CHANGES IN ASTHENIA PARAMETERS IN MILITARY PERSONNEL WITH SEQUELAE OF MILD TRAUMATIC BRAIN INJURY UNDER THE INFLUENCE OF A PHYSICAL THERAPY PROGRAM

Abstract

Topicality. The consequences of traumatic brain injury (TBI) in military personnel are associated with reduced physical performance, decreased muscle strength, development of asthenic syndrome, and impaired sleep quality. These factors limit rehabilitation outcomes and necessitate optimization of physical therapy programs.
The goal of the work is to evaluate the effectiveness of a comprehensive physical therapy program in military personnel with mild TBI sequelae based on asthenia-related outcomes.
Materials and methods. A total of 96 male military personnel were examined. The main group (n=63) was divided into two subgroups: MG1 (n=32), which received standard rehabilitation, and MG2 (n=31), which underwent a comprehensive physical therapy program. The control group consisted of 33 apparently healthy individuals. The physical therapy program included daily outpatient sessions for 4 weeks followed by 4 weeks of independent training. It combined aerobic and resistance exercises, balance and coordination training, task-oriented functional exercises tailored to professional demands, sensorimotor training using the MotionGuidance® biofeedback system, breathing exercises, oculomotor training, balance training, and progressive muscle relaxation according to Jacobson. Outcome measures included cycle ergometry, handgrip and back dynamometry, as well as the Fatigue Severity Scale (FSS), Fatigue Assessment Scale (FAS), and Pittsburgh Sleep Quality Index (PSQI).
Research results. Patients with TBI demonstrated reduced peak power output (2.33 W/kg and 2.41 W/kg vs 3.42 W/kg in controls), decreased handgrip strength of the dominant hand (37.52 kg and 38.76 kg vs 50.03 kg), and reduced back strength (115.7 kg and 119.6 kg vs 144.6 kg). After intervention, peak power increased to 2.60 W/kg in MG1 and 3.03 W/kg in MG2; handgrip strength improved to 42.09 kg and 48.19 kg, respectively; back strength increased to 122.8 kg and 132.2 kg. FSS scores decreased from 6 to 5 points in MG1 and to 4 points in MG2; total FAS scores decreased from 39 to 32 points and from 38 to 26 points, respectively. Sleep quality improved, with PSQI scores decreasing from 18.51 to 13.62 in MG1 and to 9.78 in MG2.
Conclusions. The developed comprehensive physical therapy program is more effective than standard rehabilitation, as it provides greater improvements in physical performance and muscle strength, significant reduction in asthenia, and better sleep quality in military personnel with TBI sequelae.