ICF categories in assessing the effectiveness of comprehensive rehabilitation of military personnel with mental stress in a sanatorium-based treatment facility

Objective. To develop a control set of ICF categories for assessing the effectiveness of sanatorium-based rehabilitation involving binaural therapy in military personnel with neuropsychiatric stress. Material and methods. A prospective randomized controlled study enrolled 113 male military personnel (mean age 33.7±0.49 years) with nervous tension (R45.0). The control group consisted of 39 ones without nervous tension (mean age 31.5±0.62 years). Patients were randomized into the control group (n=57, basic therapy involving psychotherapy and physical exercise) and the main group (n=56, basic therapy supplemented with a course of binaural therapy). Binaural therapy included 18 procedures (alpha and theta ranges, PRAK device). Efficacy was assessed using a control set of 10 ICF categories (4 for body functions, 4 for activity and participation, 2 for environmental factors) with calculation of integrated domain scores and final score. Assessment was conducted before and after treatment. Results. Sanatorium-based rehabilitation of military personnel with nervous tension was followed by positive dynamics of ICF categories in both groups. However, basic and binaural therapy contributed to more significant improvement. The main group achieved significant reduction in scores across all categories of «Body Functions», «Activity and Participation» and «Environmental Factors» domains (p<0.05). The most significant changes were noted in emotional functions (transition from moderate anxiety to asymptomatic status), sleep quality, stress tolerance, social communication, and ability to relax. In the control group, positive dynamics was moderate without significant impact on environmental factors. The integrated ICF score in the main group decreased by almost 50% that confirmed high effectiveness of binaural therapy to standard rehabilitation program. Conclusion. A course of binaural therapy provides systemic improvement in functioning of military personnel with neuropsychiatric stress through neurophysiological synchronization of cortical activity, restructuring of autonomic balance and activation of dopaminergic systems. The most pronounced effect was achieved in «Body Functions» and «Activity and Participation» domains clinically manifested by lower anxiety, better sleep, and increased stress resistance. The developed control set of ICF categories demonstrated high sensitivity and can be recommended for assessing the effectiveness of rehabilitation programs for neuropsychiatric stress.