorehuliatsionnoi terapii [Cerebrovascular Diseases: Possibilities of Additin Biogenulation Therapy]. Mezhd. nevrol. zhurn. – Int. Nevrol. Magazine, 6(68) [in Russian].
Radetska, L.V., Laba, I.O., & Smachylo, A.I. (2020). Osoblyvosti proiaviv boiovykh stresovykh rozladiv u poranenykh viiskovosluzhbovtsiv zbroinykh syl Ukrainy – uchasnykiv boiovykh dii [Peculiarities of manifestations of combat stress disorders in wounded servicemen of the Armed Forces of Ukraine - participants in hostilities]. Medsestrynstvo – Nursing, 4, 23-26. DOI: 10.11603/2411-1597.2020. 4.11868 [in Ukrainian].
Rosolianka, N. (2016). Suchasnyi stan zastosuvannia zasobiv ta metodiv fizychnoi reabilitatsii osib z cherepno-mozkovoiu travmoiu [The current state of the use of means and methods of physical rehabilitation of persons with craniocerebral trauma]. Sport. nauka Ukrainy – Sport. Science of Ukraine, 5(75), 46-49. DOI: 10.5281/zenodo.1294789 [in Ukrainian].
Rumiantseva, H.M. (2014). Perspektivy ispolzovaniia preparata Tserebrum kompozitum N v terapii psikhicheskikh zabolevanii [Prospects for the use of Cerebrum compositum N in the treatment of mental illness]. Farmateka – Pharmateka, 10-3, 70-73 [in Russian].
Semchyshyn, M.H. (2020). Kontsentratsiia zaliza pry cherepno-mozkovii travmi lehkoho ta serednoho stupeniv tiazhkosti v hostromu, promizhnomu ta viddalenomu periodakh u poterpilykh myrnoi terytorii ta biitsiv operatsii obiednanykh syl [Iron concentration in brain injury of mild and moderate degrees of severity in the acute, intermediate and remote periods in victims of peaceful territory and soldiers of joint forces operations]. Ukr. visn. Psykhonevr – Ukr. Herald Psychoneuro., 28, 4(105), 30-33. DOI: 10.36927/ 2079-0325-V28-is4-2020-5 [in Ukrainian]. DOI: https://doi.org/10.36927/2079-0325-V28-is4-2020-5
Sokolova, L.Y. (2006). Primenenie antigomotoksicheskikh preparatov pri nekotorykh zabolevaniiakh nervnoi sistemy [The use of antihomotoxic drugs in certain diseases of the nervous system]. Ukr. neirokhirurh. Zhurnal – Ukr. Neurosurgeon. Magazine, 1, 118-123 [in Russian]. DOI: https://doi.org/10.25305/unj.126758
Chyzhova, V.P. (2018). Vplyv intervalnykh normobarychnykh hipoksychnykh trenuvan na mikrotsyrkuliatornu lanku systemy krovoobihu ta pokaznyky vuhlevodnoho i lipidnoho obminiv u osib pokhyloho viku z prediabetom [The effect of interval normobaric hypoxic training on the microcirculatory link of the blood circulation system and the effects of carbohydrate and lipid metabolism in special patients with prediabetes]. Ukr. kardiol. zhurnal – Ukr. Cardiol. Magazine, 5, 54-65. DOI: 10.31928/1608-635X-2018. 5.5465 [in Russian]. DOI: https://doi.org/10.31928/1608-635X-2018.5.5465
Agoston, D.V. (2017). Modeling the Long-Term Consequences of Repeated Blast-Induced Mild Traumatic Brain Injuries. J. Neurotrauma, 34(S1), S44-S52. DOI: 10.1089/neu.2017.5317. DOI: https://doi.org/10.1089/neu.2017.5317
Baillif, V, Guigné, C, & Wanecq, E. (2018). A multicomponent medication (HE-100) promotes inflammation resolution. Poster presented at: Resolution of Infl ammation, Infection and Tissue Regeneration; June 25-26. New York, USA. Link to abstract: https://www.ambiotis.com/images/temoignages/NYAS-2018-submitted-abstract.pdf.
Cesnulevicius, K. (2011). The bioregulatory approach to work-related musculoskeletal disorders: using the multicomponent ultra-low-dose medication Traumeel to target the multiple pathophysiological processes of the disease. Altern. Ther. Health Med., 17(2), S8–S17.
Chebotariova, L., Solonovych, O., Kadzhaya, M., Tretiakova, A., Solonovych, A., Pronoza-Stebliuk, K., & Stebliuk, V. (2019). Risk factors of cognitive impairment in patients with blast-related mild traumatic brain injury. Ukr. Neurol. Journal, 25, 16- 24. DOI: 10.25305/unj.174610. DOI: https://doi.org/10.25305/unj.174610
Dimpfel, W. (2007). Psychophysiological effects of Neurexan on stress-induced electropsychograms. A double-blind, randomized, placebo-controlled study in human volunteers. Paper presented at: 2nd World Conference of Stress; August 23-26. Hungary: Budapest. DOI: 10.4236/wjns.2019. 93007.
Girin, S., Savinova, I., Antonenko, I., & Naumenko, N. (2016). The Effect of Ultra Low Concentrations of Some Biologically Active Substances on the Aerobic Respiration. CellBio, 5, 1-13. DOI: 10.4236/cellbio.2016.51001. DOI: https://doi.org/10.4236/cellbio.2016.51001
Göthel, D. (2011). Neurexan: The Bioregulatory Approach to the Treatment of Stress and Stress-related Disorders-Preclinical and Clinical Considerations. Altern. Ther. Health Med., 17(2), S32-S40.
Hubner, R., van Haselen, R., & Klein, P. (2009). Effectiveness of the homeopathic preparation Neurexan compared with that of commonly used valerian-based preparations for the treatment of nervousness/restlessness - an observational study. Scientific World Journal, 9, 733-745. DOI: 10.1100/tsw.2009.95. DOI: https://doi.org/10.1100/tsw.2009.95
Korshniak, V. (2022). The Impact of the Blast Wave on the Formation of Neurological Symptoms in Patients with Battle Traumatic Brain Injury. Intern. Neur. Journal, 5(83), 83-87. DOI: 10.22141/2224-0713.5.83.2016.78475. DOI: https://doi.org/10.22141/2224-0713.5.83.2016.78475
Leung, L.Y., Wei, G., Shear, D.A., & Tortella, F.C. (2013). The acute effects of hemorrhagic shock on cerebral blood flow, brain tissue oxygen tension, and spreading depolarization following penetrating ballistic-like brain injury. J. Neurotrauma, 30, 1288-1298. DOI: 10.1089/neu.2012.2715. DOI: https://doi.org/10.1089/neu.2012.2715
Maas, A.I.R., & Menon, D.K. (2012). Traumatic brain injury: rethinking ideas and approaches. Lancet. Neurol., 11, 1, 12-13. DOI: 10.1016/S1474-4422(11)70267-8. DOI: https://doi.org/10.1016/S1474-4422(11)70267-8
MacFarlane, M.P. & Glenn, T.C. (2015). Neurochemical cascade of concussion. Brain NJ. 29, 139-153. DOI: 10.3109/02699052.2014.965208. DOI: https://doi.org/10.3109/02699052.2014.965208
Martynchuk, A.A. & Popovych, S.V. (2016). Traumeel S – Bioregulatory Approach in Trauma and Inflammation. Trauma. 17. 13. DOI: 10.22141/1608-1706.2.17.2016. 74627. DOI: https://doi.org/10.22141/1608-1706.2.17.2016.74627
Mayer, K., Krylova, M., Alizadeh, S., Jamalabadi, H., van der Meer, J., Vester, J.C., … Walter, M. (2021). Nx4 Reduced Susceptibility to Distraction in an Attention Modulation Task. Frontiers in Psychiatry, 12, 746215. DOI: 10.3389/fpsyt.2021.746215. DOI: https://doi.org/10.3389/fpsyt.2021.746215
Mazuchowski, E.L., Kotwal, R.S., Janak, J.C., Howard, J.T., Harcke, H.T., & Montgomery, H.R. (2020). Mortality review of US Special Operations Command battle-injured fatalities. J. Trauma Acute Care Surg., 88(5), 686-695. PMID: 32039975. DOI: 10.1097/TA.0000000000002610. DOI: https://doi.org/10.1097/TA.0000000000002610
Nelson, N.W., Davenport, N.D., Sponheim, S.R., & Anderson, C.R. (2015). BlastRelated Mild Traumatic Brain Injury: Neuropsychological Evaluation and Findings. In: Kobeissy FH, editor. Brain Neuro trauma: Molecular, Neurop sychological, and Rehabilitation Aspects. Boca Raton (FL): CRC Press/Taylor & Francis. Chapter 32. PMID: 26269927. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/26269927/.
Phipps, H., Mondello, S., Wilson, A., Dittmer, T., Rohde, N.N., & Schroeder, P.J. (2020). Characteristics and Impact of U.S. Military blast-related mild traumatic brain injury: a systematic review. Front. Neurol., 11, 559318. PMID: 33224086. PMCID: PMC7667277. DOI: 10.3389/fneur. 2020.559318. DOI: https://doi.org/10.3389/fneur.2020.559318
Smiyan, O.I., Sichnenko, P.I., Moshchуch, O.P., Gorbas, V.A., Girin, S.V., Ivanushko, O.V., & Moshуch, O.O. (2020). Dosvid zastosuvannia alhorytmu kompleksnoi otsinky stanu orhanizmu u ditei z khronichnoiu hastroduodenalnoiu patolohiieiu [Experience in application of the complex organism assessment in children with chronic gastroduodenal pathology]. Eastern Ukrainian Medical Journal, 8(1), 52-71. DOI: 10.21272/eumj.2020;8(1):52-71 [in Ukrainian]. DOI: https://doi.org/10.21272/eumj.2020;8(1):52-71
St Laurent, G., Seilheimer, B., & Tackett, M. (2017). Deep Sequencing Transcriptome Analysis of Murine Wound Healing: Effects of a Multicomponent, Multitarget Natural Product Therapy-Tr14. Front. Mol. Biosci., 4, 57. DOI: 10.3389/fmolb.2017.00057. DOI: https://doi.org/10.3389/fmolb.2017.00057
Weiser, M., & Zenner, S. (1994). Cerebral function disorders and biological therapy an application study with 731 patients. Reprinted from Biologische Medizin., 5. 277-283.
