Background: Walking as a method of functional recovery is used to treat many diseases. It is an accessible, natural and widespread form of
physical activity. Terrenkur is defined as distance, time, and angle dosed hiking; a method of training and treating patients with cardiovascular
diseases. One alternative method of rehabilitation is Nordic Walking which leads to increasing both the number of muscles involved in
movement and physical and aerobic load.

Introduction. Functional capacity is important parameter of activity of a person. It can be assessed with different methods, including interviewing, walk tests, cardiopulmonary exercise testing. According to the recommendations of the European Society of Cardiology, the assessment of functional capacity is an important step in the perioperative management of a patient with concomitant cardiovascular pathology during non-cardiac surgery. Purpose of our study was to implement assessing of functional capacity in clinical practice, including perioperative management of patients. And also, to compare the practical value of self-reported methods of assessing functional capacity and exercise testing. Materials and methods. 15 healthy men aged 33±5.4 years and 172 patients with documented pathology of the cardiovascular system aged 65±2.8 years were included in the study, among them 51% were male. We compared the value of different methods and the expediency of assessing the functional capacity of a patient with concomitant pathology of the cardiovascular system before planned non-cardiac surgery. Results. All healthy individuals gave a positive answer to the question about ability to climb two flights of stairs. The average Duke Activity Status Index score was 52.47±5.96, which corresponded to the calculated value of METs 9.19±0.73. During cardiopulmonary exercise testing, the average value of VO2max in these individuals was 47.56±11.34 mL/(kg·min). A direct strong correlation between Duke Activity Status Index values and VO2max was established (r=0.91, р˂0.01). 36 patients (21%) reported inability to climb two flights of stairs added. The average DASI in these persons was 12.84±4.38 and the level of NTproBNP was 1116±75. On the contrary in the rest of the patients the DASI was 28.18±7.72 and NTproBNP 302±42 with statistically significant difference (p˂0.01). The dynamics of troponins in the examined subjects did not show any increase in the postoperative period. The values of the EF in patients reported inability to climb two flights were lower by 9.78% compared with others (56.57±12.34% and 62.71±6.35%, p˂0.01). The average number of days spent in the hospital was 22 in patients with inability to climb two flights and 12 in the rest. 32 patients (19%) died, 28 deceased belonged to the group with inability to climb two flights of stairs. The average time of death was 29.86 days. Correlation analysis revealed a direct relationship of average strength between the Duke Activity Status Index and EF (0.42, p 0.007), an inverse relationship of average strength between the Duke Activity Status Index and NTproBNP (-0.42, p=0.01) and the number of days spent in a hospital (-0.39, p=0.005). In conclusion we found that healthy men with an active lifestyle have higher average VO2max parameters and confirmed that the VO2max obtained during the cardiopulmonary exercise testing was comparable to questionnaire methods for assessing functional capacity. One fifth of patients with confirmed cardiovascular pathology self-reported inability to climb two flights of stairs. These individuals had a lower EF, a higher concentration of NTproBNP, a longer stay in the hospital, and significantly higher mortality. the Duke Activity Status Index correlates with left ventricular systolic function and NTproBNP level.

Abstract. This article examines the growing interest in acupuncture as a potential treatment on the battlefield, particularly for pain relief and aiding the recovery of soldiers. This trend is part of a broader movement toward the integration of complementary and alternative medicine (CAM) into military healthcare systems. The article highlights how acupuncture’s holistic approach, which differs significantly from traditional Western medicine, makes it particularly effective in managing pain by considering the physical, psychological, and other patient characteristics that contribute to imbalances. Modern research and evidence further support the integration of acupuncture into pain management strategies, especially in military contexts. The article also explores the development and application of Battlefield Acupuncture, a protocol designed for rapid pain relief in combat settings. Additionally, the introduction of innovative approaches, such as finger acupuncture for self-help on the battlefield, offers a practical and low-risk alternative for soldiers in field conditions where access to comprehensive medical care may be limited. The effectiveness, simplicity, and potential for self-treatment make acupuncture a valuable tool in military medicine, particularly in resource- constrained environments.
Keywords: battlefield acupuncture, su jok acupuncture, military medicine.

УДК 614.88:355

Резюме. У статті висвітлено особливості надання допомоги постраждалим в умовах військових дій. Найбільш результативним сьогодні вважається американський стандарт надання допомоги пораненим (Tactical Сombat Сasualty Сare – TCCC), що передбачає сукупність послідовних дій до прибуття пораненого в медичний заклад та включає допомогу під вогнем, алгоритм надання допомоги в умовно безпечному місці й допомогу на етапі тактичної евакуації. Дотримання відповідних рекомендацій забезпечує порятунок життя максимальної кількості поранених.
Ключові слова: тактична медицина, перша допомога пораненим.

Abstract. Rehabilitation of patients following an acute myocardial infarction remains one of the most urgent tasks of modern cardiology. Cardiac rehabilitation programs are aimed not only at improving the functioning of the cardiovascular system but also at ensuring the mental health of patients, restoring their working capacity, and returning to a full-quality life as soon as possible. Patients receive many benefits of cardiac rehabilitation from physical training. The main type of physical exercise in patients with cardiovascular diseases is aerobic training, which increases maximal oxygen consumption and improves cardiorespiratory endurance. The dosed training method is the basis of the development of the patient's functional adaptation to physical exertion in cardiovascular diseases. The objective was to develop and test the effectiveness of the physical therapy method proposed by the authors for the recovery of patients with acute myocardial infarction after stenting. Material and methods: clinical (standard) examination and interview of the patient, medical history, blood pressure (BP) and heart rate (HR) measurement, pulse oximetry with saturation (SpO2) determination, orthostatic test, 10-meter walk test (10MWT), the Timed Up and Go test (TUG), the 6 Minute Walk Test (6MWT). 16 patients were enrolled in the study which lasted 5 weeks. Sessions according to the developed methodology of physical therapy were conducted with each patient for 12 days. Inclusion criteria: age between 50-80 years old, medical diagnosis: myocardial infarction, after stenting, no contraindications to cardiac rehabilitation. The effectiveness of the developed method of physical therapy for the recovery of patients with acute myocardial infarction after stenting was assessed. Changes in the performance of 10MWT, 6MWT, and TUG tests indicated improved adaptation and tolerance of the respiratory and cardiovascular systems to exercise, as well as normalization of blood pressure, heart rate, and SpO2. Conclusions. Physical exercises, according to the developed program of physical therapy, improve the general physical condition of patients, increase their functional capabilities, improve indicators of cardiovascular and respiratory system and have a positive effect on life quality. The study confirmed the importance of physical therapy in the recovery of patients with acute myocardial infarction after stenting.

Keywords:
myocardial infarction, physical therapy, cardiac rehabilitation