Musculoskeletal Health After Blast Injury

Rehabilitation after blast injury is critical for regaining mobility and functional independence. In addition to immediate rehabilitation goals to facilitate activities of daily living, rehabilitation should address movement patterns and prosthetic interventions that mitigate long-term secondary (musculoskeletal) conditions. For example, after limb loss, which is a common result of blast trauma, people experience disproportionately high rates of osteoarthritis and low back pain relative to the general population. These conditions often develop and/or deteriorate over time and can have detrimental effects on mobility and quality of life. In this chapter, we describe and summarise existing knowledge of these musculoskeletal conditions secondary to blast injuries that include limb loss. Relationships between movement strategies and biomechanical outcomes are also discussed. While many musculoskeletal health conditions are multifactorial in onset and progression, these conditions are strongly related to movement biomechanics, and thus can be mitigated through rehabilitation approaches. Specifically, rehabilitation strategies that balance immediate goals of clinical outcomes and community engagement with long-term goals of healthy joint mechanics are critical for this population. In addition, rehabilitation and prosthetic interventions should be continually monitored and delivered so that they appropriately account for movement adaptations and changing mobility needs of the individual.