Rehabilitation outcome of a severe combat blast injury: a case report

Abstract: Objective: This case report describes the physiotherapy treatment of a soldier who suffered a severe combat blast injury. Methods: A 38-year-old Ukrainian man sustained blast injuries while driving over a mine during his service in the Ukrainian army. After receiving acute treatments, he was transferred to an academic hospital in the Netherlands. There, the man presented with severe soft tissue injuries on his back, as well as injuries to multiple organs, including the sciatic nerve and sacrum. Due to these injuries, the man could only lie in a prone position. His treatment goal was to be able to walk again. Results: The patient started physiotherapy, focussing on range of motion, strengthening the leg muscles, and functional transfers. Four months after the injury, he was able to achieve a standing position using a tilt table. Subsequent exercises were conducted to enable independent walking with a scale walker and, eventually, crutches. Seven months after the injury, the patient was transferred to a military rehabilitation centre. Rehabilitation efforts continued to increase joint mobility, improve muscle strength, build stamina with hydrotherapy, and enhance independence. Thirteen months after the blast injury, the man was independent in daily activities and could walk two kilometres without walking aids. Conclusion: This case report presents the challenging yet successful physiotherapeutic treatment of a soldier who suffered a blast injury. A dedicated multidisciplinary treatment team, progressive mobilisation with walking aids, targeted exercises, and the creative use of supportive materials contributed to the patient's recovery to independent daily functioning.