Adaptation disorder in military personnel with blast injury

Background. Blast injury (BI), including acoustic barotrauma and mild traumatic brain injury (mTBI), is among the most common combat-related injuries among military personnel. Although numerous studies have been conducted and effective methods for diagnosing and managing autonomic dysfunction in moderate to severe injuries have been developed, data on dysautonomia in mild injuries remain limited and controversial. Purpose – to study the characteristics disorder in military personnel after BI and to investigate the impact of trauma on the adaptation of the autonomic nervous system (ANS) during physical exertion and at rest, depending on the type of injury sustained. Materials and Methods. The study included 59 military personnel (aged 22–56 years, M = 35.8 ± 9 years) who underwent inpatient treatment following BI. Participants were divided into three groups: BI with mTBI (n = 12), BI with acubarotrauma without mTBI (n=38), and a control group with isolated BI (n = 9). ANS assessment was performed using the Kerdo index and the active standing test (Shellong test), while autonomic reactivity was classified as normal, postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension, hypertensive, or unclassified (paradoxical) response. Statistical analysis included descriptive methods and the chi-square test. Results. According to the Kerdo index, the sympathetic response was detected only in the group with acubarotrauma (5.1%). The second group had the highest percentage of eutonic (39.0%) and parasympathetic responses (20.3%). Normal autonomic response to the orthostatic test was most frequently observed in the second group (32.2%). POTS was identified in all groups, with the highest prevalence in the first (13.6%) and second (20.3%) groups. Orthostatic hypotension and hypertensive response were observed only in the group with acoustic barotrauma. The obtained data demonstrated the presence of intragroup disturbances in ANS function across all groups; however, no statistically significant differences were found between the groups. This may indicate the similarity of ANS adaptation mechanisms following BI. Conclusions. The obtained data indicate that despite deviations in autonomic regulation, no statistically significant differences were found between the groups, which may suggest a similar level of adaptation to orthostatic stress regardless of the type of injury. Future studies should be expanded to include female military personnel for a more in-depth analysis of ANS adaptation following blast injury.