FOR PHYSICAL THERAPY STUDENTS

1. PROCESS AND MODELS
OF DISABLEMENT
Dr. QURATULAIN MUGHAL
DPT (2019)
ISRA UNIVERSITY
DR. QURATULAIN MUGHAL 1

2. CONTENTS
1. Disablement Definition
2. The Disablement Process
3. Models Of Disablement
4. Comparison Of Terminology Of Three Disablement Models
5. Use Of Disablement Models And Classifications In Physical Therapy
6. Impact Of Therapeutic Exercise On The Disablement Process
7. Common Physical Impairments Managed With Therapeutic Exercise
8. Common Functional Limitations Related To Physical Tasks
9. General Categories Of Activities Relevant To Disability
10. Disablement Risk Factors DR. QURATULAIN MUGHAL 2

3. 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.”
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4. 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.
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5. 3. MODELS OF DISABLEMENT
1. NAGI MODEL
2. THE INTERNATIONAL CLASSIFICATION OF
IMPAIRMENTS, DISABILITIES, AND HANDICAPS
(ICIDH) MODEL
3. THE NATIONAL CENTER FOR MEDICAL
REHABILITATION RESEARCH (NCMRR) MODEL
4. INTERNATIONAL CLASSIFICATION OF FUNCTIONING,
DISABILITY, AND HEALTH (ICF) MODEL
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6. NAGI MODEL
Tissue/Cellul
ar Level
Active pathology
Organ/Syste
m Level
Impairment
Personal
Level
Functional
limitation
Societal Level Disability
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7. THE INTERNATIONAL CLASSIFICATION
OF IMPAIRMENTS, DISABILITIES, AND
HANDICAPS (ICIDH) MODEL
Tissue/Cellular Level Disease
Organ/System Level Impairment
Personal Level Disability
Societal Level Handicap
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8. INTERNATIONAL CLASSIFICATION OF
FUNCTIONING, DISABILITY, AND
HEALTH (ICF) MODEL
Tissue/Cellular Level - - - - - - - - -
Organ/System Level Impairment of body
structure/function
Personal Level Activity limitation
Societal Level Participation
restriction DR. QURATULAIN MUGHAL 8

9. 4. COMPARISON OF TERMINOLOGY
OF THREE DISABLEMENT MODELS
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10. 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
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11. 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.
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12. 6. IMPACT OF THERAPEUTIC EXERCISE ON
THE DISABLEMENT PROCESS
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13. 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.
Risk Factors: related to disablement are influences or characteristics that predispose
a person to the process of disablement.
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14. 7. COMMON PHYSICAL IMPAIRMENTS
MANAGED WITH THERAPEUTIC EXERCISE
Musculoskeletal Neuromuscular
DR. QURATULAIN MUGHAL 14
Pain
Muscle weakness/reduced torque
production
Decreased muscular endurance
Limited range of motion due to
•Restriction of the joint capsule
• Restriction of periarticular
connective tissue
• Decreased muscle length
Joint hypermobility
Faulty posture
Muscle length/strength imbalances
Pain
Impaired balance, postural stability, or
control
Incoordination, faulty timing
Delayed motor development
Abnormal tone (hypotonia, hypertonia,
dystonia)
Ineffective/inefficient functional
movement strategies

15. Cardiovascular/Pulmonary Integumentary
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Decreased aerobic capacity
(cardiopulmonary
endurance)
Impaired circulation
(lymphatic, venous,
arterial)
Pain with sustained
physical activity
(intermittent claudication)
Skin hypomobility (e.g.,
immobile or adherent
scarring)

16. 8. COMMON FUNCTIONAL LIMITATIONS
RELATED TO PHYSICAL TASKS
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17. 9. GENERAL CATEGORIES OF
ACTIVITIES RELEVANT TO
DISABILITY
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18. 10. DISABLEMENT RISK FACTORS
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19. DR. QURATULAIN MUGHAL 19

20. ASSIGNMENT
ACUTE OR CHRONIC CONDITIONS
SIGNS AND SYMPTOMS
PERIARTICULAR CONNECTIVE TISSUE
ADL
IADL
TYPES OF PREVENTION
DELAYED MOTOR DEVELOPMENT
HYPOTONIA
HYPERTONIA
DYSTONIA
AEROBIC CAPACITY
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21. REFERENCE
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