Humanitarian Military Journal

The article presents a methodological development of an algorithm for evidence generation and verification of the results of pedagogical research conducted within the system of military professional education. The proposed algorithm addresses typical threats to the internal and external validity of the study and ensures the reproducibility and transparency of conclusions. The algorithm is based on the systemic logic of conducting an experiment: from defining the objective and constructing a logical model to operationalizing criteria and indicators, selecting an appropriate research design, and controlling for initial group comparability; to assessing the reliability and validity of measurements, describing the completeness and accuracy of the implementation of the pedagogical technology; and to controlling for factors that could distort the research results. For each level of verification (conceptual, procedural, outcome-based , and causal), procedures are provided for eliminating typical interpretation errors. The final conclusion is formed through the alignment of pedagogical, psychological, and morphological-physiological domains of evidence. The proposed algorithm has practical value for military professional education, as it integrates educational, psychological, and physiological indicators into a unified assessment system and enables the transfer of the obtained results into professional practice. The theoretical significance of the study lies in clarifying the methodological foundations of evidence in applied pedagogical research and in developing a universal framework that ensures the comparability of the results of different experiments. Thus, the developed algorithm standardizes the procedure for verifying a pedagogical experiment, raises the level of evidence , and can be adapted to various areas of professional education.

BACKGROUND: The current regulatory framework of the Russian Federation requires educational organizations to provide first aid capabilities and staff training; however, students' actual emergency readiness is heterogeneous. A major methodological gap is the lack of clear organizational and pedagogical conditions that link regulatory requirements, training content, practical skill rehearsal, and objective readiness assessment.

AIM: To assess differences in aggregated self-reported knowledge, skills, and behavioral readiness to provide first aid in schoolchildren, university students, cadets/students of military educational organizations, and military personnel with special military operation experience, and to identify organizational and pedagogical conditions for improving first aid training.

METHODS: A pilot cross-sectional survey was conducted using a 20-item Likert-scale questionnaire developed by the authors. Descriptive analysis included aggregated data from 169 respondents: schoolchildren (n = 41), university students (n = 37), cadets/students of military educational organizations (n = 59), and military personnel participating in a special military operation (n = 32). The primary outcome was an integrated self-assessment score for first aid knowledge and skills on a 1–5 scale. Additional outcomes were self-assessed skill proficiency and readiness to provide first aid on a 0%–100% scale. To address methodological risks noted during peer review, the revised version separately describes the calculation algorithm, the limitations of aggregated data, the absence of hypothesis testing, and the requirement for subsequent validation of the primary dataset.

RESULTS: The mean integrated score was 1.36 in schoolchildren, 1.65 in university students, 3.03 in cadets/students of military educational organizations, and 4.18 in military personnel participating in a special military operation. The lowest aggregated values were found in civilian educational groups and the highest in military personnel. The data reflect self-assessment differences but do not prove causality, since individual responses, variability measures, and information on group comparability were unavailable. Additional self-assessed skill proficiency and readiness remained moderate in all groups.

CONCLUSION: The pilot data indicate a need to shift from information-based first aid education toward a standardized practice-oriented model featuring simulation scenarios, regular skill renewal, and objective certification at all educational levels.

In adapted physical activity, outcome assessment is often reduced to muscle strength, endurance, range of motion, and isolated motor tests, which does not fully capture activity, participation , and environmental influences. Based on an analysis of current Russian and international publications, this work aimed to substantiate the applicability of the International Classification of Functioning, Disability and Health (ICF) to assessing the rehabilitation effect of adapted physical activity, and to develop a practice-oriented assessment algorithm. The study used theoretical analysis, comparative review of published studies, modeling, and content analysis of official World Health Organization documents. Methodological papers, systematic reviews, and empirical studies published from 2001 to 2025 were analyzed. The review showed that the ICF provides a universal biopsychosocial language for describing functioning, links adapted physical activity outcomes to body functions and structures , activity and participation , and environmental factors, and makes the assessment of rehabilitation effects clinically and socially meaningful. At the same time, studies of physical exercise and adapted motor activity still tend to overemphasize impairments, whereas participation and environmental factors remain underrepresented. The paper proposes an original algorithm based on a brief target ICF profile, baseline and follow-up qualifiers, a combination of objective tests and patient-reported measures, and a two-component rule for interpreting results. The ICF is methodologically productive for evaluating the rehabilitation effect of adapted physical activity provided that it is used not as a standalone scale but as a framework integrating rehabilitation diagnosis, goal setting, measurement tools, and final judgment.

BACKGROUND: The relevance of this study stems from the growing number of military personnel with mine-blast and shrapnel-induced traumatic brain injuries (TBI) . The consequences of such injuries include a complex of cognitive, motor, and psychoemotional impairments, and traditional treatment is complicated by rapid attention fatigue and low ecological validity of office-based training. This article presents a clinical and instrumental study of the efficacy of integrating virtual (VR) and augmented (AR) reality technologies into combatant rehabilitation. A specialized VR scenario system adapted to patients' cognitive profiles was developed and clinically tested. A key feature of the system is an algorithm for dynamic adjustment of environment complexity based on continuous biometric monitoring.

AIM: To evaluate the clinical and neurobiological efficacy of adaptive VR/AR technologies in restoring cognitive and locomotor functions in military personnel with TBI sequelae.

METHODS: A 6-week neurorehabilitation course was tested in a single-blind, randomized, controlled trial (n = 86). The primary endpoints were changes on the Montreal Cognitive Assessment (MoCA) and the Trail Making Test Part B (TMT-B). Secondary endpoints included balance (Berg Balance Scale, BBS) and functional magnetic resonance imaging (fMRI) data.

RESULTS: Adaptive VR therapy resulted in statistically significant improvements in executive functions (a 37% reduction in TMT-B completion time, p <  0.001, Cohen’s d = 1.32) and spatial coordination (BBS, p <  0.001, d = 1.25). Resting-state fMRI showed increased BOLD signal and enhanced functional connectivity in the dorsolateral prefrontal cortex and hippocampus (p_FWE <  0.05).

CONCLUSION: This methodology shows high potential for personalized neurorehabilitation, improving treatment adherence in military personnel. Further multicenter studies are required to confirm long-term effects.

Modern armed conflicts are leading to an increase in the number of service members with limb amputations, necessitating new approaches to rehabilitation and prosthetics. The choice of prosthesis type is based on motor activity criteria. Selecting the prosthesis type according to objective motor activity criteria is a key factor in successful patient reintegration. This review examines current approaches to limb prosthetics in service members with amputations through a comprehensive analysis of the relationship between the amputation level and the physical activity coefficient (K-level). A retrospective analysis of scientific studies on combat-related limb amputations was performed. The search was conducted in the PubMed database. The search period was 24 years (2000–2024). The search strategy included the keywords combat amputation, traumatic amputation, K-level amputation, and prosthetic rehabilitation. Inclusion criteria were studies with quantitative data on amputation level distribution, publications assessing functional outcomes (including K-levels), and studies describing rehabilitation outcomes in service members. According to an analysis of 1705 U.S. service members with amputations (2001–2017), transtibial amputations predominated among lower limb amputations (65.4%), transfemoral amputations comprised 26.5%. Among upper limb amputations, finger amputations predominated (59.6%), transradial comprised 23.2%. The METALS study (n = 161) showed that only 24.4% of patients after transfemoral amputation achieved K4 level, compared with 73.6% for limb salvage. Long-term outcomes (12.2 years of follow-up) showed that amputees were significantly more likely to use mobility devices (38.9% vs 6.3%, p <  0.01). The prosthetic strategy should be based on objective K-level assessment. Transtibial amputations offer the greatest rehabilitation potential. Transfemoral amputations and bilateral injuries require high-tech prosthetic systems and individualized rehabilitation programs. The military context calls for specialized prosthetic rehabilitation protocols.

The article examines the epistemological and existential status of psychiatric diagnosis in the context of contradictions between nosological (classificatory) and phenomenological approaches. It is shown that the dominance of evidence-based medicine and the focus on operational criteria of the ICD and DSM, despite all their advantages, lead to a reduction of the patient’s subjective world and the risk of turning the diagnosis into a “self-fulfilling prophecy.” This work aimed to present an existential-phenomenological perspective in which diagnosis is understood not as a static label but as a dynamic structure of “being-in-the-world,” setting the boundaries of existence while simultaneously opening a field for personal freedom and responsibility. Drawing on the ideas of K. Jaspers, M. Heidegger, A. Längle, L. Binswanger, and R. D. Laing, the authors substantiate the necessity of transitioning from “explanation” to “understanding” in therapeutic practice. Special attention is paid to contemporary discussions on the boundaries of normality and pathology, as well as to the critique of the reification of diagnosis. An original model of three phases of acceptance and integration of diagnosis into identity is proposed: confrontation, identification, and integration. It is concluded that genuine therapeutic work consists in helping the patient to acquire the ability to be the author of their own life within the objective constraints imposed by the illness, transforming the diagnosis from a “cage” into a “fulcrum.”