Understanding Impairment and Disability

Objectives

• Define impairment
• Identify disability
• Recognize causes of disability
• Define classification of disability
• Define handicap

Introduction

• Disabled people represent a significant social problem.
• Rehabilitation is the best form of assistance for disabled people.
• Comprehensive rehabilitation is crucial; meeting all the needs of the disabled person during the process.
• Man is a complex being with physical, psychological, and social dimensions.

Impairment

• Impairment is a loss or abnormality in psychological, physiological, or anatomical structure.
• Impairments of organs or functions can result in disability.
• Impairment involves abnormalities in body structure, appearance, or organ/system functioning, no matter the cause.
• Examples of impairments include blindness, deafness, limb amputation, etc.

Disability

• Disability is a restriction or lack of ability to perform a normal daily life activity due to impairment.
• Disability refers to the functional consequence of impairment and it limits the ability to perform daily life activities.

Handicap

• A handicap is a social concept.
• It is a disadvantage resulting from impairment or disability, hindering interaction with the environment.
• Examples include being homebound, unable to use public transport, and social isolation.
• Impairment is NOT the same as disability or handicap.

Simple Explanations

• Impairment is a problem with a body structure/organ.
• Disability is a limitation regarding a particular activity.
• Handicap is a disadvantage in life roles.

Factors Influencing Disability

• Cognition
• Education
• Culture
• Psychological factors (gender, race, age)
• Physical environment
• Financial

Classifications of Disability

• Persistence:
  • Temporary: Lasting for a set time (e.g., temporary paralysis after a stroke).
  • Permanent: Not expected to change or go away (e.g., blindness, limb amputation).
• Time of Onset:
  • From birth: Due to hereditary or congenital factors, or injuries during labor.
  • Acquired: Occurs later in life due to diseases or injuries (accidents).
• Progression:
  • Progressive: Deteriorates and worsens (e.g., optic atrophy leading to blindness).
  • Regressive: Improves or recovers (e.g., regaining limb function after a stroke).

Causes of Disability

• Hereditary and congenital factors
• Diseases
• Malnutrition
• Injuries (traumas)
• Aging

Disability Prevention

• First Level: Preventing impairments (e.g., eradicating malnutrition, communicable diseases).
• Second Level: Limiting or reversing disability caused by impairment (e.g., adequate drug provision).
• Third Level: Preventing disability from becoming a handicap (e.g., rehabilitation, vocational and educational counseling).

First Level Prevention (Most Effective)

• Eradicate malnutrition
• Prevent communicable diseases
• Immunization against infectious diseases
• Extensive perinatal care
• Safe water and sanitation facilities
• Reduce accident rates

Second Level Prevention

• Adequate drug provision (leprosy, TB, ear infections, hypertension, diabetes)
• Essential surgeries (wounds, limb injuries, cataracts)
• Rehabilitation as early as possible in the course of disability
• Effective referral system to health centers

Third Level Prevention

• Rehabilitation
• Prostheses and orthopedic braces
• Glasses for vision impairment
• Hearing aids
• Vocational schools for disabled
• Education and improving economic status
• Speech therapy
• Job provision for disabled

Categories of Handicapped Persons

• Physically Handicapped:
  • Locomotor system impairment: (e.g., arthritis, fractures, muscle disorders)
  • Internal system (organ) disorders: (e.g., chronic internal diseases like asthma, high blood pressure)
• Sensorily Handicapped: (e.g., visually impaired, hearing impaired)
  • Visual impairment from cataracts, retinopathy (diabetic retinopathy)
  • Ear disease causing vertigo, falls, and immobility
• Mentally Handicapped:
  • Mentally retarded
  • Mentally ill persons
  • Epilepsy sufferers

Mental Retardation (MR) Causes

• Illness during childhood (42%)

• Head trauma in childhood (10%)

• Pregnancy and birth problems (3%)

• Heredity (2%)

• Unknown causes (23%)

• Limited abilities in perception, memory, decision-making, judgment, reasoning, and problem-solving.

• Usually experience slower mental processes and reduced learning abilities.

• Mental development is usually measured by IQ level.

• There is a wide range of IQs and related levels of care. These can be categorized as superior, above average, average, borderline, mild, moderate, severe, and profound.

Dementia

• Dementia is not a specific disease, but an overall term describing declines in memory, thinking skills, and language.
• The decline is severe enough to impact everyday tasks.
• Common types include Alzheimer's disease (60-80% prevalence) and vascular dementia.

Interventions in Dementia (Physiotherapy)

• Improve physical function (mobility, balance, coordination, strength).
• Reduce the risk of falls (improve judgment and spatial awareness).
• Improve mood, ease stress and add calm.
• Improve cardiovascular health.
• Provide a sense of accomplishment.
• Improve sleep.

Physiotherapy Role (Aerobic and Endurance)

• Recommend 30 minutes of cardio-respiratory endurance exercises daily (walking, cycling, swimming).
• Short, frequent exercise sessions are acceptable for those who tire easily.
• Improve the body's ability to deliver oxygen and nutrients; remove wastes.
• Increase exercise tolerance and ability to do everyday tasks.

Physiotherapy Role (Strength and Resistance)

• Recommend 10-15 repetitions of 8-10 exercises, 3 times a week.
• Use resistance bands or light weights.
• Improve lean muscle mass, metabolism, and blood sugar control.

Physiotherapy Role (Stretching and Flexibility)

• Stretching is essential for warming up and cooling down.
• Improve flexibility, prevent injuries, and reduce soreness/stiffness.

Physiotherapy Role (Balance Training)

• Improve confidence, reduce fall risk.
• Balance is position-specific, so train both sitting and standing.
• Improve coordination, sense of space, and environment awareness.
• Start with weight shifts (sitting and standing).

Physiotherapy Role (Gait Training)

• Improve mobility and function without support.
• Lengthen stride, broaden base of support (BOS).
• Improve stepping and heel-toe gait patterns.
• Increase contralateral (opposite side) movement and arm swing.
• Regular walking program.

Occupational Therapy

• Assists with changes to the environment to improve function and safety.
• Assess the home environment.
• Prevent access to potentially dangerous items or areas (basements, garages, sheds, kitchen, bathrooms).
• Lock doors and remove hazardous items.

Ensuring Safety Inside the Home

• Dementia sufferers may not rationalize safe/unsafe differences.
• Lock doors leading to dangerous areas.
• Remove electrical appliances from bathrooms/kitchens

Environmental Modifications

• Adding signs and labels (bathroom doors, drawers, etc.).
• Using color contrast in home decor (rugs, bedding, coverings).

Mentally Ill Persons (b)

• Differ from mentally retarded individuals.
• Severe mental illnesses (psychoses) cause emotional disturbances, behavioral abnormalities, and impaired daily functioning.
• Acquired later in life, sometimes episodic.

Mental Illnesses (Psychogenic)

• May be psychogenic (originating from psychological factors).
• May also be caused by organic changes to the brain.
• Common and serious psychoses: schizophrenia, manic depressive psychosis, paranoia.

Causes of MI (Mental Illness)

• Pregnancy and birth-related problems (46%)
• Unknown causes (36%)
• Illness during childhood (9%)

Epilepsy (III)

• Epilepsy is a nervous disorder with episodic brain functioning disturbances, potentially affecting mental function, particularly in later stages.
• The key feature is a sudden loss of consciousness, often associated with convulsions, altered sensations, and involuntary movements.

This quiz explores key concepts related to impairment, disability, and intelligence assessment. Participants will answer questions regarding definitions, characteristics, and examples of these terms, along with aspects of rehabilitation and intelligence testing. Test your understanding of how these topics interrelate in the context of health and psychology.