44 terms

M&A 2: The Disablement Process

Dr. Riddle's Measurement and Assessment Class Spring 2009 VCU DPT Class of 2011
Three Main Models of Disablement
Nagi Model, WHO Model (ICF), National Center for Medical Rehabilitation Research
APTA endorses this model of disablement
The WHO's International Classification of Functioning, Disability and Health (ICF)
The Nagi models serves as the basis for...
most other models, including ICF and the Guide for Physical Therapist Practice
in opposition to the MD, who Diagnoses, treats and prevents disease (Pathology), the PT
Diagnoses, Treats and prevents CONSEQUENCES of disease
disease is the same thing as
pathology or condition
The impact of acute and chronic conditions on the functioning of specific body systems , on basic human performance, and on people's functioning in expected roles in society is Verbrugge and Jette's definition of
The disablement process
interruption of normal cellular processes and the efforts of the affected systems to regain homostasis
losses or abnormalities in physiologic, psychologic or anatomical structure or function
functional limitation
a restriction in the ability to perform, at the level of the whole person, a physical activity in an efficient, typically expected or competent manner
inability to perform or a limitation in the performance of actions, tasks, activities, usually expected in specific roles that are customary for the individual or expected for a person's status or role in a specific sociocultural context and physical environment
4 parts of the Nagi Model
pathology, impairment, functional limitations, disability
4 parts of the ICF disablement process
Health Condition, Impairment, Activity limitation, Participation restriction
Health Condition, in short, according to the ICF
is the medical diagnosis
___ is more informative than knowing the Health Condition to a PT
The impairment
Examples of impairment include
Reduced PROM/AROM, reduced muscle force, pain, swelling, anatomically short lower limb, excessive anterior glide of gh jt
Impairment means deviation from..
generally accepted population standards and can be temporary or permanent
Activity limitation is (according to V+Jette)
limitation in performing fundamental physical and mental actions typically used in daily life by one's age/gender group
ANother way of phrasing activity limitation
whole body action limitations
Activity limitations include those that would affect
altered gait, sleep, climbing stairs, watching TV... SIMPLE THINGS
Altered ability to sit, stand, or push is an example of a(n)
Activity limitation
Participation restriction is defined as a problem...
an individual may experience in involvement in life situations
A Participation restriction is ___ in comparison to an activity limitation
More complex, i.e. ability to exercise/drive to the grocery store
Basic ADLs fall under...
Activity limitation
Instrumented ADLs fall under this category
Participation restrictions
Altered ability to prepare meals is an example of...
A Participation restriction
Active pathology results in ____
Not all impairments originate in
Limits in social or occupational activities
are Participation Restrictions
in the ICF all arrows
go in both directions
Consider ___ and ___ when understanding why person is disabled
- impairments and activity limitations AND person's social circumstances
Considering disability, reflect on these three things
- person's reaction, - others' perception/sick role expectations, Environment characteristics
The disablement process is not
Most important to considering disability level is...
risk factors that can affect the presence and severity of impairment, functional limitation and disability
Muscle paralysis is an example of a(n)...
decreased spinal motion is an example of...
an impairment
being unable to reach without pain is an example of
Activity limitation
increased anterior glide (with pain, decreased motion) of GH joint is example of
Loss of job due to diagnosis?
Participation restriction
unable to stand for prolonged periods of time is example of:
participation restriction
unable to run without pain is example of
activity limit
PT's least common domain in which to intervene:
Participation restriction
MDs most commonly intervene in this domain
health condition
we spend most of the time in examination assessing relevant ____
Treatment of impairments may not:
carry over to improvements in functional limitations and disabilities