Restoration of the functional state of military personnel after gunshot wounds to the upper limb using physical therapy measures based on the principles of neuroplasticity

Purpose. To evaluate the impact of physical therapy (PT) measures on the fastest possible recovery of military personnel after gunshot wounds to the upper limb (GWUL), taking into account the principles of neuroplasticity. Material & Methods: The study involved 72 patients aged 28 to 52 years diagnosed with gunshot wound of the upper limb (GWUL), who were divided into two groups - the main group (MG, n=36) and the control group (CG, n=36). Patients in the MG underwent rehabilitation according to the developed PT program, which included: motor activity of targeted actions to simulate situations significant for each patient and his professional activity, bimanual therapy, therapeutic massage, therapeutic exercises, special training devices of the Thera-Band progressive exercise system, Artromot training devices. And the CG - according to the standard program carried out in a medical institution: therapeutic exercises, physiotherapy, kinesiotherapy, Artromot training devices, therapeutic massage. For a comprehensive examination of patients in both groups, medical, biological and sociological methods were used: the DASH scale (Disability of the Arm, Shoulder and Hand Outcome Measure), questionnaires (military questionnaire), goniometry, dynamometry and methods of mathematical statistics. Results: After PT, the DASH severity scores (p<0.05), goniometry scores in the elbow joint of the upper limb (p<0.05), and dynamometry scores (p<0.05) were significantly better in MG patients than in CG. MG patients experienced significantly fewer limitations associated with upper limb dysfunctions compared to CG, which had a positive effect on the ability to perform exercises related to professional activity according to the results of the military questionnaire. Conclusions: The application of neuroplasticity principles in the PT program in the MG contributed to the improvement of the functional state of military personnel, as well as their professional and social capabilities, and can be applied to wider practical implementation in specialized medical and rehabilitation institutions.