model of disability and its types .pdf

Models of disability are tools for defining impairment and ultimately, for providing a basis upon which government and society can devise strategies for meeting the needs of disabled people.

1. Models of Disability
Assist. Lect. Ra’aed Al-Obaidi
College of Health and Medical Technology -Baghdad
Physiotherapy Department Techniques

2. Modelsofdisabilityaretoolsfordefiningimpairmentand
ultimately,forprovidingabasisuponwhichgovernmentand
societycandevisestrategiesformeetingtheneedsofdisabled
people.
Modelsofdisabilityareessentiallydevisedbypeople(normal
people)aboutother(disabled)people.
ThefirsttwoschemadevelopedweretheNagimodelandthe
InternationalClassificationofImpairments,Disabilities,and
Handicaps(ICIDH)model,fortheWorldHealthOrganization
(WHO).
Models of Disablement

3. 1.The International Classification of Impairment, Disability
and Handicaps(ICIDH Model )
2.Ngai's Model
3.International Classification of Functioning, Disability, and
Health (ICF)
Types of Models of Disability
TheInternationalClassificationofImpairment,DisabilityandHandicaps,
knownasICIDH,waspublishedbytheWorldHealthOrganizationin
1980.
The International Classification of Impairment, Disability
and Handicaps (ICIDH Model)

4. Itwasintendedasaclassificationmanualrelatedtothe
consequencesofdisease,injuries,andotherdisordersanda
frameworkforhealth-relatedinformation.
According to the ICIDH manual, "impairmentis any loss or
abnormality of a psychological, physiological, or anatomical
structure or function".
Classification ofimpairments(I code) reflected:
Abnormalities of body structure and appearance (temporary or
permanent)
Disturbances at the level of the organ or system function
resulting from any cause

5. intellectual,
other psychological,
language,
aural,
ocular,
visceral,
skeletal,
disfiguring,
general,
Sensory and other.
The following categories of impairments were
listed in the manual:
Adisabilitywasconsidered"anyrestrictionorlack
(resultingfromanimpairment)ofabilitytoperforman
activityinthemannerorwithintherangeconsidered
normalforahumanbeing".

6. An individual's functional performance and activity
Disturbances at the level of the person
Classification of disabilities (D code) reflected:
•behaviour,
•communication,
•personal care,
•locomotor,
•body disposition,
•dexterity,
•situational,
•particular skill, and other
activity restrictions.
The following categories of disability were included:

7. orientation,
physical independence,
mobility,
occupation,
social integration,
and economic self-sufficiency.
Handicaps (H code)were defined as "the disadvantages experienced by
the individual due to impairments and disabilities".
These limit or prevent "the fulfilment of a role that is normal (depending
on age, sex, and social and cultural factors) for that individual" .
The following categories of Handicaps were included

8. aconceptualframeworkbyRomanNagithatdescribesthe
disablementprocessasaprogressionfromactivepathology(a
cellularinterruption),toimpairment(alossorabnormalityat
theorganorbodysystemlevel),tofunctionallimitation
(difficultyperformingphysicalactions),andfinallyto
disability(difficultymeetingsocietalroles).
Thistermcanbeusedtocategorizeclinicalobservations
systematically.
NAGI’S MODELS OF DISABILITY
Linear progression:Pathology → Impairment → Functional
Limitation → Disability.

9. Diseaseis"apathologicalconditionofthebodyorabnormalentitywitha
characteristicgroupofsignsandsymptomsthataffectthebody".
Aetiologycanbeknownorunknown.Signsaredirectobservableor
measurableevidenceofphysicalabnormalitywhilesymptomsarethe
moresubjectivereactionstothephysicalabnormality.
Disease
Impairments(direct)aretheresultofpathologyordiseasestatesandincludeanylossor
abnormalityofphysiologic,anatomic,orpsychologicstructureorfunction.Forapatient
withstroke,examplesofimpairmentsthatarethedirectresultofpathologymight
includesensoryloss,paresisandhemianopia.
Impairmentsmayormaynotbepermanent.
Secondaryimpairments(indirect)arethesequelaeorcomplication(eg.Decubitusulcer,
DVT,UTI,Pneumonia,Depression)
Impairments

10. “Therestrictionoftheabilitytoperformatthelevelofthewholeperson,a
physicalaction,taskoractivityinanefficient,typicallyexpectedor
competentmanner.BADLBasicADL–Dressing,feeding,bathingIADL
InstrumentalADL–Housecleaning,preparingmeals,shopping,
managingfinance,etc
Functional Limitation
Thetermdisabilityreferstosocietalratherthanindividualfunctioning,itis
definedasaninabilitytoperformoralimitationintheperformanceof
actions,tasksandactivitiesusuallyexpectedinspecificsocialrolesthatare
customaryfortheindividualorexpectedfortheperson’sstatusorroleina
specificsocioculturalcontextandphysicalenvironment.
Categoriesofrequiredrolesincludedareself-care,homemanagement,
workandcommunity/leisure.
Disability

11. Throughacomprehensiveconsensusprocessoveranumberofyears,the
WHOdevelopedtheInternationalClassificationofFunctioning,
Disability,andHealth(ICF).
Thisnewconceptualmodelintegratesfunctioninganddisabilityandis
characterizedasabio-psycho-socialmodelofdisablementthatprovides
acoherentperspectiveofvariousaspectsofhealth.
The International Classification of Functioning,
Disability, and Health (ICF)
Therevisedmodelwasalsodesignedtoplacelessemphasisondisease
andgreateremphasisonhowpeopleaffectedbyhealthconditionslive.

12. The ICF model consists of the following components of
health and health-related influences.
Impairmentofbodystructure(anatomical)andfunction(physiological)
Problemsinbodyfunctionandstructuresuchassignificantdeviationor
loss
ActivitylimitationDifficultiesanindividualmayhaveinexecuting
activities
ParticipationrestrictionProblemsanindividualmayexperiencein
involvementinlifesituationsCarryingoutdailyroutine(e.g.Transferring
oneself,Driving,Toileting,CommunitylifeRecreation)andleisure
Impactofcontextualfactors (environmentalandpersonal)on
functioning,disability,andhealth

13. Environmentalfactors
Thephysical,socialandattitudinalenvironmentinwhichpeople
liveandconducttheirlives.Theseareeitherbarrierstoor
facilitatorsoftheperson'sfunctioning.(e.g.Productsand
technologyforpersonaluseindailyliving,Design,construction,
andbuildingproductsandtechnologyofbuildingsforprivateuse,
Physicalgeography,Healthprofessionals)
Personalfactors
PersonalFactorsshouldalsobeconsideredinthismodelbutare
notclassifiedwithintheactualICFframework

15. 1.TherapeuticExercise:FoundationsandTechniques(Therapeutic
Exercise:Foundations&Techniques)Hardcover–2Apr
2007.byCarolynKisner(Author), LynnAllenColby(Author).
2.Therapeutic Exercise: Foundations and TechniquesBy Carolyn
Kisner, 6th edition, 17 Oct 2012
3.Exercise and Physical Functioning in Osteoarthritis Medical,
Neuromuscular and Behavioral Perspectives, Editor
JoostDekker
4.EXERCISE THERAPY Prevention and treatment of disease, Edited
by John Gormleyand Juliette Hussey,2005
References