Medico-biological substantiation of readaptation models for functional reserves of military personnel in the post-rehabilitation period: a systematic review

Abstract

Abstract: Objective. The work is dedicated to the biomedical rationale of an integrated military readaptation model based on the objective monitoring of functional reserves. The primary focus is on developing algorithms for managing the process of restoring combat readiness in the post-rehabilitation period, allowing for the elimination of the gap between the completion of clinical treatment and the commencement of active duty. Methods. The study is based on a systematic analysis of scientific publications from 2019–2025 in Scopus, Web of Science, and Google Scholar databases. A retrospective comparison of methods with 2007 approaches was conducted. Mathematical modeling of VO2max indicators and heart rate variability (HRV/RMSSD) analysis were applied. The results of implementing HIFT training and proprietary rehabilitation techniques for injuries were synthesized. Results. During the study, the phenomenon of "post-rehabilitation failure" was identified as a state of critically low functional reserves following formal clinical recovery. Parameters of the loss of bodily resources due to hospital-induced inactivity were systematized: it was established that the "detraining" effect leads to a decrease in aerobic power (VO2max) by 15–18% as early as the 4th week, accompanied by a shift in the anaerobic threshold by 15% and the early development of metabolic acidosis. The authors' three-stage readaptation model was formed: 1) vagal restitution (normalization of the n. vagus through breathing techniques and isometry to stabilize autonomic tone); 2) functional activation (restoration of the skeletal muscle mitochondrial apparatus through HRV-controlled low-intensity interval HIIT loads); 3) specific professional adaptation (transfer of physical conditions into combat effectiveness through high-intensity functional training HIFT in full gear). Conclusions. It is substantiated that readaptation must be a continuous process managed by objective physiological markers. The implementation of the proposed model allows for the objectification of personnel readiness for task performance according to target indicators, minimizing the risks of re-injury and decompensation under conditions of prolonged combat distress. The transition from passive observation to active controlled recovery is strategically important for maintaining the combat effectiveness of the Armed Forces of Ukraine.