PHYSICAL THERAPY AND OCCUPATIONAL THERAPY OF PATIENTS AFTER CLOSED TRAUMATIC BRAIN INJURY

Abstract

Topicality. Traumatic brain injury is among the most common types of trauma and one of the leading causes of disability and mortality in the working-age population. Mortality from severe TBI is several times higher than that from cardiovascular or oncological diseases, and persistent loss of working capacity is observed in more than half ofaffected individuals. According to the World Health Organization, the annual number of patients with TBI increases by approximately 2 %, creating a significant socio-economic burden. In the context of military operations in Ukraine, the incidence of combat-related TBI is rising sharply, which increases the demand for effective rehabilitation programs.Moderate and severe TBI are frequently accompanied by persistent motor and cognitive impairments, as well as behavioral and psycho-emotional disorders, which complicate the return of patients to full social and professional life.Modern international clinical guidelines emphasize early initiation, multidisciplinary teamwork, and individualization of rehabilitation. At the same time, there is an urgent need in Ukraine to adapt evidence-based approaches to national conditions and to develop integrated physical and occupational therapy programs. Thus, summarizing contemporaryscientific data and clinical experience regarding the restoration of motor and cognitive functions after moderate and severe TBI is of great practical and social importance. The goal. To summarize current scientific evidence on the rehabilitation of patients after moderate and severe closed traumatic brain injury, with special emphasis on recent publications by Ukrainian authors. Materials and methods. The study applied comparative-analytical and data-systematization methods.The search was carried out among articles in Ukrainian professional journals and conference proceedings. The analysis included systematization and comparison of clinical and rehabilitation approaches described in the selected sources in order to identify optimal strategies of physical and occupational therapy for the consequences of traumatic braininjury. Research results. A comparative and analytical review of recent Ukrainian scientific sources made it possibleto systematize key directions in the rehabilitation of individuals after moderate and severe TBI. It was established that early initiation and continuity of rehabilitation measures within a multidisciplinary team are leading factors of successfulrecovery. Among the most effective methods of physical therapy are kinesio- and mechanotherapy, therapeutic exercise,graded walking, breathing training, and positioning therapy. Occupational therapy, aimed at restoring self-care skills,daily activities, and professional functioning, significantly increases the level of patients’ functional independence andensures their social and vocational reintegration. In the military context, the necessity of combining physical methods with psycho-emotional support, cognitive-behavioral therapy, and programs for overcoming post-traumatic stress disorder has been demonstrated. Particular attention is paid to methods stimulating neuroplasticity, such as sensory stimulation, motor learning and relearning techniques, and the use of computer-based and video technologies. Conclusions. Effective recovery of patients after moderate and severe closed traumatic brain injury is achieved through an early, continuous, and individualized multidisciplinary approach. The key role belongs to the combination of physical therapy (kinesitherapy, therapeutic exercise, mechanotherapy, graded walking, breathing training) and occupational therapy focused on restoring daily and professional skills and social reintegration. Important components are stimulation of neuroplasticity and the use of standardized assessment scales that allow objective monitoring of recovery dynamics. In the context of warfare, strengthening psycho-emotional support and intersectoral cooperation is essential to ensure complete social and professional adaptation of patients.