PHTY2030 - Week 1 Exam Study
Guide
Models of Disability - ANSWER "Evaluation and treatment models based on specific
impairment, functional loss and attainable quality of life rather than a medical diagnosis"
Jette 2005
E.g. International Classification of Functioning (ICF)
Elaboration of Disablement Model - ANSWER Pathology impairments have functional
limitations which is related to Disability Behaviour. The factors that affect it are the
Physical and Social Environment,
Demographic Background and Behavioural/Psychological Risk Factors
International Classification of Functioning - ANSWER WHO's codes help to standardize
concepts and terminology across the globe (ICD -10 codes)
In clinical settings ICF is used for functional status assessment, goal setting, treatment
planning and outcome measurement
At the international level ICF is used to guide disability management
Implications for Rehabilitation - ANSWER Patient centred focus for planning intervention
Need for evidence to be linked to movement skills rather than disease categories
The outcome of therapy is the development of skill → was the goal achieved
consistently, efficiently and with flexibility?
What is Rehabilitation - ANSWER "The restoration of the handicapped (disability) to the
fullest physical, mental, social, vocational and economic usefulness of which they are
capable" Kumar 2000
Discourage the use of "handicapped"
What is the Rehab Process - ANSWER To restore lost abilities as much as possible
To prevent related complications
To improve the patient's quality of life
To educate the family and patient about prevention
To promote reintegration into family, home, work, leisure and community activities
Rehab Settings - ANSWER Inpatient/Acute/Specialized wards
, Rehab Unit within general hospital
Transitional care
Outpatients/ Day Hospital/Private Practice
Community health
Understand the concept of impairment, disability and handicap (participation) in
neurological rehabilitation. - ANSWER Impairment
Reference is on the function of tissues, organs and body systems
e.g. Measuring ROM (if it is reduced)
Function
Focus is on the capacity of the person to perform basic tasks or actions - performance
of the whole person
e.g. Motor Assessment Scale
Participation
Limitation in performance in defined roles and tasks within a socio/cultural and physical
environment
e.g. has to use wheelchair, can't do to wheelchair friendly places
Problem List e.g. - ANSWER Impairments - G3 UL power distal to elbow
Functions - Feeding, Dressing
Participation - Shopping, Caring for Children
Understand the process and the physio role in neurological rehabilitation. - Levels of
intervention - ANSWER Remedy the cause of the person's disability by restoring the
ability = restoration
Compensate for the disability by enhancing other characteristics of the person =
compensation (e.g. If patient has weak Tib Ant and has foot drop in their gait, increase
hip and knee flexion to compensate)
Change the environmental circumstances so that the impact of the disability is negated
= adaptation (e.g. put an ankle brace to prevent a foot drop in the gait)
Usually incorporate all 3 approaches
Most measures of function do not distinguish between them
Compensatory strategies may limit recovery (Roby-Brami, 2003)
Guide
Models of Disability - ANSWER "Evaluation and treatment models based on specific
impairment, functional loss and attainable quality of life rather than a medical diagnosis"
Jette 2005
E.g. International Classification of Functioning (ICF)
Elaboration of Disablement Model - ANSWER Pathology impairments have functional
limitations which is related to Disability Behaviour. The factors that affect it are the
Physical and Social Environment,
Demographic Background and Behavioural/Psychological Risk Factors
International Classification of Functioning - ANSWER WHO's codes help to standardize
concepts and terminology across the globe (ICD -10 codes)
In clinical settings ICF is used for functional status assessment, goal setting, treatment
planning and outcome measurement
At the international level ICF is used to guide disability management
Implications for Rehabilitation - ANSWER Patient centred focus for planning intervention
Need for evidence to be linked to movement skills rather than disease categories
The outcome of therapy is the development of skill → was the goal achieved
consistently, efficiently and with flexibility?
What is Rehabilitation - ANSWER "The restoration of the handicapped (disability) to the
fullest physical, mental, social, vocational and economic usefulness of which they are
capable" Kumar 2000
Discourage the use of "handicapped"
What is the Rehab Process - ANSWER To restore lost abilities as much as possible
To prevent related complications
To improve the patient's quality of life
To educate the family and patient about prevention
To promote reintegration into family, home, work, leisure and community activities
Rehab Settings - ANSWER Inpatient/Acute/Specialized wards
, Rehab Unit within general hospital
Transitional care
Outpatients/ Day Hospital/Private Practice
Community health
Understand the concept of impairment, disability and handicap (participation) in
neurological rehabilitation. - ANSWER Impairment
Reference is on the function of tissues, organs and body systems
e.g. Measuring ROM (if it is reduced)
Function
Focus is on the capacity of the person to perform basic tasks or actions - performance
of the whole person
e.g. Motor Assessment Scale
Participation
Limitation in performance in defined roles and tasks within a socio/cultural and physical
environment
e.g. has to use wheelchair, can't do to wheelchair friendly places
Problem List e.g. - ANSWER Impairments - G3 UL power distal to elbow
Functions - Feeding, Dressing
Participation - Shopping, Caring for Children
Understand the process and the physio role in neurological rehabilitation. - Levels of
intervention - ANSWER Remedy the cause of the person's disability by restoring the
ability = restoration
Compensate for the disability by enhancing other characteristics of the person =
compensation (e.g. If patient has weak Tib Ant and has foot drop in their gait, increase
hip and knee flexion to compensate)
Change the environmental circumstances so that the impact of the disability is negated
= adaptation (e.g. put an ankle brace to prevent a foot drop in the gait)
Usually incorporate all 3 approaches
Most measures of function do not distinguish between them
Compensatory strategies may limit recovery (Roby-Brami, 2003)
