低频磁疗在战伤后遗症康复中的疗效

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BACKGROUND

In recent years, the number of military personnel with mine-blast injuries sustained during special military operations has significantly increased. These injuries often lead to severe damage and further disability. The injured often have open and complex fractures of the extremities, multiple penetrating missile wounds of soft tissues of the extremities, as well as neuropsychiatric disorders, which complicates the rehabilitation plan. The complexity of mine-blast injuries treatment and their consequences is determined by the combined nature of injuries, extensive destruction of the tissue structures, as well as long treatment and rehabilitation [1–3]. Research and implementation of new methods of medical rehabilitation is an urgent task of modern medicine. Low-frequency magnetotherapy has become one of the safest and most commonly recommended treatment modalities. Magnetic field improves microcirculation in tissues, has anti-inflammatory and analgesic effect, which determines its application in various fields of medicine. Magnetotherapy is included in the guidelines of the Ministry of Health of the Russian Federation for anti-inflammatory, anti-edema, reparative and regenerative actions, and better microcirculation [4–14].

The World Health Organization and the Ministry of Health of the Russian Federation (Order of the Ministry of Health of the Russian Federation No. 788n On Approval of the Procedure for the Organization of Medical Rehabilitation of Adults, dated July 31, 2020) recommend using the International Classification of Functioning, Disability and Health (ICF) as a tool to objectively assess the health status of patients, to determine the prognosis of impaired functions and the effectiveness of rehabilitation measures.

AIM

The work aimed to assess the effectiveness of low-frequency magnetotherapy in complex medical rehabilitation of patients with the consequences of combat trauma from the perspective of ICF.

METHODS

The study was conducted at medical rehabilitation departments of Sadykov City Clinical Hospital No. 7, Kazan. The study included patients with the consequences of combat trauma, aged 25.9 ± 2.1 years. The study was approved by the local ethical committee of the Sadykov City Clinical Hospital No. 7, Kazan.

The study group included 48 patients who received standard therapy with low-frequency magnetotherapy on the POLIMAG-02M apparatus as part of the complex rehabilitation program. Exposure parameters: exposure mode: continuous; type of magnetic field: right-hand rotation; magnetic induction: 20 mT; pulse frequency: 10 Hz; exposure time: 20 min. Exposure duration: 10 min. The course consisted of 14 daily sessions.

The comparison group included 47 patients. The standard therapy course involved therapeutic exercises, massage therapy, and psycho-emotional correction.

Inclusion criteria: age from 20 to 55 years, diagnosis: consequences of combat trauma (mine-blast injuries).

Non–inclusion criteria: somatic diseases in decompensation stage and acute infectious diseases.

Exclusion criterion: patients’ refusal to participate in the study.

In clinical examination, pain syndrome was assessed using the Visual Analog Scale, swelling was assessed by measuring the diameter of the affected extremity in the area of swelling in centimeters. Treatment efficacy was evaluated using the Functional Independence Measure (FIM) scale, as well as the results of assessment of patients’ psychoemotional disorders: Spielberger–Khanin State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory.

An individual rehabilitation diagnosis for each patient was determined over time according to the ICF. When assessing the extent of impairment in structure, function, activity, and participation, the following leading domains were identified: b280, sensation of pain; b439, functions of the hematological and immunological systems; d240, handling stress and other psychological demands; and d450, walking.

Statistical calculations were performed on a personal computer running MS Windows 10 operating system (Microsoft) using MS Excel spreadsheet program from Office 365 package (Microsoft). The statistical analysis was performed using Mann–Whitney criterion for independent variables, and Spearman’s rank correlation coefficient.

RESULTS

Ninety-five patients with the consequences of combat trauma were examined. Complaints of lower extremity pain were presented in 95 (100%) patients. In 95 (100%) patients, edema was detected in the injured lower extremities. Neurologic examination revealed motor disturbances in the affected lower limb in 95 (100%) individuals.

The assessment of the domain “b280, sensation of pain” according to ICF after the course of rehabilitation in the study group revealed a significant reduction in pain syndrome by 45.8% (7.2±1.7 points vs 3.6±1.3 points after the course; p <0.001; Fig. 1). During rehabilitation, the values of these indicators in the comparison group did not change significantly.

 

Fig. 1. Changes in Visual Analog Scale pain score after rehabilitation of patients with the consequences of combat trauma.

 

When assessing the domain “b439, functions of the hematological and immunological systems,” physical examination revealed a decrease in the severity of edema syndrome: the knee joint circumference of the injured extremity compared with the healthy extremity decreased by 42.7% (from 1.92±0.7 to 1.1±0.3 cm; p <0.001) in the study group.

When assessing the quality of life using the FIM functional independence scale, an 11.5% improvement was noted: from 106.1±8.4 to 118.3±7.9 points (p <0.001); Fig. 2. During rehabilitation, the values of these indicators in the comparison group did not change significantly.

 

Fig. 2. Changes in the FIM functional independence scale after rehabilitation of patients with the consequences of combat trauma.

 

When assessing the domain “d240, handling stress and other psychological demands” on the Spielberger–Khanin scale, the patients in the study group reported a 10.9% decrease in the anxiety level: from 33.1±1.5 to 29.5±1.4 points (p < 0.001). When assessing the level of depression on the Beck scale in the study group, a 30.5% decrease was found: from 10.8±1.3 to 7.5±1.2 points (p <0.001); Fig. 3. No significant change was found in the comparison group, from 33.7±2.3 to 32.7±2.1 points (p=0.27) and from 10.6±0.9 to 10.4±1.3 points (p=0.09), respectively.

 

Fig. 3. Changes in psychoemotional disturbances on the Beck scale after rehabilitation of the patients with the consequences of combat trauma.

 

DISCUSSION

The conducted study demonstrates the effectiveness of low-frequency therapy in patients with the consequences of combat trauma: a reduction in pain syndrome by 45.8%, which is confirmed by subjective dynamics of patients’ complaints and data on the Visual Analog Scale; a decrease in swelling by 42.7%, which is confirmed by the data of clinical examination; an improvement in psycho-emotional status, which is confirmed by a decrease in the severity of anxiety by 10.9%, and the level of depression by 30.5%; an improvement in general well-being, and normalization of psycho-emotional status of patients with combat trauma.

It is known that magnetic field improves microcirculation in tissues, has anti-inflammatory and analgesic effects, which determines its use in patients with the consequences of combat trauma.

CONCLUSION

Thus, the inclusion of low-frequency magnetotherapy in the complex medical rehabilitation of patients with the consequences of combat trauma increases clinical effectiveness from the perspective of ICF.

The absence of any adverse events associated with magnetotherapy using POLIMAG-02M (Elamed, Russia) apparatus and good tolerance of magnetotherapeutic procedures by all patients in group 1 (study group, n=48) during the study, including the period of prospective observation, allow us to conclude that the inclusion of low-frequency magnetotherapy in the complex medical rehabilitation of patients with the consequences of combat trauma is safe and does not entail the risk of adverse events for patients.

ADDITIONAL INFORMATION

Author contributions. R.A. Bodrova — concept development, research, scientific guidance, methodology development, formal analysis, visualization, validation of results; A.D. Zakamyrdina — research, formal analysis, visualization, validation of results; A.M. Delyan — administrative management of the research project; G.I. Akhmetova — research, provision of resources. Аll authors made a substantial contribution to the conception of the work, acquisition, analysis, interpretation of data for the work, drafting and revising the work, final approval of the version to be published and agree to be accountable for all aspects of the work.

Ethics approval. The study was approved by the local Ethics Committee of the M.N. Sadykov Municipal Clinical Hospital No. 7 (Protocol No. 23 dated 04/30/2025).

Consent for publication. All study participants voluntarily signed an informed consent form before being included in the study, and they also agreed to publish photos.

Funding sources. No funding.

Disclosure of interests. The authors have no relationships, activities or interests for the last three years related with for-profit or not-for-profit third parties whose interests may be affected by the content of the article.

Statement of originality. In creating this work, the authors did not use previously published information (text, illustrations, data).

Data availability statement. The editorial policy regarding data sharing does not apply to this work, and no new data was collected or created.

Generative AI. Generative AI technologies were not used for this article creation.

Provenance and peer-review. This paper was submitted to the journal on an unsolicited basis and reviewed according to the usual procedure. Two external reviewers, a member of the editorial board, and the scientific editor of the publication participated in the review.

作者简介

Rezeda A. Bodrova

Russian Medical Academy of Continuous Professional Education; City Clinical Hospital № 7 of Kazan

编辑信件的主要联系方式.
Email: bodrovarezeda@yandex.ru
ORCID iD: 0000-0003-3540-0162
SPIN 代码: 1201-5698

MD, Dr. Sci. (Medicine), Associate Professor; Kazan State Medical Academy — Branch Campus of Russian Medical Academy of Continuous Professional Education

俄罗斯联邦, Kazan; 54 Marshal Chuikov st, Kazan, 420103

Aygul D. Zakamyrdina

Russian Medical Academy of Continuous Professional Education; City Clinical Hospital № 7 of Kazan

Email: aigul55@mail.ru
ORCID iD: 0000-0002-3234-6976
SPIN 代码: 8153-6610

Kazan State Medical Academy — Branch Campus of Russian Medical Academy of Continuous Professional Education

俄罗斯联邦, Kazan; 54 Marshal Chuikov st, Kazan, 420103

Artur M. Dilyan

City Clinical Hospital № 7 of Kazan

Email: gkb7@bk.ru
ORCID iD: 0000-0002-2328-7679
SPIN 代码: 6958-9179

MD, Cand. Sci. (Medicine)

俄罗斯联邦, 54 Marshal Chuikov st, Kazan, 420103

Guzel I. Akhmetova

City Clinical Hospital № 7 of Kazan

Email: akhmeguzel@yandex.ru
ORCID iD: 0009-0006-0974-0971
俄罗斯联邦, 54 Marshal Chuikov st, Kazan, 420103

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