Recovery from severe injuries or illnesses requires a comprehensive approach and the involvement of specialists from various fields. Modern rehabilitation focuses on helping people regain maximum independence in daily life, mobility, and social activity. Anastasia Boichuk, head of the trauma rehabilitation initiative for Ukraine at the patient organization “Patients of Ukraine,” explains the specifics of how multidisciplinary teams work in an interview for the podcast “120 Beats Per Minute.” They focus on restoring lost bodily functions and helping patients adapt to new living conditions, moving away from outdated Soviet practices of sanatorium treatment.
Focus on functionality rather than diagnosis
A medical diagnosis serves solely as a basis for understanding the patient’s clinical condition. Rehabilitation teams focus primarily on a person’s functional abilities and develop a recovery prognosis together with the patient. A person with a spinal cord injury learns skills such as using a wheelchair, moving independently, and preparing meals in specially equipped wards. Stroke patients practice sitting, standing, maintaining balance, and walking. Anastasia Boichuk explains this approach as follows:
“The task of rehabilitation specialists is to move beyond simply focusing on the diagnosis and instead seek solutions for what needs to be done so that a person can go to the bathroom or move around independently.”
A Multidisciplinary Approach and the Disappearance of Massage Therapists
Global practices completely exclude massage therapists from rehabilitation teams. The expert emphasizes this point:
“If you look at the guidelines and documents from developed countries, you won’t find massage therapists listed there.”
The process is led by a physician of physical and rehabilitation medicine, who assesses the patient’s condition and identifies contraindications to physical exertion. A physical therapist works on mobility, balance, and gait restoration. An occupational therapist helps restore the ability to perform self-care tasks by teaching patients how to wash, dress, and use specially selected daily living aids. A speech-language pathologist addresses swallowing disorders, speech comprehension difficulties, and stuttering, which often arise following blast or traumatic brain injuries. Boichuk notes the high effectiveness of these specialists:
“They can actually correct a stuttering problem if addressed quickly, within 10 therapy sessions.”
Read also:
Free medicines and access to medicines in Ukraine at public expense: myth or reality
Government Funding and Myths About Prosthetics Abroad
Patients who have undergone amputations require high-quality prosthetic devices and training on how to use them. The government program guarantees reimbursement for the cost of prosthetics. According to the initiative’s director, the program allows for reimbursement of up to four million hryvnias per limb for military personnel. Prosthetics companies are required to manufacture the device and train the person to use it. Anastasia advises undergoing this process closer to home, as the prosthesis requires regular maintenance to accommodate physiological changes in the stump during the first year. The expert considers traveling abroad for prosthetics to be impractical:
“There’s no point in going abroad for prosthetics. In countries where there is no war, they fit basic prostheses designed for people with diabetes. Their functionality is significantly lower than the needs of young, active people.”
Early Intervention and Integration into Multidisciplinary Hospitals
Highly specialized rehabilitation care should be provided where the patient receives primary treatment, through integration into multidisciplinary hospitals. Maximum effectiveness is achieved when the process begins early, even in the intensive care unit. Physical therapists begin to help patients stand up just a few hours after complex surgeries. Boichuk cites an example of the successful integration of this approach:
“The average length of stay in the ICU, after early rehabilitation was introduced, decreased from 7–8 days to 3–4 days.”
Creating isolated rehabilitation centers outside the city is considered a less effective path for developing the system compared to strengthening the capabilities of existing medical facilities.
Financial Challenges of the Inpatient Phase
The current system faces serious challenges due to the fact that financial support for military personnel is tied to their stay in the hospital. Servicemembers try to stay in hospitals longer to maintain high payments, ignoring the need to transition to the outpatient phase. This situation overloads the system, limits access to care for new patients, and creates artificial queues in healthcare facilities. Anastasia Boichuk sees the root of the problem in flawed state support mechanisms:
“We are addressing the wrong problem with the wrong solution. We simply need to provide financial support after an injury for the recovery period, regardless of whether the soldier is in the hospital or not.”
System Sustainability Through Specialists and Systemic Changes
The quality of patient recovery depends directly on well-designed government policies and the development of medical personnel capacity. Scaling up infrastructure takes a back seat to the urgent need to train qualified rehabilitation specialists capable of handling the most complex cases. The successful reintegration of veterans and civilians following severe injuries requires a reevaluation of support approaches at all stages of treatment. Shifting the focus from hospital bed occupancy to ensuring continuous patient care from the intensive care unit to the home environment will enable the creation of an effective healthcare model capable of rapidly adapting to current challenges and the real needs of society.
Read also:
A Steel Touch Restores Movement: How Ukrainians Are Creating Affordable Finger Prosthetics
