Disability and Rehabilitation Overview

Introduction

• Age is a risk factor for disabilities.
• Rehabilitation aims to maximize independence and enable participation.
• Movement requires cognitive, sensory, and motor functions.
• Cognitive impairments include stroke, dementia, and Parkinson's.
• Sensory impairments include blindness, deafness, and spinal cord injury.
• Motor impairments include stroke, multiple sclerosis, and spinal cord injury.
• Impairments can be permanent or degenerative, congenital or acquired.
• Injuries lasting more than 6 months are classified as disabilities.

Disability Phases

• Acute: First month after injury.
• Subacute: 1-3 months after injury.
• Chronic: More than 3 months after injury (classified as a disability).

Types of Impairment

• Paresis: Weakness or partial loss of voluntary muscle movement, often in limbs.
• Paralysis: Complete loss of voluntary muscle movement.
• Incidence: New cases per population within a given time period.
• Prevalence: Total number of existing cases within a given population.
• Aetiology of amputations: Vascular disease, diabetes, trauma, tumors, infections.
• Causes of spinal cord injuries: Accidents, falls, violence, sports.
• Stroke: Ischemic (80%) or hemorrhagic (20%) types, leading to hemiplegia/hemiparesis and neglect.
• Traumatic brain injury: External force to the skull or penetrating objects causing physical, cognitive, and emotional effects
• Parkinson's disease: Neurodegenerative disorder causing bradykinesia, hypokinesia, tremor, and problems with balance and reflexes, affecting mood and pain.

Definitions

• Structures: Body parts like limbs and organs.
• Functions: Physiological processes of a structure.
• Activity: Performing a task
• Participation: Engaging in life situations

Personal, Environmental, and Impairment Factors

• Personal factors: Motivation and self-esteem.
• Environmental factors: Attitudes, relationships, and policies.
• Impairment: Body function problems.
• Activity limitation: Impeded activity due to disability (e.g., blindness impedes reading)
• Participation restriction: Inability to participate in various life situations due to disability.
• Disability: Lack of ability to perform an activity or participate in a life situation due to an impairment.
• Handicap: Disadvantage arising from disability that impacts role fulfillment

Multiple Sclerosis

• Autoimmune reaction against myelin, impacting ataxia, spasticity, vision, and speech.

Cerebral Palsy

• Brain lesions during or after birth, causing motor dysfunction, spasticity, and cognitive deficits.

Muscular Dystrophy

• Genetic condition resulting in muscle weakness and breakdown.

Rehabilitation

• Improves impaired body functions.
• Reduces disability effects of diseases.
• Increases participation in daily life.
• Rehabilitation team involves physicians, therapists, and other specialists.
• Rehabilitation medicine covers diagnosis, treatment, and rehabilitation.

Therapeutic Techniques

• Cardiovascular exercises (to improve endurance).
• Strength training (major muscle groups).
• Flexibility exercises (injuries).
• Neurofacilitation (e.g., spinal manipulative therapy for central nervous system problems).
• Integrative training therapies (e.g., meditation, yoga, pilates).

Assistive Devices

• Prosthetics: Replace lost functions.
• Orthotics: Support weakened functions.
• Substitution: Replace functions with other means.
• Assistive technology: Devices for maintaining functional capabilities.

Social Inclusion

• Different models of disability: individual, social, human rights.
• Includes accessibility, freedom of choice, and participation.
• Goal of the UN Convention on the Rights of Persons with Disabilities is to enhance accessibility, choice, and participation.

Global Access to Assistive Technology

• WHO focuses on advancing universal health coverage.
• Assistive technology encompasses various tools to aid people with disabilities.

Prevention of Disease and Injury

• Health promotion: Encouraging healthy choices and lifestyles.
• Primary prevention: Avoiding the appearance of disease or injury (vaccinations, smoking bans).
• Secondary prevention: Preventing disease or injury from worsening (cancer screening).
• Tertiary prevention: Minimizing long-term damages and relapses (rehabilitation).

Types of Health Insurance in Switzerland

• Health insurance in Switzerland is universal and mandatory but not free.
• Private but state-approved health insurers.
• Basic (OKP) and supplementary insurance.

Accident Insurance in Switzerland

• Employer covers occupational and non-occupational work-related accidents
• Different legal definitions and coverage levels for accidents and illnesses.
• Insurance covers medical costs, daily allowance, and invalidity pension payments in eligible conditions.

Global Access to Assistive Technology

• WHO advances universal health coverage globally.
• Assistive technology provides resources to people with disabilities, encompassing communication, cognition, vision, mobility, and self-care.