Disability Models - Therapeutic Exercises 1 - جامعة بلاد الرافدين

‫جامعة بالد الرافدين\كلية التقنيات الطبية والصحية\قسم تقنيات العالج الطبيعي‬ ‫‪therapeutic exercises1‬‬ ‫المرحلة الثانية‬ ‫‪Disability models‬‬ ‫م‪.‬م‪.‬عباس فاضل طاهر‬ ‫‪MSc. Physiotherapy‬‬...

‫جامعة بالد الرافدين\كلية التقنيات الطبية والصحية\قسم تقنيات العالج الطبيعي‬ ‫‪therapeutic exercises1‬‬ ‫المرحلة الثانية‬ ‫‪Disability models‬‬ ‫م‪.‬م‪.‬عباس فاضل طاهر‬ ‫‪MSc. Physiotherapy‬‬ ‫استاذ مادة التمارين العالجية‪1‬‬ 1. DISABLEMENT Definition: “ It is a term that refers to the impact(s) and functional consequences of acute or chronic conditions, such as disease, injury, and congenital or developmental abnormalities, on specific body systems that compromise basic human performance and an individual’s ability to meet necessary, customary, expected, and desired societal functions and roles.” 2. THE DISABLEMENT PROCESS 1. The process is not unidirectional (it is not necessarily unpreventable or irreversible). 2. It is assumed that in most instances, it depends on factors such as the severity and duration of the pathological condition. 3. Also depends on the motivation and desires of the patient. 3. MODELS OF DISABLEMENT 1. NAGI MODEL 2. THE INTERNATIONAL CLASSIFICATION OF IMPAIRMENTS, DISABILITIES, AND HANDICAPS (ICIDH) MODEL 3. INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY, AND HEALTH (ICF) MODEL NAGI MODEL Tissue/ Active pathology Cellular Level Organ/ Impairment System Level Personal Functional Level limitation Societal Disability Level THE INTERNATIONAL CLASSIFICATION OF IMPAIRMENTS, DISABILITIES, AND HANDICAPS (ICIDH) MODEL Tissue/Cellular Disease Level Organ/System Impairment Level Personal Level Disability Societal Level Handicap INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY, AND HEALTH (ICF) MODEL Tissue/Cellular --------- Level Organ/System Impairment of Level body structure/function Personal Level Activity limitation Societal Level Participation 4. COMPARISON OF TERMINOLOGY OF THREE DISABLEMENT MODELS  INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY, AND HEALTH (ICF) MODEL The ICF model consists of the following components of health and health-related influences: 1. Impairment of body structure (anatomical) and function (physiological). 2. Activity limitation. 3. Participation restriction. 4. Impact of contextual factors (environmental and personal) on functioning, disability, and health 5. USE OF DISABLEMENT MODELS AND CLASSIFICATIONS IN PHYSICAL THERAPY 1. Provided an appropriate framework for clinical decision making in practice and research. 2. To standardize terminology for documentation and communication. 3. Can help to prevented, eliminated, or reduced the risk of occurrence or severity of pathology, impairment, or functional limitation. 4. Shows the effective interventions, in particular therapeutic exercise. 6. IMPACT OF THERAPEUTIC EXERCISE ON THE DISABLEMENT PROCESS Pathology/Pathophysiology: refers to disruptions of the body’s homeostasis as the result of acute or chronic diseases, disorders, or conditions characterized by a set of abnormal findings (clusters of signs and symptoms). Impairments: they are the consequences of pathological conditions; that is, they are the signs and symptoms that reflect abnormalities at the body system, organ, or tissue level. They can be (direct/primary impairments)or(indirect/secondary impairments). The combination of primary or secondary impairments, the term composite impairment is sometimes used. Functional Limitations: occur at the level of the whole person. The term now used by the WHO to denote functional limitation is “ability limitation,” as defined in the ICF model of functioning and disability. Disability: is the inability to perform or participate in activities or tasks. Prevention: reduction of the severity or duration of existing disease.   7. COMMON PHYSICAL IMPAIRMENTS MANAGED WITH THERAPEUTIC EXERCISE Musculoskeletal Neuromuscular Pain Pain Muscle weakness/reduced torque production Impaired balance, postural stability, or Decreased muscular endurance control Limited range of motion due to Incoordination, faulty timing Restriction of the joint capsule Restriction of periarticular Delayed motor development connective tissue Decreased muscle length Abnormal tone (hypotonia, hypertonia, Joint hypermobility dystonia) Faulty posture Ineffective/inefficient functional Muscle length/strength imbalances movement strategies  Cardiovascular/Pulmonary Integumentary Decreased aerobic Skin hypomobility capacity (e.g., immobile or (cardiopulmonary adherent scarring) endurance) Impaired circulation (lymphatic, venous, arterial) Pain with sustained physical activity (intermittent claudication)