Comprehensive Respiratory and Physical Therapy Program for Military Personnel After Behind-Armor Blunt Chest Trauma: Results of a Prospective Pilot Study

Abstract

Objective. To evaluate the effectiveness of a physical therapy program for military personnel following behind-armor blunt chest trauma. Materials and Methods. The study involved the analysis and synthesis of scientific and methodological literature related to the research topic. A prospective single-center pilot clinical study was conducted involving five military personnel undergoing rehabilitation at a healthcare facility in the Rivne region, Ukraine. Rehabilitation assessment included pain intensity using the Visual Analogue Scale (VAS), blood oxygen saturation at rest and during exercise (SpO₂), the Borg Rating of Perceived Exertion Scale, the modified Medical Research Council Dyspnea Scale (mMRC), and the Six-Minute Walk Test (6MWT). Statistical analysis was performed using the arithmetic mean (M) and standard deviation (SD). Given the small sample size (n = 5), the non-parametric Wilcoxon signed-rank test was applied. The clinical significance of the findings was evaluated by calculating the effect size. Results. The respiratory and physical therapy program was developed based on the International Classification of Functioning, Disability and Health (ICF) and the biopsychosocial model of rehabilitation. The intervention was implemented in sequential phases according to the clinical course of recovery (acute, early recovery, late recovery, and outpatient phases). Rehabilitation goals were established using the SMART approach. The program included diaphragmatic and segmental breathing exercises, inspiratory muscle training, early mobilization, verticalization, aerobic training, postural exercises, and gait training. Exercise intensity was individualized according to blood oxygen saturation, pain severity, and the patient's clinical condition. To ensure continuity of rehabilitation, a home-based respiratory and physical therapy program was developed. The effectiveness criteria included the prevention of respiratory complications and improvement of respiratory system function. Pain intensity assessed using the Visual Analogue Scale (VAS) decreased by 92%, contributing to the gradual restoration of an effective cough and improved bronchopulmonary clearance. At the same time, mMRC and Borg scores demonstrated reductions of 80% and 75%, respectively, indicating substantial improvements in dyspnea and perceived exertion. Improved respiratory function was accompanied by enhanced exercise tolerance, as evidenced by an approximately 17% increase in the distance covered during the Six-Minute Walk Test (6MWT). Mean blood oxygen saturation (SpO₂) increased from 94.2% to 98.2% at rest and from 92.4% to 97.6% during exercise, indicating improved oxygenation and respiratory function. These findings demonstrate the positive effect of the proposed rehabilitation program on the functional recovery of military personnel following behind-armor blunt chest trauma. However, given the pilot nature of the study and the limited sample size, the findings should be considered preliminary and require confirmation in larger-scale studies. Conclusions. The positive changes observed in the rehabilitation outcome measures demonstrate the effectiveness of the proposed respiratory and physical therapy program in improving respiratory function, reducing pain and dyspnea, increasing exercise tolerance, and restoring mobility in military personnel following behind-armor blunt chest trauma. Further studies involving larger patient cohorts are required to confirm the effectiveness of the proposed rehabilitation program.