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Non-specific adaptation reactions in combatants with somatic disorders in the post-acute period of stationary medical-psychological rehabilitation

Non-specific adaptation reactions in combatants with somatic disorders in the post-acute period of stationary medical-psychological rehabilitation

ISSN 2223-6775 Ukrainian journal of occupational health Vol.20, No 2, 2024


https://doi.org/10.33573/ujoh2024.02.098

Non-specific adaptation reactions in combatants with somatic disorders in the post-acute period of stationary medical-psychological rehabilitation

Zaitsev D.V.1,2, Lashko O.M.1, Varyvonchyk D.V.2, Kurmyshov O.V.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): UKR

Introduction. Participation in combat operations can lead to the development of adaptation disorders in military personnel, including combat stress. Combat stress is considered a psychological disorder, while adaptation disorders may have underestimated manifestations in the physical condition. The objective assessment of the functional-adaptive mechanisms of the body in combatants during the post-acute rehabilitation period remains poorly researched, although the effectiveness of medical-psychological rehabilitation measures depends on its resolution. One of the methods of nonspecific integral assessment of functional-adaptive mechanisms is determining the type of reactivity based on the temporal dynamics of indicators of the leukocyte formula of peripheral blood.

Objective: to develop methods and criteria for assessing functional-adaptive changes in the body of combatants to forecast and determine the effectiveness of medical-psychological rehabilitation of combatants.

Materials and Methods. The study involved 56 male military personnel, participants in combat operations, receiving comprehensive rehabilitation at the Clinic of Occupational Diseases of the SI "Institute of Occupational Health of the NAMS" in 2023. Informed consent was obtained from all participants included in the study groups. Peripheral blood samples were taken one day before the start of the rehabilitation course and one day before the planned discharge from the hospital. A series of leukocyte indices was calculated to identify patients whose changes in leukocyte fractions could be a specific reaction. To assess the effectiveness of comprehensive medical-psychological rehabilitation, the dynamics of adaptive reactions based on leukocyte formula indicators (method by L.K. Harkavi) was applied according to the following algorithm. 1) The type of nonspecific adaptive reaction is determined by the percentage content of lymphocytes. 2) As an intermediate calculation, the degree of intensity of nonspecific adaptive reaction was determined separately for each of the following fractions: monocytes, eosinophils, segmented neutrophils, and basophils. 3) Based on the obtained signs of the intensity of nonspecific adaptive reaction, the level of reactivity was determined: high, moderate, or low. Data processing was carried out using variation statistics methods with the STATISTICA program. The study was conducted within the framework of the research and development work "Development and improvement of methods of rehabilitation and treatment of the population affected by military actions," registration number 0123U100982, funded by the state budget. The authors declare no conflict of interest.

Results and Discussion. There were no signs of inflammation and endogenous intoxication according to all studied leukocyte indices, which allows using the data to assess nonspecific adaptive processes. According to the leukocyte formula indicators, the physiological condition of the body at the end of the rehabilitation course remained unchanged in 55.4 ± 13.0% of individuals; in this group, predominantly high levels of reactivity were observed (p<0.05). Conditional improvement was observed in 30.4 ± 12.0% of individuals. Conditional deterioration was observed in 14.3 ± 9.2% of individuals. The number of improvement cases significantly exceeded the number of deterioration cases (p<0.01). High levels of reactivity were noted before the start of the course in 42.9 ± 13.0% of individuals, at the end – in 66.1 ± 12.4% of individuals, increase (Δ) – +23.2% (p<0.01). Moderate levels of reactivity were noted before the start of the rehabilitation course in 46.4 ± 13.1% of individuals, at the end – in 28.6 ± 11.8% of individuals, Δ = -17.8% (p<0.01). Reaction training was noted at the beginning of the rehabilitation course in 25.0 ± 11.3% of individuals, at the end – in 14.3 ± 9.2% of individuals, Δ = -10.7% (p<0.05).

Conclusions. In all studied patients during the post-acute period of stationary medical-psychological rehabilitation, favorable types of adaptive reactions were observed. Determination of leukocyte indices is an informative and inexpensive method of monitoring the functional reactivity of combatants' bodies during their medical-psychological rehabilitation.

Keywords: Combat Stress, Adaptation Disorders, Rehabilitation, Leukocytes.

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