It includes Introduction of ICF, Aims, Application of ICF, Principles of ICF, Component of ICF, ICF model, Ethical guidelines for use of ICF, Coding , Qualifiers, Case examples
This PPT is prepared for the basic understanding of third year physiotherapy students in the field of ICF. It describes the reasons for use of ICF, basic terminology and its meanings, relationship between different domains of ICF with relevant clinical examples.
International classification of functioning, disability and healthHetvi Shukla
The document provides an overview of the International Classification of Functioning, Disability and Health (ICF). It describes the ICF as a WHO framework for classifying health and health-related domains to establish a common language for disability. The ICF classification includes components on body functions, structures, activities, participation, and environmental/personal factors. The document outlines the development, aims, applications and coding guidelines of the ICF to provide a standardized system for assessing functioning and disability.
Mandatory to learn to classify various sorts of disabilities and dysfunctions occurring due to impairment and making physically handicapped either due to hampering in the physical functions.
A highly structured, goal-oriented, individualized intervention program designed to return the employee to work. Our Work Hardening programs are multidisciplinary in nature and utilize real or simulated work activities designed to restore physical, behavioral and vocational functions.
This presentation give an upto date insightful information on balance/postural assessment and key domains of Occupational Therapy during assessment of balance using different scales.
This document discusses rehabilitation, including definitions, models, approaches, and services. It defines rehabilitation as using medical, social, educational, and vocational measures to train individuals to their highest functional ability level. The main models discussed are biomedical, social, biopsychosocial, ICIDH, CBR, and HRQOL. Approaches include institution-based rehabilitation, community-based rehabilitation, homes, day care centers, outpatient clinics, and camp approaches. Current rehabilitation services in India are also outlined.
1. Geriatric rehabilitation aims to help the elderly regain independence by recovering physical, psychological, or social skills lost due to aging or disability.
2. The key principles of geriatric rehab are addressing the variability in aging, preventing the effects of inactivity, and maintaining optimal health.
3. Interventions include a variety of exercises, assistive devices, and environmental adaptations delivered through different settings and providers.
This PPT is prepared for the basic understanding of third year physiotherapy students in the field of ICF. It describes the reasons for use of ICF, basic terminology and its meanings, relationship between different domains of ICF with relevant clinical examples.
International classification of functioning, disability and healthHetvi Shukla
The document provides an overview of the International Classification of Functioning, Disability and Health (ICF). It describes the ICF as a WHO framework for classifying health and health-related domains to establish a common language for disability. The ICF classification includes components on body functions, structures, activities, participation, and environmental/personal factors. The document outlines the development, aims, applications and coding guidelines of the ICF to provide a standardized system for assessing functioning and disability.
Mandatory to learn to classify various sorts of disabilities and dysfunctions occurring due to impairment and making physically handicapped either due to hampering in the physical functions.
A highly structured, goal-oriented, individualized intervention program designed to return the employee to work. Our Work Hardening programs are multidisciplinary in nature and utilize real or simulated work activities designed to restore physical, behavioral and vocational functions.
This presentation give an upto date insightful information on balance/postural assessment and key domains of Occupational Therapy during assessment of balance using different scales.
This document discusses rehabilitation, including definitions, models, approaches, and services. It defines rehabilitation as using medical, social, educational, and vocational measures to train individuals to their highest functional ability level. The main models discussed are biomedical, social, biopsychosocial, ICIDH, CBR, and HRQOL. Approaches include institution-based rehabilitation, community-based rehabilitation, homes, day care centers, outpatient clinics, and camp approaches. Current rehabilitation services in India are also outlined.
1. Geriatric rehabilitation aims to help the elderly regain independence by recovering physical, psychological, or social skills lost due to aging or disability.
2. The key principles of geriatric rehab are addressing the variability in aging, preventing the effects of inactivity, and maintaining optimal health.
3. Interventions include a variety of exercises, assistive devices, and environmental adaptations delivered through different settings and providers.
This document discusses perceptual and cognitive dysfunction. It begins by defining perception as the process of integrating sensory stimuli into meaningful information. Cognition is defined as the act of knowing, including awareness, reasoning, judgment, intuition and memory.
The document then discusses assessment of perceptual and cognitive deficits. It notes that perception is positively correlated with ability to perform activities of daily living and is a prerequisite for learning and rehabilitation. Clinical indicators of perception deficits include functional loss unexplained by motor or sensory deficits and deficient comprehension. Assessment aims to determine intact and affected perceptual abilities and how task performance is affected by deficits.
For management, the document discusses five approaches: transfer of training, sensory integrative, neurodevelopmental, functional, and cognitive
The government plays several key roles in community-based rehabilitation (CBR) programs, including formulating policies, establishing administrative structures, mobilizing resources, promoting decentralization, providing training, building referral systems, and conducting monitoring and evaluation. Specifically, the government is responsible for setting up management structures to facilitate CBR; establishing committees to oversee programs; identifying and allocating funding, personnel, equipment and infrastructure; encouraging community participation through decentralization; training stakeholders; ensuring access to treatment, education, employment and legal services through referrals; and regularly assessing the progress and quality of all disability-related initiatives.
PROFESSIONAL ISSUES [INCLUDING ETHICS] IN PHYSIOTHERAPY SRSSreeraj S R
The document discusses the World Confederation for Physical Therapy (WCPT) and its role in establishing standards for the physical therapy profession worldwide. It outlines WCPT's objectives, executive committee, secretariat, subgroups, guidelines for practice, and ethical principles. It also discusses the need for a regulatory council in India to maintain standards and investigate complaints, and outlines the constitution and functions of the Indian Association of Physiotherapists, including its aims, objectives, membership types, and central executive council.
The document discusses several functional evaluation scales used in physical therapy assessments including the Functional Reach Test (FRT), Berg Balance Scale, Modified Ashworth Scale, Glasgow Coma Scale, and Timed Up and Go Test (TUG). It provides details on the objectives, methods, and scoring for each test.
CBR vs IBR-CBR subject. Download [15.00 KB]. Author Amisha Angle Posted on December 2, 2016. Leave a Reply Cancel reply.Community Based Rehabilitation: With CBR, the locus of control should be with the community.
Professional Practice and Ethics for PhysiotherapistsSreeraj S R
The document discusses professional practice and ethics for physiotherapists in India. It outlines key laws and regulations related to physiotherapy, including the Clinical Establishment Act, POSCO Act on child sexual abuse, rules on biomedical waste management, and laws on sexual harassment and consumer protection. The document also discusses ethical responsibilities of physiotherapists, principles of ethics in research and teaching, and important professional bodies like the World Physiotherapy organization.
COMMUNITY BASED REHABILITATION AND INSTITUTIONAL BASED REHABILITAIONNaveen K
This document compares and contrasts community-based rehabilitation (CBR) and institutional-based rehabilitation (IBR). CBR is defined as a strategy that enhances quality of life for disabled people through improved service delivery, equitable opportunities, and promotion of human rights. It is implemented through collaboration between organizations, communities, and disabled individuals. In contrast, IBR focuses on treatment within institutions and hospitals and can only reach a small population. Some key advantages of CBR include wide coverage, community empowerment, and sustainability, while disadvantages include lack of specialized training and unreliable community involvement.
The International Classification of Functioning, Disability and Health, provides a standard language and framework for classification of health and health-related domains
It throws light on certain points-
What changes in body function and structure have occurred in a person with a health condition?
What a person with a health condition can do in a standard environment -their level of function
What can be done to maximize function?
The document discusses functional capacity evaluations (FCEs), which objectively assess an individual's physical abilities and capacity to perform work. It describes the purpose of FCEs in determining work capacity and needed accommodations. The document outlines different types of FCEs and covers specific tests administered to evaluate areas like strength, mobility, balance and endurance. It notes limitations in the validity and reliability of most FCEs and areas that could be improved through further research.
This document discusses muscle energy technique (MET), a manual therapy procedure that involves voluntary muscle contraction against resistance applied by a therapist. It describes the types of muscle contractions involved - isotonic, eccentric, concentric, and isometric. MET uses post-isometric relaxation and reciprocal inhibition to facilitate muscle lengthening. Indications for MET include acute muscle spasm and restricted joints, while contraindications are acute injuries and unstable joints. Benefits of MET include restoring normal muscle tone, strengthening weak muscles, and improved joint mobility. Guidelines are provided for safely applying light contractions over multiple repetitions.
This document provides an overview of prosthetics and orthotics. It defines prosthetics as devices that replace missing body parts, while orthotics are devices that support or correct limb or torso function. Various materials are used for prosthetics and orthotics including metals, plastics, wood, leather, rubber and fabric. The document outlines the specifications and types of prosthetics and orthotics used for different parts of the body, such as the upper and lower limbs as well as the spine. It provides details on the components, suspension systems and various models of prosthetic knees, feet and orthotic devices.
Job simulations are employment tests that ask candidates to perform tasks that they would perform on the job. Applicants complete tasks that are similar to tasks they would complete when actually working in the position on a day to day basis
Understanding the various theories of motor control- reflex-hierarchal theory, ecological theory, dynamic systems theory and it's clinical application; also forming the basis of neurological rehabilitation techniques like Task-orient approach, Constraint induced movement therapy (CIMT), NDT (Neurodevelopmental Facilitation).
Physiotherapy management of perceptual disordersKeerthi Priya
This document discusses various perceptual disorders including their definitions, types, causes, tests used for assessment, and treatment approaches. It covers disorders related to body scheme and image like unilateral neglect. It also discusses agnosia, spatial relation disorders involving figure ground discrimination, form discrimination, and position in space. Other topics include topographic disorientation, depth and distance perception, and vertical disorientation. The document also summarizes visual, auditory and tactile agnosia as well as different types of apraxia such as ideomotor, ideational, and buccofacial apraxia. Remedial, compensatory, sensory integration and neurofunctional approaches are discussed as treatment options.
This document provides guidance on prescribing wheelchairs. It outlines the parts of a wheelchair, important considerations in evaluating patients, and goals of prescription. A proper evaluation involves medical history, physical exam, and functional assessment. Prescriptions are developed using tools like the SEAT checklist to address safety, comfort, and accommodation of needs over time. The goals of prescription include normalization of tone, improved function and mobility, and increased comfort and skin integrity.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
International classification of functioning, disability and health. sakshisadhu1
The International Classification of Functioning, Disability and Health (ICF) is a classification system developed by the World Health Organization to describe and organize information on functioning and disability. It provides a standardized language and framework for the description of health and health-related states. The ICF was approved by 191 WHO member states in 2001 and aims to serve as a scientific basis for understanding health and as a common language for communication between health professionals and policymakers. It classifies functioning and disability into four components: body functions and structures, activities and participation, and environmental and personal factors.
International Classification of Functioning, Disability, and Health (ICF) is a model approved by WHO in 2001 to like health with functioning and disability.
This power-point presentation contains all the relevant information regarding ICF and ICF model for third year physiotherapist students.
Hope it helps to whosoever refers these slides.
I hope this content helps you in understanding this condition. Thank You for sparing your precious time and going through this PowerPoint presentation.
This document discusses perceptual and cognitive dysfunction. It begins by defining perception as the process of integrating sensory stimuli into meaningful information. Cognition is defined as the act of knowing, including awareness, reasoning, judgment, intuition and memory.
The document then discusses assessment of perceptual and cognitive deficits. It notes that perception is positively correlated with ability to perform activities of daily living and is a prerequisite for learning and rehabilitation. Clinical indicators of perception deficits include functional loss unexplained by motor or sensory deficits and deficient comprehension. Assessment aims to determine intact and affected perceptual abilities and how task performance is affected by deficits.
For management, the document discusses five approaches: transfer of training, sensory integrative, neurodevelopmental, functional, and cognitive
The government plays several key roles in community-based rehabilitation (CBR) programs, including formulating policies, establishing administrative structures, mobilizing resources, promoting decentralization, providing training, building referral systems, and conducting monitoring and evaluation. Specifically, the government is responsible for setting up management structures to facilitate CBR; establishing committees to oversee programs; identifying and allocating funding, personnel, equipment and infrastructure; encouraging community participation through decentralization; training stakeholders; ensuring access to treatment, education, employment and legal services through referrals; and regularly assessing the progress and quality of all disability-related initiatives.
PROFESSIONAL ISSUES [INCLUDING ETHICS] IN PHYSIOTHERAPY SRSSreeraj S R
The document discusses the World Confederation for Physical Therapy (WCPT) and its role in establishing standards for the physical therapy profession worldwide. It outlines WCPT's objectives, executive committee, secretariat, subgroups, guidelines for practice, and ethical principles. It also discusses the need for a regulatory council in India to maintain standards and investigate complaints, and outlines the constitution and functions of the Indian Association of Physiotherapists, including its aims, objectives, membership types, and central executive council.
The document discusses several functional evaluation scales used in physical therapy assessments including the Functional Reach Test (FRT), Berg Balance Scale, Modified Ashworth Scale, Glasgow Coma Scale, and Timed Up and Go Test (TUG). It provides details on the objectives, methods, and scoring for each test.
CBR vs IBR-CBR subject. Download [15.00 KB]. Author Amisha Angle Posted on December 2, 2016. Leave a Reply Cancel reply.Community Based Rehabilitation: With CBR, the locus of control should be with the community.
Professional Practice and Ethics for PhysiotherapistsSreeraj S R
The document discusses professional practice and ethics for physiotherapists in India. It outlines key laws and regulations related to physiotherapy, including the Clinical Establishment Act, POSCO Act on child sexual abuse, rules on biomedical waste management, and laws on sexual harassment and consumer protection. The document also discusses ethical responsibilities of physiotherapists, principles of ethics in research and teaching, and important professional bodies like the World Physiotherapy organization.
COMMUNITY BASED REHABILITATION AND INSTITUTIONAL BASED REHABILITAIONNaveen K
This document compares and contrasts community-based rehabilitation (CBR) and institutional-based rehabilitation (IBR). CBR is defined as a strategy that enhances quality of life for disabled people through improved service delivery, equitable opportunities, and promotion of human rights. It is implemented through collaboration between organizations, communities, and disabled individuals. In contrast, IBR focuses on treatment within institutions and hospitals and can only reach a small population. Some key advantages of CBR include wide coverage, community empowerment, and sustainability, while disadvantages include lack of specialized training and unreliable community involvement.
The International Classification of Functioning, Disability and Health, provides a standard language and framework for classification of health and health-related domains
It throws light on certain points-
What changes in body function and structure have occurred in a person with a health condition?
What a person with a health condition can do in a standard environment -their level of function
What can be done to maximize function?
The document discusses functional capacity evaluations (FCEs), which objectively assess an individual's physical abilities and capacity to perform work. It describes the purpose of FCEs in determining work capacity and needed accommodations. The document outlines different types of FCEs and covers specific tests administered to evaluate areas like strength, mobility, balance and endurance. It notes limitations in the validity and reliability of most FCEs and areas that could be improved through further research.
This document discusses muscle energy technique (MET), a manual therapy procedure that involves voluntary muscle contraction against resistance applied by a therapist. It describes the types of muscle contractions involved - isotonic, eccentric, concentric, and isometric. MET uses post-isometric relaxation and reciprocal inhibition to facilitate muscle lengthening. Indications for MET include acute muscle spasm and restricted joints, while contraindications are acute injuries and unstable joints. Benefits of MET include restoring normal muscle tone, strengthening weak muscles, and improved joint mobility. Guidelines are provided for safely applying light contractions over multiple repetitions.
This document provides an overview of prosthetics and orthotics. It defines prosthetics as devices that replace missing body parts, while orthotics are devices that support or correct limb or torso function. Various materials are used for prosthetics and orthotics including metals, plastics, wood, leather, rubber and fabric. The document outlines the specifications and types of prosthetics and orthotics used for different parts of the body, such as the upper and lower limbs as well as the spine. It provides details on the components, suspension systems and various models of prosthetic knees, feet and orthotic devices.
Job simulations are employment tests that ask candidates to perform tasks that they would perform on the job. Applicants complete tasks that are similar to tasks they would complete when actually working in the position on a day to day basis
Understanding the various theories of motor control- reflex-hierarchal theory, ecological theory, dynamic systems theory and it's clinical application; also forming the basis of neurological rehabilitation techniques like Task-orient approach, Constraint induced movement therapy (CIMT), NDT (Neurodevelopmental Facilitation).
Physiotherapy management of perceptual disordersKeerthi Priya
This document discusses various perceptual disorders including their definitions, types, causes, tests used for assessment, and treatment approaches. It covers disorders related to body scheme and image like unilateral neglect. It also discusses agnosia, spatial relation disorders involving figure ground discrimination, form discrimination, and position in space. Other topics include topographic disorientation, depth and distance perception, and vertical disorientation. The document also summarizes visual, auditory and tactile agnosia as well as different types of apraxia such as ideomotor, ideational, and buccofacial apraxia. Remedial, compensatory, sensory integration and neurofunctional approaches are discussed as treatment options.
This document provides guidance on prescribing wheelchairs. It outlines the parts of a wheelchair, important considerations in evaluating patients, and goals of prescription. A proper evaluation involves medical history, physical exam, and functional assessment. Prescriptions are developed using tools like the SEAT checklist to address safety, comfort, and accommodation of needs over time. The goals of prescription include normalization of tone, improved function and mobility, and increased comfort and skin integrity.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
International classification of functioning, disability and health. sakshisadhu1
The International Classification of Functioning, Disability and Health (ICF) is a classification system developed by the World Health Organization to describe and organize information on functioning and disability. It provides a standardized language and framework for the description of health and health-related states. The ICF was approved by 191 WHO member states in 2001 and aims to serve as a scientific basis for understanding health and as a common language for communication between health professionals and policymakers. It classifies functioning and disability into four components: body functions and structures, activities and participation, and environmental and personal factors.
International Classification of Functioning, Disability, and Health (ICF) is a model approved by WHO in 2001 to like health with functioning and disability.
This power-point presentation contains all the relevant information regarding ICF and ICF model for third year physiotherapist students.
Hope it helps to whosoever refers these slides.
I hope this content helps you in understanding this condition. Thank You for sparing your precious time and going through this PowerPoint presentation.
International classification of functioning by athulAthul Soman
The document discusses the International Classification of Functioning (ICF) framework developed by the World Health Organization (WHO). It provides a standardized language for classifying and describing human functioning and disability. The ICF aims to establish a common language to improve communication about health and disability across countries, disciplines, services and time. It takes a holistic and interactive approach by considering body functions and structures, activities, participation and environmental factors. The ICF can be applied across various sectors like health, education, labor and policymaking.
ICF- International Classification of Functioning, Disability and HealthHozefa Mohammed Husain
The document provides an overview of the International Classification of Functioning, Disability and Health (ICF). It describes the ICF as a classification system developed by the World Health Organization to define and classify functioning and disability. The ICF aims to provide a standardized language for describing health and serves various purposes including research, clinical practice, and policymaking. The ICF considers both individual and environmental factors and classifies functioning at the levels of body, individual, and society.
Using ICF to understand problems faced in the bathrooms by elders with knee painAlakananda Banerjee
The document discusses a pilot study that used the International Classification of Functioning (ICF) framework to understand elderly problems in the bathroom due to lower leg pain. Only 15% of surveyed elderly homes had grab rails in the bathroom, indicating an environmental barrier. The ICF was useful for considering the dynamic interaction between health conditions, activities, and environmental factors on participation and identifying appropriate home modifications. More research is needed on applying the ICF to understand disability in the elderly and inform policies to ensure safe, accessible homes.
This document provides an overview of the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) and how it can be used to assess children with disabilities. The ICF-CY is a framework published by the World Health Organization to describe health and disability at both individual and population levels using common terminology. It considers body functions and structures, activities, participation, environmental factors, and personal factors. Several assessment tools are also described that can be used to evaluate children based on the ICF-CY framework and measure things like motor skills, balance, trunk control, quality of life, and cognitive development.
UNIT-VII model and methods of rehabilitation.pptxanjalatchi
Results: Six conceptual rehabilitation models were identified in the literature: the Biomedical Model, the Social Model, the Bio-Psycho-Social Model (BPS), the International Classification of Impairments, Disabilities, and Handicaps Model (ICIDH), the Community Based Rehabilitation Model (CBR), and the Health-Related ..
UNIT-VII model and methods of rehabilitation.pptxanjalatchi
Models assist understanding by allowing one to examine and think about something that is not the real thing, but that may be similar to the real thing. People use a variety of models to obtain a clearer understanding of a problem or the world around them. Such models include physical models, three-dimensional graphical models, animal models of biological systems, mathematical or ideal models, and computer models. When relationships are highly complex, however, as they are in rehabilitation processes and other areas of human endeavor, it is seldom possible to develop models that are quantitatively predictive. Nevertheless, it is often possible to establish rough relationships between various variables that are observabl
The document provides an overview of a 3-day workshop on applying the International Classification of Functioning, Disability and Health (ICF) framework for interprofessional care. The workshop aims to teach participants how to use the ICF to improve patient outcomes and health systems. On Day 1, participants are introduced to the ICF and complete a case study analysis. On Day 2, teams present case studies and provide peer feedback. On Day 3, teams conduct a hospital ward round using the ICF framework. Throughout the workshop, participants engage in structured reflections and develop a proposal arguing for the ICF to encourage patient-centered care.
The document discusses the concept of human occupation from an occupational therapy perspective. It defines occupation as any activities that occupy people's time and give meaning to their lives, including productive, self-care, and leisure activities. The document outlines how occupational therapists evaluate occupations and consider factors like independence, safety, and quality. It also describes different methods of evaluating occupations, such as questioning, observing, and testing clients to understand their abilities and needs.
This document discusses rehabilitation nursing and defines key related terms. It describes the World Health Organization's (WHO) model that progresses from disease to impairment, disability, and handicap. Impairment refers to abnormalities in body structure/function, disability is a restriction in activities, and handicap is a social disadvantage. Rehabilitation aims to help people reach their highest potential and includes restoring functions, preventing further issues, and assisting with abilities. It involves a multidisciplinary team and can be community- or institution-based. The nurse plays an important role in rehabilitation by providing care, education, and support.
ICF Environmental Factors: catalyst for person-centred healthcareJanice Miller
This powerpoint presentation outlines the development process and features of Environmental Factors in the World Health Organization 2001 ICF. This presentation was delivered as part of the 2017 ICF Symposium in Cape Town, South Africa 2017
REHABILITATION OR PHYSIOLOGICAL HANDICAPPEDKailash Nagar
The document discusses rehabilitation nursing and defines key terms according to the WHO such as impairment, disability, and handicap. It describes the rehabilitation process as helping people reach their fullest physical, psychological, social and educational potential given their limitations. Rehabilitation nursing aims to restore abilities, prevent further disability, protect existing abilities, and assist people to use their abilities. A rehabilitation team typically includes nurses, physiotherapists, psychologists, and other professionals who work together using medical, social and educational measures. Community-based rehabilitation and institution-based rehabilitation are two approaches discussed.
Functional Independence Measure (FIM)
Is an 18-item, 7-level ordinal scale
Is designed to assess areas of dysfunction in activities that commonly occur
The scale has few cognitive, behavioral, and communication-related functional items
Is not specific for spinal cord injuries but is designed to assess neurological, musculoskeletal, and other disorders.
Validated tools for assessment of medical disability
At the end of this lecture you will be able to:-
Describe the impact of disease/injury on an individual
List the requirements of an instrument to measure disability
Describe the features of the WHOIDAS 2.0 instrument and its role in medical disability assessment
Quality of life (QoL) and Wellbeing (WB) - differences and similaritiesStella I. Tsartsara
Well-being is about Quality of Life. In Health related evaluation both are Patient Reported Outcome (PRO) tools, measuring population health and relate therefore strongly with Behavioral Economics. Both are lowering Healthcare costs, raising productivity and therefore community competitiveness . They also relate to Active and Healthy Ageing (AHA) theory for elderly population, and Gerontology/Geriatric Assessment.
The document discusses definitions and concepts related to impairment, disability, and handicap from the International Classification of Impairments, Disabilities and Handicaps. It defines impairment as any loss or abnormality of body structure or function, disability as any restriction resulting from impairment in performing activities, and handicap as a disadvantage resulting from impairment or disability that limits fulfilling social roles. The document also discusses the World Health Organization's community-based approach to rehabilitation, which aims to enhance quality of life for people with disabilities through community participation and mobilizing local resources.
The document discusses definitions and concepts related to impairment, disability, and handicap from the WHO and ICIDH models. It defines impairment as an abnormality of structure or function, disability as a restriction resulting from impairment, and handicap as a social disadvantage faced due to impairment or disability. Community-based rehabilitation (CBR) is described as an approach that provides rehabilitation services within communities using their existing resources, with the goals of equalizing opportunities and socially integrating people with disabilities. The roles of the rehabilitation team, which includes nurses, physiotherapists, psychologists and others, are also summarized.
The document provides guidance on assessing impairment of the upper limb. It discusses the four regions of the upper limb - digits/hand, wrist, elbow, and shoulder. Assessment involves considering the diagnosis, complaints, clinical examination findings, and investigation results. Impairment is determined using diagnosis-based regional grids, with adjustments made using grade modifiers for functional history, physical examination, and clinical studies. The process involves determining the impairment class from the regional grid and then the grade using the adjustment grids before calculating the final impairment rating. Examples are provided to demonstrate this methodology.
Similar a ICF (International Classification of Functioning Disability and Health) (20)
Tibial nerve Nerve roots: L4-S3
Sensory: Innervates the skin of the posterolateral leg, lateral foot and the sole of the foot.
Motor: Innervates the posterior compartment of the leg and the majority of the intrinsic foot muscles.
Clinical Relevance
Injury to the tibial nerve can cause motor loss and altered sensation and pain to any of the areas it supplies, depending on site of involvement.
Popliteal Fossa region. Injury may occur due to:
Space occupying lesion
Laceration injury
Posterior dislocation of knee.
Fractures of the tibia and fibula
Local trauma to the posterior lower leg.
Medial malleolus level:
Compression of the tibial nerve in the osseofibrous tunnel below the flexor retinaculum of the ankle causes tarsal tunnel syndrome. On examination it presents as pain and paresthesia in the sole of the foot.
Tarsal Tunnel Syndrome
Tarsal tunnel syndrome (TTS) is a compressive neuropathy of the posterior tibial nerve.
The tunnel lies posterior to the medial malleolus of the ankle, beneath the flexor retinaculum.
Symptoms include pain radiating into the foot, usually, this pain is worsened by walking (or weight-bearing activities).
Etiology
Tarsal tunnel syndrome is divided into intrinsic and extrinsic etiologies.
Extrinsic causes include poorly fitting shoes, trauma, anatomic-biomechanical abnormalities (tarsal coalition, valgus or varus hindfoot), post-surgical scarring, systemic diseases, generalized lower extremity edema, diabetes, and post-surgical scarring.
Intrinsic causes include tendinopathy, tenosynovitis,osteophytes, hypertrophic retinaculum, and space-occupying or mass effect lesions (enlarged or varicose veins, ganglion cyst, lipoma, neoplasm, and neuroma).
Pathophysiology
Up to 43% of patients have a history of trauma including events such as ankle sprains. Abnormal biomechanics can contribute to disease progression. Risk factors include systemic diseases such as diabetes mellitus, hypothyroidism, gout, mucopolysaccharidosis, and hyperlipidemia
History and Physical
There is no specific test for the diagnosis of tarsal tunnel syndrome, and diagnosis is made with a detailed history and clinical examination.
Sharp shooting pain in the foot, numbness on the plantar surface, radiation of pain and paresthesias along the distribution of the posterior tibial nerve, pain with extremes of dorsiflexion and eversion, and a tingling or burning sensation.
The symptoms may worsen at night, with walking or standing, or after physical activity, and typically get better with rest.
On exam, the provider may observe pes planus, pronated foot, or talipes equinovarus.
In chronic cases, atrophy, weakness of the intrinsic foot muscles, and contractures of the toes may be appreciated. They are typically tender on deep palpation of the tarsal tunnel.
The gait should be analyzed for abnormalities including excessive pronation or supination, toe eversion, excessive foot inversion or eversion, and antalgic gait.
Light touch and two-point discrimination
More than 16 million patients throughout the world have been treated for leprosy in the last 20 years, with 211,973 new cases occurring in 2015, accounting for 2.9 new cases per 10,000 people.
These new cases indicate the transmission continuity of the disease, of which 94% were registered in only 13 countries (Bangladesh, Brazil, Democratic Republic of Congo, Ethiopia, India, Indonesia, Madagascar, Myanmar, Nepal, Nigeria, Philippines, Sri Lanka And the United Republic of Tanzania)
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes
The Ridley-Jopling system classifies leprosy as:
Tuberculoid leprosy
Lepromatous leprosy
Borderline tuberculoid leprosy
Borderline leprosy
Borderline lepromatous leprosy
WHO classification (1982) is more of a therapeutic classification based on number of skin lesions present:
Paucibacillary group (PB) exhibits 1–5 skin lesions.
Multibacillary type (MB) involves more than 6 skin lesions.
The Indian classification was modified and accepted by the Indian Association of Leprologists in 1981:
Tuberculoid
Borderline
Lepromatous
Indeterminate
Pure neuritic.
Signs and symptoms
The disease can cause skin symptoms such as:
Discolored patches of skin, usually flat, that may be numb and look faded (lighter than the skin around)
Growths (nodules) on the skin
Thick, stiff or dry skin
Painless ulcers on the soles of feet
Painless swelling or lumps on the face or earlobes
Loss of eyebrows or eyelashes
Numbness of affected areas of the skin
Muscle weakness or paralysis (especially in the hands and feet)
Enlarged nerves (especially those around the elbow and knee and in the sides of the neck)
Eye problems that may lead to blindness (when facial nerves are affected).
Symptoms caused by the disease in the mucous membranes are:
A stuffy nose
Nosebleeds
If left untreated, the signs of advanced leprosy can include:
Paralysis and crippling of hands and feet
Shortening of toes and fingers due to reabsorption
Chronic non-healing ulcers on the bottoms of the feet
Blindness
Loss of eyebrows
Nose disfigurement
Other complications that may sometimes occur are:
Painful or tender nerves
Redness and pain around the affected area
Burning sensation in the skin
Histopathologic examination of skin biopsies
confirm diagnosis of leprosy
classification of leprosy.
Bacteriological Examination
Skin smears:
Smears taken from the lesions ,from ear lobules and eyebrows and are stained using modified zeihl-neelsen method.
Reading of smears:
Bacteriological index- Indicates density of leprosy bacilli (live & dead) in the smears and ranges from 0 to 6+
Morphological index- It is the percentage of presumably living bacilli in relation to total number of bacilli in the smear
Lepromin test
Immunological test indicative of host resistance to lepra bacilli.
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Amplifier system
The electrodes convert bioelectric signal resulting from muscle or
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2. CONTENT
• Introduction
• Aims
• Application of ICF
• Principles of ICF
• Component of ICF
• ICF model
• Ethical guidelines for use of ICF
• Coding
• Qualifiers
• Case examples
3. INTRODUCTION
• The International Classification of Functioning, Disability and Health (
ICF) is a framework for describing and organising information on
functioning and disability .
• It provides a standard language and a conceptual basis for definition and
measurement of health and disability.
• ICF was approved for use by the World Health Assembly in 2001, after
extensive testing across the world involving people with disabilities and
people from a range of relevant disciplines.
4. • The domains contained in ICF can, therefore be seen as health domains
and health related domains.
• These domains are described from the perspective of the body, the
individual and society in two basic lists:
1. Body function and structures.
2. Activities and participation.
• As a classification, ICF systematically groups different domains for a
person in given health condition (what a person with a disease or
disorder does do or can do)
5. • Functioning is an umbrella term encompassing all body functions,
activities and participation.
• Disability serves as an umbrella term for impairments, activity limitations
or participation restriction.
• ICF also lists environmental factors that interact with all these constructs.
In this way, it enables the user to record useful profiles or individual
functioning, disability and health in various domains.
6. AIMS OF ICF
• ICF is a multipurpose classification designed to serve various disciplines
and different sectors. Example: education, transportation as well as in
health and community services and across different countries and
cultures. Its specific aims can be summarised as follows:
To provide a scientific basis for understanding and studying health and
health related states, outcomes, determinants and changes in health
status and functioning.
7. To establish a common language for describing health and health related
states in order to improve communication between different users, such
as health care workers, researchers, including people with disabilities.
To permit comparison of data across countries, health care disciplines,
services and time.
To provide a systematic coding scheme for health information systems.
These aims are interrelated, since the need for and the uses of ICF require
the construction of a meaningful and a practical system that can be used
by various consumers for health policy, quality assurance and outcome
evaluation in different culture.
8. APPLICATIONS OF ICF
• As a research tool – to measure outcomes, quality of life or
environmental factors.
• As a clinical tool – in needs assessment, matching treatments with
specific conditions, vocational assessment, rehabilitation and outcome
evaluation
9. PRINCIPLES OF ICF
• UNIVERSALITY: A classification of functioning and disability should be
applicable to all people irrespective of health condition and in all physical,
social and cultural contexts. The ICF achieves this and acknowledges
that anyone can experience some disability. It concerns everyone’s
functioning and disability and was not designed nor should be used, to
label persons with disabilities as a separate social group.
10. • PARITY AND AETOLOGICAL NEUTRALITY:
In classifying functioning and disability there is not an explicit or implicit
distinction between different health conditions, whether ‘mental’ or
‘physical’.
It places all health conditions on an equal footing, allowing them to be
compared using common metric.
• NEUTRALITY:
Domain definitions are worded in neutral language, wherever possible, so
that the classification can be used to record both the positive and negative
aspects of functioning and disability.
11. • Environmental Influence:
• In recognition of the important role of environment in people’s
functioning.
Factors range from physical factors such as climate, terrain or building
design
12. COMPONENTS OF ICF
• Body Function: physiological function of body system.
• Body Structures: anatomical parts of body.
• Impairments: problem in body function and structure such as significant
deviation or loss.
• Activity: execution of a task or action by an individual.
• Participation: involvement in a life situation.
13. • Activity limitations: difficulties an individual may have in executing
activities.
• Participation restriction: problems an individual may experience in
involvement in life situations.
14.
15.
16.
17. MODEL OF FUNCTIONING AND
DISABILITY
• The ICF conceptualises a person’s level of functioning as a dynamic
interaction between her or his health conditions, environmental factors
and personal factors.
• There is a dynamic interaction among these entities that is intervention in
one entity have the potential to modify the other entities.
18.
19. ETHICAL GUIDELINES FOR THE
USE OF ICF
• Respect and confidentiality:
1. ICF should always be used so as to respect the inherent value and
autonomy of individual persons.
2. ICF should never be used to label people or otherwise identify them
solely in terms of one or more disability categories.
3. In clinical settings, ICF should always be used with the full knowledge,
cooperation, and consent of the persons whose levels of functioning are
being classified.
20. • Clinical use of ICF:
1. The clinician should explain to the individual or the individual's advocate
the purpose of the use of ICF and invite questions about the
appropriateness of using it to classify the person’s levels of functioning.
2. The person whose level of functioning is being classified (or the
person's advocate) should have the opportunity to participate.
21. CODING
• ICF components are denoted by prefixes in each code.
• b for Body Functions and
• s for Body Structures
• d for Activities and Participation
• e for Environmental Factors
22. • The letters b, s, d and e are followed by a numeric code that starts with
the chapter number (one digit), followed by the second level (two digits),
and the third and fourth level21 (one digit each). For example, in the
Body Functions classification there are these codes:
• b2 Sensory functions and pain
• b210 Seeing functions
• b2102 Quality of vision
• b21022 Contrast sensitivity
23. QUALIFIERS
• The ICF codes require the use of one or more qualifiers, which denote,
for example, the magnitude of the level of health or severity of the
problem at issue. Qualifiers are coded as one, two or more numbers after
a point. Use of any code should be accompanied by at least one qualifier.
Without qualifiers codes have no inherent meaning (by default, WHO
interprets incomplete codes as signifying the absence of a problem --
xxx.00).
24. BODY FUNCTIONS
• Qualifier Generic qualifier with the negative scale, used to indicate the extent or
magnitude of an impairment:
• .0 NO impairment (none, absent, negligible,… )
• .1 MILD impairment (slight, low,…)
• .2 MODERATE impairment (medium, fair,...)
• .3 SEVERE impairment (high, extreme, …)
• .4 COMPLETE impairment (total,…)
• .8 not specified
• .9 not applicable
25. • EXAMPLE: The impairment of a person with hemiparesis can be
described with code b7302 it can be scaled:
b7302.1 MILD impairment of power of muscles of one side of body
b7302.2 MODERATE impairment of power of muscles of one side of body
b7302.3 SEVERE impairment of power of muscles of one side of body
b7302.4 COMPLETE impairment of power of muscles of one side of body
b7302.0 NO impairment in power of muscles of one side of body
26. BODY STRUCTURES
• Body structures are coded with three qualifiers. The first qualifier
describes the extent or magnitude of the impairment, the second qualifier
is used to indicate the nature of the change, and the third qualifier
denotes the location of the impairment
27. FIRST QUALIFIER (EXTENT OF
IMPAIRMENT)
• .0 NO impairment
• .1 MILD impairment
• .2 MODERATE impairment
• .3 SEVERE impairment
• .4 COMPLETE impairment
• .8 not specified
• .9 not applicable
28. SECOND QUALIFIER (NATURE OF
IMPAIRMENT)
• .0 no change in structure
• .1 total absence
• .2 partial absence
• .3 additional part
• .4 aberrant dimensions
• .5 discontinuity
• .6 deviating position
• .7 qualitative changes in structure,
including accumulation of fluid
• .8 not specified
• .9 not applicable
29. THIRD QUALIFIER (SUGGESTED)
LOCATION OF IMPAIRMENT
• .0 more than one region
• .1 right
• .2 left
• .3 both sides
• .4 front
• .5 back
• .6 proximal
• .7 distal
• .8 not specified
• .9 not applicable
30. • Example: patient having periarthritis shoulder
S = Body Structure
730 = structure of upper extremity
Extent of impairment (first qualifier)
Nature of impairment (second qualifier)
Location of impairment (third qualifier)
Example: s730.1 = Mild impairment in structure of upper extremity
s730.10 = Mild impairment along with no change in structure
s730.101= Mild impairment on right side along with no change in
strucuture
31. ACTIVITIES AND PARTICIPATION
• The two qualifiers for the Activities and Participation component are the
performance qualifier and the capacity qualifier.
• The performance qualifier describes what an individual does in his or her
current environment. This context includes the environmental factors – all
aspects of the physical, social and attitudinal world, which can be coded
using the Environmental Factors component.
32. • The capacity qualifier describes an individual’s ability to execute a task or
an action.
• This qualifier identifies the highest probable level of functioning that a
person may reach in a given domain at a given moment. Capacity is
measured in a uniform or standard environment, and thus reflects the
environmentally adjusted ability of the individual. The Environmental
Factors component can be used to describe the features of this uniform
or standard environment.
33. ENVIRONMENTAL FACTORS
• The first qualifier indicates the extent to which a factor is a facilitator or a
barrier.
• For facilitators, the coder should keep in mind issues such as the
accessibility of a resource, and whether access is dependable or
variable, of good or poor quality, and so on.
• In the case of barriers, it might be relevant how often a factor hinders the
person, whether the hindrance is great or small, or avoidable or not.
34. • First qualifier
• The following is the negative and positive scale for the extent to which an
environmental factor acts as a barrier or a facilitator. A point or separator alone
denotes a barrier, and the + sign denotes a facilitator, as indicated below:
• .0 NO barrier +0 NO facilitator
• .1 MILD barrier +1 MILD facilitator
• .2 MODERATE barrier +2 MODERATE facilitator
• .3 SEVERE barrier +3 SUBSTANTIAL facilitator
• .4 COMPLETE barrier +4 COMPLETE facilitator
• .8 Barrier, not specified +8 Facilitator, not specified
• .9 Not applicable +9 Not applicable
35. APPLICATION OF ICF IN
PHYSIOTHERAPY
For example: The patient is 67 year old woman with major complain of 6
months history of pains and stiffness of both knees.
• She reported insidious onset of symptoms that had become worsened
and constant for about 3 months. Pain intensity was measured using
visual analogue scale, and at onset was rated 5/10 on the right knee and
6/10 on the left knee. When pain intensity is at worst, patient rated it to be
7/10 on the right and 9/10 on the left knee
36. • Lifting, bending forward, prolong sitting for more than 20 minutes
aggravates the pain .
• Symptoms as varying from day to day, but typically worse at the start of
the day with associated stiffness and disturbed sleep