{"id":4738,"date":"2026-04-26T19:53:48","date_gmt":"2026-04-26T17:53:48","guid":{"rendered":"http:\/\/www.internalmed-journal.in.ua\/?p=4738"},"modified":"2026-05-15T21:48:03","modified_gmt":"2026-05-15T19:48:03","slug":"%d1%80%d0%b5%d0%b0%d0%b1%d1%96%d0%bb%d1%96%d1%82%d0%b0%d1%86%d1%96%d1%8f-%d0%bf%d1%80%d0%b8-%d0%bc%d1%96%d0%bd%d0%bd%d0%be-%d0%b2%d0%b8%d0%b1%d1%83%d1%85%d0%be%d0%b2%d1%96%d0%b9-%d1%82%d1%80%d0%b0","status":"publish","type":"post","link":"http:\/\/www.internalmed-journal.in.ua\/en\/archives\/4738","title":{"rendered":"Rehabilitation for mine-blast trauma, practical guidelines"},"content":{"rendered":"

Prof. L.V. Andriyuk <\/b><\/strong>1<\/b><\/sup><\/strong>, prof. L.S. Babinets <\/b><\/strong>2<\/b><\/sup><\/strong>, asst. O.V. Grabous <\/b><\/strong>1<\/b><\/sup><\/strong><\/p>\n

1 Danylo Halytsky Lviv National Medical University, <\/b><\/strong><\/p>\n

2 I. Horbachevsky Ternopil National Medical University <\/b><\/strong><\/p>\n

Mine-blast trauma (MBT) is characterized by combined damage caused by blast wave, fragments, acceleration\/impact of the body, thermal and toxic factors, which forms a multi-organ injury profile and a high frequency of long-term functional limitations.<\/p>\n

In 2022-2025, rehabilitation after blast injuries evolved from a fragmented approach to a model of continuous care (from early rehabilitation in the acute period to long-term outpatient, community, and professional reintegration), relying on multidisciplinary teams, the International Classification of Functioning (ICF) and clinical guidelines for amputations, traumatic brain injury, acoustic trauma, burns, and pain.<\/p>\n

The article summarizes key evidence-based approaches and organizational solutions: early mobilization and prevention of complications, pre-prosthetic preparation, modern prosthetics, neurorehabilitation for blast-related mTBI, audiological management of tinnitus\/hearing loss, burn rehabilitation, multimodal pain management, integrated psychological support, and hospital-rehabilitation-community routing. The article separately highlights the issue of resource planning in the context of mass emergencies and challenges for the rehabilitation system in Ukraine.<\/p>\n

Key words: <\/b><\/strong>mine-blast trauma; polytrauma; amputation; prosthetics; osseointegration; traumatic brain injury; acoustic trauma; burns; phantom pain; PTSD; ICF; multidisciplinary rehabilitation.<\/p>\n

https:\/\/doi.org\/10.15407\/internalmed2026.01.053<\/strong><\/p>\n

Download.PDF (ukr)<\/a><\/strong><\/p>\n

Cite:<\/strong><\/p>\n

\u0410\u043d\u0434\u0440\u0456\u044e\u043a, \u041b.\u0412. \u0420\u0435\u0430\u0431\u0456\u043b\u0456\u0442\u0430\u0446\u0456\u044f \u043f\u0440\u0438 \u043c\u0456\u043d\u043d\u043e-\u0432\u0438\u0431\u0443\u0445\u043e\u0432\u0456\u0439 \u0442\u0440\u0430\u0432\u043c\u0456, \u043f\u0440\u0430\u043a\u0442\u0438\u0447\u043d\u0456 \u043e\u0440\u0456\u0454\u043d\u0442\u0438\u0440\u0438 \/ \u041b.\u0412. \u0410\u043d\u0434\u0440\u0456\u044e\u043a, \u041b.\u0421. \u0411\u0430\u0431\u0456\u043d\u0435\u0446\u044c, \u041e.\u0412. \u0413\u0440\u0430\u0431\u043e\u0443\u0441 \/\/ \u0421\u0445\u0456\u0434\u043d\u043e\u0454\u0432\u0440\u043e\u043f\u0435\u0439\u0441\u044c\u043a\u0438\u0439 \u0436\u0443\u0440\u043d\u0430\u043b \u0432\u043d\u0443\u0442\u0440\u0456\u0448\u043d\u044c\u043e\u0457 \u0442\u0430 \u0441\u0456\u043c\u0435\u0439\u043d\u043e\u0457 \u043c\u0435\u0434\u0438\u0446\u0438\u043d\u0438. \u2014 2026. \u2014 \u2116 1. \u2014 \u0421. 53-59. doi: 10.15407\/internalmed2026.01.053<\/p>\n

Andriyuk LV, Babinets LS, Grabous OV. Reabilitatsiia pry minno-vybukhovii travmi, praktychni orientyry [Rehabilitation for mine-blast trauma, practical guidelines]. Shidnoevr. z. vnutr. simejnoi med. 2026;1:53-59. Ukrainian. doi: 10.15407\/internalmed2026.01.053<\/p>\n

References:<\/strong><\/p>\n

    \n
  1. \n

    Action on Armed Violence. The hierarchy of explosive violence: a decade of global impact: report. London; 2025.<\/p>\n<\/li>\n

  2. \n

    Insecurity Insight. The effects on health care of the use of explosive weapons: report. Geneva; 2024.<\/p>\n<\/li>\n

  3. \n

    International Committee of the Red Cross. The constant danger of explosive hazards. Geneva; 2025.<\/p>\n<\/li>\n

  4. \n

    International Committee of the Red Cross. Human cost of weapon contamination in Asia-Pacific. Geneva; 2024.<\/p>\n<\/li>\n

  5. \n

    World Health Organization. Rehabilitation 2030: a call for action: meeting report. Geneva: WHO; 2017.<\/p>\n<\/li>\n

  6. \n

    World Health Organization. Package of interventions for rehabilitation. Module 1: introduction. Geneva: WHO; 2023.<\/p>\n<\/li>\n

  7. \n

    World Health Organization. Package of interventions for rehabilitation. Geneva; 2023.<\/p>\n<\/li>\n

  8. \n

    Chopyak V, Chemerys O, Hdyrya O. The development of the rehabilitation system in Ukraine. Proc Shevchenko Sci Soc Med Sci. 2024;76(2). https:\/\/doi.org\/10.25040\/ntsh2024.02.01<\/a><\/p>\n<\/li>\n

  9. \n

    Ministry of Health of Ukraine. At the international meeting in Geneva, the Ministry of Health presented the updated rehabilitation system implemented in Ukraine; 2024.<\/p>\n<\/li>\n

  10. \n

    Barmatz C, et al. Rehabilitation resource planning for mass casualty incidents: a retrospective analysis of blast and ballistic injuries. Injury. 2025;56(11). https:\/\/doi.org\/10.1016\/j.injury.2025.112692<\/a><\/p>\n<\/li>\n

  11. \n

    Roy CM, Garbern SC, Relan P, et al. Acute facility management of blast injuries in low- and middle-income countries: a systematic review and meta-analysis. Prehosp Disaster Med. 2025;40(3):169-81. https:\/\/doi.org\/10.1017\/S1049023X25101222<\/a><\/p>\n<\/li>\n

  12. \n

    Volianskyi OM, Kikh AY. Zastosuvannia Mizhnarodnoi klasyfikatsii funktsionuvannia, obmezhen zhyttiediialnosti ta zdorovia dlia otsinky efektyvnosti reabilitatsii viiskovosluzhbovtsiv [Application of the International Classification of Functioning, Disability and Health to evaluate the effectiveness of rehabilitation of military personnel]. Ukr J Mil Med. 2024;5(3):75-84. Ukrainian. https:\/\/doi.org\/10.46847\/ujmm.2024.3(5)-075<\/a><\/p>\n<\/li>\n

  13. \n

    Joint Trauma System. Amputation: evaluation and treatment: clinical practice guideline. 2024 Oct 10.<\/p>\n<\/li>\n

  14. \n

    Bespalenko AA, Shchehliuk OI, Kikh AY, et al. Algorithm for rehabilitation of combat-related patients with limb amputations based on multiprofessional and individual approach. Ukr J Mil Med. 2020;1(1):64-72.<\/p>\n<\/li>\n

  15. \n

    Litovchenko V, Dandash K, Pidkopay D, et al. Rehabilitation of patients with consequences of mine-explosive trauma of lower extremities on the policlinic stage. Med Today Tomorrow. 2020;75(2):64-70.<\/p>\n<\/li>\n

  16. \n

    Boiko AS, Shestopal NO, Yarmak VV. Algorithm of physical therapy for people after leg amputation following mine blast injury. Sports Med Phys Ther Occup Ther. 2024;2:184-90.<\/p>\n<\/li>\n

  17. \n

    Edwards DS, Kuhn KM, Potter BK, Forsberg JA. Heterotopic ossification: a review of current understanding, treatment, and future. J Orthop Trauma. 2016;30(Suppl 3):S27-30. https:\/\/doi.org\/10.1097\/BOT.0000000000000666<\/a><\/p>\n<\/li>\n

  18. \n

    Trutyak I, Malickii V, Samotowka M, et al. Problematic issues of limb amputation in wounded with combat trauma. Proc Shevchenko Sci Soc Med Sci. 2023;72(2). https:\/\/doi.org\/10.25040\/ntsh2023.02.08<\/a><\/p>\n<\/li>\n

  19. \n

    Shevchenko MV, Yurochko TP, Maistruk PO, et al. The cost of treatment and rehabilitation of servicemen with amputation after mine-blast injury. Nation’s Health. 2025:125-34. https:\/\/doi.org\/10.32782\/2077-6594\/2025.3\/15<\/a><\/p>\n<\/li>\n

  20. \n

    Romanowski KS, et al. American Burn Association guidelines on the management of acute pain in the adult burn patient. J Burn Care Res. 2020;41(6):1129-51. https:\/\/doi.org\/10.1093\/jbcr\/iraa119<\/a><\/p>\n<\/li>\n

  21. \n

    Department of Veterans Affairs; Department of Defense. VA\/DoD clinical practice guideline for the management of upper limb amputation rehabilitation; 2022.<\/p>\n<\/li>\n

  22. \n

    Haluzynskyi O, Linenko O, Bondarenko S, et al. Osseointegrative prosthetics: opportunities, challenges, and prospects for its application in the rehabilitation of patients with amputated limbs. Orthop Traumatol Prosthet. 2024;(3):86-97. https:\/\/doi.org\/10.15674\/0030-59872024386-97<\/a><\/p>\n<\/li>\n

  23. \n

    Handford C, McMenemy L, Kendrew J, et al. Improving outcomes for amputees: the health-related quality of life and cost utility analysis of osseointegration prosthetics in transfemoral amputees. Injury. 2022;53(12):4114-22. https:\/\/doi.org\/10.1016\/j.injury.2022.10.007<\/a><\/p>\n<\/li>\n

  24. \n

    Toderita D, et al. Self-reported health outcomes and medical complications at 6- and 8-year follow-up after direct skeletal fixation in individuals with bilateral transfemoral amputations. Int J Rehabil Res. 2025;48(3):173-9. https:\/\/doi.org\/10.1097\/MRR.0000000000000677<\/a><\/p>\n<\/li>\n

  25. \n

    Holm D, et al. Blast-related mild traumatic brain injury: case report highlighting the long-term neurocognitive sequelae. Cureus. 2025;17(9). https:\/\/doi.org\/10.7759\/cureus.92404<\/a><\/p>\n<\/li>\n

  26. \n

    Department of Veterans Affairs; Department of Defense. VA\/DoD clinical practice guideline for the management and rehabilitation of post-acute mild traumatic brain injury; 2021.<\/p>\n<\/li>\n

  27. \n

    Hall CD, et al. Vestibular rehabilitation for peripheral vestibular hypofunction. J Neurol Phys Ther. 2022;46(2):118-77. https:\/\/doi.org\/10.1097\/NPT.0000000000000382<\/a><\/p>\n<\/li>\n

  28. \n

    Joint Trauma System. Aural blast injury\/acoustic trauma and hearing loss: clinical practice guideline. 2025 Aug 14.<\/p>\n<\/li>\n

  29. \n

    Joint Trauma System. Vybu khova travma vukha \/ akustychna travma i vtrata slukhu: pereklad klinichnoho kerivnytstva [Aural blast injury \/ acoustic trauma and hearing loss: translation of clinical guidance]. 2023. Ukrainian.<\/p>\n<\/li>\n

  30. \n

    Paik CB, Pei M, Oghalai JS. Review of blast noise and the auditory system. Hear Res. 2022;425. https:\/\/doi.org\/10.1016\/j.heares.2022.108459<\/a><\/p>\n<\/li>\n

  31. \n

    Ahmed MM, Allard RJ, Esquivel CR. Noise-induced hearing loss treatment: systematic review and meta-analysis. Mil Med. 2022;187(5-6):e661-6. https:\/\/doi.org\/10.1093\/milmed\/usaa579<\/a><\/p>\n<\/li>\n

  32. \n

    Masri S, et al. Contributions of hearing loss and traumatic brain injury to blast-induced cortical parvalbulum neuron loss and auditory processing deficits. J Neurotrauma. 2023;40(3-4):395-407. https:\/\/doi.org\/10.1089\/neu.2022.0179<\/a><\/p>\n<\/li>\n

  33. \n

    Serghiou MA, et al. One world one burn rehabilitation standard. Burns. 2016;42(5):1047-58. https:\/\/doi.org\/10.1016\/j.burns.2016.04.002<\/a><\/p>\n<\/li>\n

  34. \n

    Koyro KI, et al. Burn guidelines – an international comparison. Eur Burn J. 2021;2(3):125-39. https:\/\/doi.org\/10.3390\/ebj2030010<\/a><\/p>\n<\/li>\n

  35. \n

    Nagorna OB, Kunynets OB, Kravets KP. Physical therapy and occupational therapy for military personnel after blast-related thoracic trauma. Rehabil Recreat. 2025;19(3):21-8. https:\/\/doi.org\/10.32782\/2522-1795.2025.19.3.2<\/a><\/p>\n<\/li>\n

  36. \n

    Smits I, et al. Rehabilitation outcome of a severe combat blast injury: a case report. Eur J Physiother. 2024;26(6):359-64. https:\/\/doi.org\/10.1080\/21679169.2024.2395325<\/a><\/p>\n<\/li>\n

  37. \n

    Rushchak LV, Yevchenko DO, Sereda IK. Key aspects of improving the effectiveness of rehabilitation care for military personnel through innovative technologies. Ukr J Mil Med. 2024;5(3):21-29. https:\/\/doi.org\/10.46847\/ujmm.2024.3(5)-021<\/a><\/p>\n<\/li>\n

  38. \n

    International Committee of the Red Cross. Physical rehabilitation programme: 2023 annual report. Geneva; 2024.<\/p>\n<\/li>\n

  39. \n

    Engel CC, et al. Limb salvage and recovery after severe blast injury: a review of the scientific literature: RAND report. Santa Monica; 2020.<\/p>\n<\/li>\n

  40. \n

    Liang R, et al. Assessment model of blast injury: a narrative review. iScience. 2025;28(7). https:\/\/doi.org\/10.1016\/j.isci.2025.112830<\/a><\/p>\n<\/li>\n

  41. \n

    Haun JN, et al. Rehabilitation outcomes of service members and veterans with mild-to-moderate traumatic brain injury. Med Care. 2025;63(12):922-8. https:\/\/doi.org\/10.1097\/MLR.0000000000002228<\/a><\/p>\n<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Prof. L.V. Andriyuk 1, prof. L.S. Babinets 2, asst. O.V. Grabous 1 1 Danylo Halytsky Lviv National Medical University, 2 I. Horbachevsky Ternopil National Medical University Mine-blast trauma (MBT) is characterized by combined damage caused by blast wave, fragments, acceleration\/impact of the body, thermal and toxic factors, which forms a multi-organ injury profile and a…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[137,131,139],"tags":[],"translation":{"provider":"WPGlobus","version":"2.12.2","language":"en","enabled_languages":["uk","en","ru"],"languages":{"uk":{"title":true,"content":true,"excerpt":false},"en":{"title":true,"content":true,"excerpt":false},"ru":{"title":false,"content":false,"excerpt":false}}},"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"","_links":{"self":[{"href":"http:\/\/www.internalmed-journal.in.ua\/en\/wp-json\/wp\/v2\/posts\/4738"}],"collection":[{"href":"http:\/\/www.internalmed-journal.in.ua\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.internalmed-journal.in.ua\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.internalmed-journal.in.ua\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.internalmed-journal.in.ua\/en\/wp-json\/wp\/v2\/comments?post=4738"}],"version-history":[{"count":4,"href":"http:\/\/www.internalmed-journal.in.ua\/en\/wp-json\/wp\/v2\/posts\/4738\/revisions"}],"predecessor-version":[{"id":4812,"href":"http:\/\/www.internalmed-journal.in.ua\/en\/wp-json\/wp\/v2\/posts\/4738\/revisions\/4812"}],"wp:attachment":[{"href":"http:\/\/www.internalmed-journal.in.ua\/en\/wp-json\/wp\/v2\/media?parent=4738"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.internalmed-journal.in.ua\/en\/wp-json\/wp\/v2\/categories?post=4738"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.internalmed-journal.in.ua\/en\/wp-json\/wp\/v2\/tags?post=4738"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}