Keywords
muscle tissue
military trauma
musculoskeletal system
How to Cite
Abstract
Background. Intensive care of injured military personnel with polytrauma and amputations is associated with a high risk of developing secondary sarcopenia due to prolonged immobilization, systemic inflammation, hypercatabolism, and inadequate nutrition.
Aim. To determine the effectiveness of the developed physical therapy program based on structural and functional parameters of muscle tissue in injured military personnel with amputation and secondary sarcopenia.
Materials and Methods. The control group consisted of 36 healthy men. The study group included 59 injured military personnel with transtibial amputation and sarcopenia, who were divided into two subgroups. Group 1 underwent a standard 12-week rehabilitation program, while Group 2 received a 12-week comprehensive physical therapy program incorporating sarcopenia-targeted interventions (resistance training and nutritional correction). Assessment methods included anthropometry, muscle ultrasound, and computed tomography. The study constitutes a component of the Vasyl Stefanyk Precarpathian National University research project "Improvement of Functional Status, Quality of Life, and Correction of Pathological Conditions of Various Origins by Means of Therapy and Rehabilitation" (2023–2026), state registration No.0123U01534.
Research Ethics. The study was conducted in accordance with the principles of the Declaration of Helsinki, with informed consent obtained from all participants. The study protocol was approved by the institutional bioethics committee.
Results. At baseline, injured participants demonstrated reduced limb circumferences, decreased muscle thickness (based on ultrasound measurements of the biceps brachii, triceps brachii, brachioradialis, and rectus femoris muscles), increased muscle echogenicity, and reduced muscle area (based on cross-sectional area of the psoas muscle and skeletal muscle index calculation). Following rehabilitation, both subgroups showed positive changes; however, the improvements were significantly greater in Group 2. Body mass gain was [6.03±0.39] kg compared to [4.63±0.50] kg in Group 1. Greater increases in limb circumferences, muscle thickness (ultrasound), and improved echogenicity were also observed. The skeletal muscle index in Group 2 increased to [54.12±1.44] cm²/m², exceeding the lower threshold for sarcopenia.
Conclusions. The developed physical therapy program is recommended for correcting anthropometric, ultrasound, and tomographic manifestations of sarcopenia in injured military personnel with transtibial amputation.
Keywords: rehabilitation, muscle tissue, military trauma, musculoskeletal system.
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